Is the Perceived Neighbourhood Environment Associated With Preventive Dental Care Among Adults Aged 50 Years and Older? A Cross‐Sectional Analysis of ELSI ‐Brazil

Objective To assess whether perceived barriers in the neighbourhood pedestrian environment are associated with a last dental visit being for preventive reasons among Brazilian adults aged 50 years and older. Methods Cross‐sectional study using data from the second wave of ELSI‐Brazil (2019–2021). The dependent variable was the last dental visit for preventive reasons versus treatment‐related reasons, restricted to participants who had previously visited a dentist. The main exposures were perceived litter, rubble, or tall weeds in the neighbourhood, fear of falling due to sidewalk defects, and concern about difficulty crossing the street, restricted to urban residents. Prevalence ratios (PR) and 95% confidence intervals (95% CI) were estimated using Poisson regression with robust variance, accounting for the complex sampling design. Each exposure was analysed in a separate model adjusted for sex, age, skin colour, income, education, depressive symptoms and difficulty walking. Results Among 6454 urban‐dwelling adults aged 50 years and older who had previously visited a dentist, 30.1% (95% CI 25.8–34.9) reported that their last dental visit was for preventive reasons. After adjustment, perceived litter, rubble, or tall weeds (PR = 0.85; 95% CI 0.73–0.99), fear of falling due to sidewalk defects (PR = 0.85; 95% CI 0.74–0.97), and concern about difficulty crossing the street (PR = 0.79; 95% CI 0.68–0.92) were associated with a lower prevalence of a preventive last dental visit. Conclusion Perceived barriers in the neighbourhood pedestrian environment were associated with a lower prevalence of a preventive last dental visit among urban‐dwelling Brazilian adults aged 50 years and older.