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Community Dent Oral Epidemiol. 2015 Apr;43(2):172-82. doi: 10.1111/cdoe.12139. Epub 2014 Nov 21.

Social support and social network as intermediary social determinants of dental caries in adolescents.

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Family Health Strategy, Municipal Health Secretariat of Dourados, Dourados, Brazil.



The aim of this study was to investigate the association between intermediary social determinants, namely social support and social network with dental caries in adolescents.


An adapted version of the WHO social determinants of health conceptual framework was used to organize structural and intermediary social determinants of dental caries into six blocks including perceived social support and number of social networks. A cross-sectional study was conducted with a representative sample of 542 students between 12 and 14 years of age in public schools located in the city of Dourados, Brazil in 2012. The outcome variables were caries experience (DMFT ≥ 1) and current dental caries (component D of DMFT ≥ 1) recorded by a calibrated dentist. Individual interviews were performed to collect data on perceived social support and numbers of social networks from family and friends and covariates. Multivariate Poisson regressions using hierarchical models were conducted.


The prevalence of adolescents with caries experience and current dental caries was 55.2% and 32.1%, respectively. Adolescents with low numbers of social networks and low levels of social support from family (PR 1.47; 95% CI = 1.01-2.14) were more likely to have DMFT ≥ 1. Current dental caries was associated with low numbers of social networks and low levels of social support from family (PR 2.26; 95% CI = 1.15-4.44).


Social support and social network were influential psychosocial factors to dental caries in adolescents. This finding requires confirmation in other countries but potentially has implications for programmes to promote oral health.


dental caries; social support, social network, social determinants of health, psychosocial factors

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