Association between socioeconomic contextual factor, dental care service availability, and prevalence of periodontitis in Brazil: a multilevel analysis

This study aimed to examine the effect of dental care services on periodonti-tis cases in Brazilian municipalities. The sample comprised 3,426 individuals aged 35-44 years. Moderate to severe periodontitis with clinical attachment loss and probing depth was the dependent variable, both > 3mm. Its explor-atory variables were grouped into four categories: (1) individual characteris-tics; (2) contextual development indicators; (3) health service and structural factors; and (4) dental care use. Data were collected using the SBBrasil 2010 Project, the Brazilian Institute of Geography and Statistics, the Brazilian In-formation System of Primary and Secondary Care, and the Program to Im-prove Access and Quality of Dental Specialization Centers (PMAQ-CEO). Multilevel logistic regression was used to assess associations of periodontitis with individual and context variables. Municipalities with > 1 CEO or > 1 of any centers were associated with periodontitis, with OR = 0.97 (95%CI: 0.55-1.71) and OR = 0.41 (95%CI: 0.17-0.97), respectively. Prevalence of periodon-titis was more likely in older people, lower education levels, and individuals that sought dental visits for pain/extraction and periodontal treatment. Other dental care services availability were not associated with the prevalence of periodontitis.