Social support and social network as intermediary social determinants of dental caries in adolescents Fontanini H, Marshman Z, Vettore M. Social support and social network as intermediary social determinants of dental caries in adolescents. Community Dent Oral Epidemiol 2014. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. Abstract – Objective: 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. Methods: 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. Results: 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). Conclusion: 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. Humberto Fontanini 1 , Zoe Marshman 2 and Mario Vettore 2 1 Family Health Strategy, Municipal Health Secretariat of Dourados Dourados, Brazil, 2 Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield Sheffield, UK Key words: dental caries; social support, social network, social determinants of health, psychosocial factors Mario V. Vettore, Unit of Dental Public Health, School of Clinical Dentistry, University of Sheffield, Claremont Crescent, Sheffield, S10 2TA, UK Tel.: +44-0114-2265325 Fax: +44-0114-2717843 e-mail: m.vettore@sheffield.ac.uk Submitted 7 March 2014; accepted 15 October 2014 Dental caries remains a public health problem in most countries not only because of its high prev- alence but also because of its impact on overall well-being and quality of life (1–3). Until recently, most research has focused on the indi- vidual behavioural risk factors of dental caries. However, this does not take into account the underlying social, economic and environmental aspects related to the distribution of the disease (1, 4, 5). Societal processes and socioeconomic character- istics are considered the underlying determinants of oral health because they can influence proximal risk factors of oral diseases, such as shaping oral health-related behaviours and modifying lifestyle (4–6). The importance of structural and intermedi- ary social determinants of dental caries in children and adolescents has been well established (4, 7–10). The World Health Organization Commission on the Social Determinants of Health (CSDH) doi: 10.1111/cdoe.12139 1 Community Dent Oral Epidemiol All rights reserved Ó 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd