Determinants of tooth loss among adolescents (15-19 years) from Minas Gerais, Brazil: a multilevel analysis

In this cross-sectional study, carried out in 2012, we assessed factors associated with tooth loss among adolescents from Minas Gerais, Brazil, utilizing data from a secondary database. Individual and local-level variables were selected to represent health determinants. Individual covariates included sex, age, skin color, maternal education, household income, use of dental services, and self-perceived need for dental care. The contextual variables included illiteracy, unemployment, income, primary health care coverage, dental specialty centers, and oral health team coverage. Multilevel logistic regression models were used to examine the relationship between contextual and individual variables and the outcome (STATA version 16.0) - odds ratio (OR) and 95% confidence interval (CI). The prevalence of tooth loss was 12.4%. Female individuals were 40% more likely to experience the outcome (OR: 1.40; 95%CI: 1.01-1.98). Increased age was associated with greater tooth loss (OR: 1.16; 95%CI: 1.03-1.31). Low maternal education (OR: 1.72; 95%CI: 1.13-2.61), low household income (OR: 1.71; 95% CI 1.09-2.67), and self-perceived dental needs (OR: 2.94; 95% CI 1.97-4.39) were also associated with the outcome. Regular dental visits reduced the likelihood of tooth loss by 38% (OR: 0.62; 95 CI 0.44-0.87). Larger tooth loss was observed in municipalities with higher illiteracy rates (OR: 1.04; 95%CI: 1.01-1.08). Municipalities with larger dental specialty centers were associated with the outcome (OR: 0.58; 95%CI: 0.37-0.92). Contextual and individual factors influenced tooth loss in adolescents from Minas Gerais, Brazil, but socioeconomic status was the main determinant.