The relationship between neighborhood empowerment and dental caries experience: a multilevel study in adolescents and adults.

OBJECTIVE To investigate the relationship of contextual social capital (neighborhood empowerment) and individual social capital (social support and social network) with dental caries experience in adolescents and adults. METHODS A population-based multilevel study was conducted involving 573 subjects, 15-19 and 35-44 years of age, from 30 census tracts in three cities of Paraíba, Brazil. A two-stage cluster sampling was used considering census tracts and households as sampling units. Caries experience was assessed using the DMFT index (decayed, missing and filled teeth) and participants were divided into two groups according to the median of the DMFT index in low and high caries experience. Demographic, socioeconomic, behaviors, use of dental services and social capital measures were collected through interviews. Neighborhood empowerment was obtained from the mean scores of the residents in each census tract. Multilevel multivariate logistic regression was used to test the relationship between neighborhood empowerment and caries experience. RESULTS High caries experience was inversely associated with neighborhood empowerment (OR = 0.58; 95%CI 0.33-0.99). Individual social capital was not associated with caries experience. Other associated factors with caries experience were age (OR = 1.15; 95%CI 1.12-1.18) and being a female (OR = 1.72; 95%CI 1.08-2.73). CONCLUSION The association between neighborhood empowerment and caries experience suggests that the perception of features of the place of residence should be taken into account in actions of oral health promotion.