Neighborhood factors and use of dental services among young adults in Southern Brazil: a 5-year cohort study.

This prospective cohort study assessed the influence of contextual variables of the residential neighborhood on the pattern of preventive use of dental services among young adults from southern Brazil. The study was linked to a population-based cross-sectional survey carried out in 2018 that evaluated the oral health conditions of adolescents aged 15-19 years from Santa Maria, southern Brazil (n = 1,197). After a mean (± SD) period of 5 (± 0.5) years, 570 individuals were reassessed (response rate: 47.6%). Questionnaires collected sociodemographic characteristics, dental service use (including the reason for the last visit), and participants' addresses. The outcome was the last dental visit for prevention, defined as positive responses at both baseline and follow-up. The main predictor variables were contextual neighborhood variables (mean income, percentage of literate inhabitants, percentage of residences with tap water, paved streets, sewerage system, and public lighting). Unadjusted and adjusted multilevel Poisson regression models were used to estimate relative risk (RR) and 95% confidence intervals (CI). Approximately one-quarter of participants reported that their last dental visit was for prevention (n = 151, 26.5%). After controlling for individual-level variables, participants living in neighborhoods with above-median income (RR=1.27; 95%CI: 1.04-1.55; p = 0.02), higher literacy levels (RR = 1.31; 95%CI:1.02-1.68; p = 0.03), greater proportion of paved streets (RR =1.28; 95%CI: 1.01-1.63; p = 0.04), or greater sewerage coverage (RR = 1.40; 95%CI: 1.05-1.85; p = 0.02) were more likely to report their last dental visit for prevention. In conclusion, this cohort study demonstrated that neighborhood-level variables influenced the pattern of preventive dental visits among young adults in southern Brazil.