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Title:	Human ecological and social determinants of dental caries among the Xavante Indigenous people in Central Brazil
Authors:	Arantes, Rui Welch, James R. Tavares, Felipe Guimarães Ferreira, Aline Alves Vettore, Mario Vianna Coimbra Junior, Carlos Everaldo Alvares
Affilliation:	Fundação Oswaldo Cruz. Fiocruz Mato Grosso do Sul. Campo Grande, MS, Brasil. Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil. Universidade Federal Fluminense. Escola de Enfermagem. Niterói, RJ, Brasil. Universidade Federal do Rio de Janeiro. Centro de Ciências da Saúde. Instituto de Nutrição Josué de Castro. Rio de Janeiro, RJ, Brasil. The University of Sheffield. School of Clinical Dentistry. Sheffield, United Kingdom. Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.
Abstract:	This community study evaluates complex interactions between macro and micro determinants of oral health in a local Indigenous population based on a theoretical framework of demographic, economic, and healthcare transformation over the last half century. The study population included all residents of eight Xavante villages in Central Brazil. Our hypothetical model posited multiple direct and indirect associations between dental caries and village groups with differentiated territorial and oral care histories, as well as household socioeconomic indicators and food acquisition patterns, individual sociodemographic characteristics, use of dental health services, and oral hygiene practices. Structural equation modelling methods were used to evaluate direct and indirect associations linking exogenous factors and dental caries. Results include 18 direct and 14 indirect statistically significant pathways between determinant variables and dental caries. Significant links with dental caries were shown for socioeconomic indicators, oral healthcare variables, household food acquisition patterns, sex, and age. These findings suggest that the oral health of Xavante residents in the villages studied is associated with determinant factors of different epidemiological and historical scales. The specific historical frame of territorial circumscription and demographic crisis followed by rapid population increase since the 1970s should be considered a cause-of-cause determinant of the economic, healthcare, and sociodemographic profile contributing to oral health among the Xavante. Considering the limitations of cross-sectional studies, our findings underline the importance for oral health determination of historical currents affecting minority ethnic groups within national societies.
Keywords:	Oral health Caries Food Socioeconomic aspects of health Brazil Diet Indigenous populations Teeth
Keywords:	Região Centro-Oeste Xavante Economia Saudável Fluorides
DeCS:	Brasil Índios Sul-Americanos Saúde de Populações Indígenas Saúde Bucal Cárie Dentária Fluoretos
Issue Date:	2018
Publisher:	Public Library of Science
Citation:	ARANTES, Rui et al. Human ecological and social determinants of dental caries among the Xavante Indigenous people in Central Brazil. PLoS ONE, v. 13, n. 12, p. 1-20, 19 Dec. 2018.
metadata.dc.identifier.doi:	10.1371/journal.pone.0208312
ISSN:	1932-6203
Copyright:	open access
Appears in Collections:	AS - Artigos de Periódicos

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