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Community Dent Oral Epidemiol. 2007 Oct;35(5):331-6.

Social inequality in tooth extraction in a Brazilian insured working population.

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Department of Epidemiology, Institute of Social Medicine, University of State of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil.



Given the scant evidence of the socioeconomic gradient in tooth loss incidence, the purpose of this study was to compare the odds of individuals of distinct social strata being subjected to tooth extraction.


We undertook a case-control study at the head office of a large Brazilian company whose employees had access to dental care through the company's dental insurance.


During 2 years of observation, 264 teeth were extracted and the distribution of such extractions was rather unequal. A strong suggestion of a social gradient was noted and the odds of tooth extraction occurring per social strata, adjusted by age and gender, were five times higher in employees pertaining to the lowest social stratum, when compared with those at the highest.


We concluded that lower social strata were strongly associated with increased risk of having teeth extracted. Dental insurance was not able to equalize the chances of tooth extraction among different social strata, in a population of employed adults.

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