Dental caries, periodontal disease and restorative dental care among Indigenous and non-Indigenous groups in Brazil: A descriptive study

Objective: To compare patterns of dental caries, periodontal disease and dental care among Indigenous and non-Indigenous Central-West Brazilian subpopulations.

Methods: Data were from two population-based cross-sectional studies involving 5-, 12-, 15-19- and 35-44-year-olds. The first examined were the Guarani, Kaiowá, Terena and Kadiwéu Indigenous groups from Mato Grosso do Sul Brazilian state and the second comprised a non-Indigenous population. Mean numbers of sound teeth, decayed, missing and filled teeth (dmft/DMFT), prevalence of poor oral hygiene for adults (35-44 years) and of periodontal disease were estimated. Restorative dental service utilization was measured using the Care Index.

Results: The study populations comprised of 1830 Indigenous and 29 395 non-Indigenous people. The Kaiwoá ethnic group had the lowest DMFT among Indigenous groups for ages 12, 15-19 years; 0.9 (95% CI 0.7-1.1) and 2.4 (95% CI 1.9-2.9), respectively. The highest values were observed among the 12-year-old Terena ethnic group and 15- to 19-year-old Kadiwéo groups; 2.2 (95% CI 1.8-2.5) and 3.7 (95% CI 3.1-4.4), respectively. The mean DMFT values were significantly lower among Indigenous than non-Indigenous people for all age groups. The prevalence of bleeding and calculus was 70.3% (95% CI 64.5%-75.5%) and 80.1% (95% CI 74.8%-84.5%), respectively, for Indigenous people and 43.9% (95% CI 34.4%-50.7%) and 61.5% (95% CI 55.4%-67.2%), respectively, for the non-Indigenous population. Restorative services were higher among 5-year-old non-Indigenous children and adults than for Indigenous groups. Among Indigenous groups, the Terena had the highest level of restored teeth (38.0% at 12 years) and Kadiwéu the lowest level (8.8% at 12 years).

Conclusion: In our study, Indigenous people had a lower caries burden, but less access to restorative services than their non-Indigenous counterparts. These disparities likely reflect differences in historical, socioeconomic, cultural, environmental and political determinants that both groups have experienced differently over time.

Keywords: Brazil; caries; dental care; indigenous; oral health.