scholarly journals Persistent Socioeconomic Inequality in Child Dental Caries in England despite Equal Attendance

2019 ◽  
Vol 5 (2) ◽  
pp. 185-194 ◽  
Author(s):  
V. Ravaghi ◽  
D.S. Hargreaves ◽  
A.J. Morris

Introduction: Despite a decline in the prevalence of dental caries among children in England and ongoing arrangements for the provision of free dental care up to the age of 18 y, there is limited information on the pattern and trend of socioeconomic inequalities in dental caries and dental attendance. Methods: We estimated the magnitude of deprivation-related inequalities for dental caries and dental attendance in young children, using publicly available data and 2 regression-based summary measures of inequalities: slope index of inequality and relative index of inequality. Results: We found no significant absolute or relative inequalities in dental attendance across English areas in the past decade, while there were persistent absolute and relative inequalities in dental caries. Socioeconomic inequalities in dental caries decreased between 2007 and 2012; thereafter, the relative inequalities increased. Conclusions: The apparent widening inequality in child dental caries in England despite equal access to dental care is a challenge for policy makers. Knowledge Transfer Statement: While caries prevalence among English children has declined over the past decade, there has been an increase in socioeconomic inequalities in oral health despite there being no inequality in dental attendance. This has implications for the development of oral health strategy and planning dental services.

Author(s):  
Kanade Ito ◽  
Noriko Cable ◽  
Tatsuo Yamamoto ◽  
Kayo Suzuki ◽  
Katsunori Kondo ◽  
...  

Countries with different oral health care systems may have different levels of oral health related inequalities. We compared the socioeconomic inequalities in oral health among older adults in Japan and England. We used the data for adults aged 65 years or over from Japan (N = 79,707) and England (N = 5115) and estimated absolute inequality (the Slope Index of Inequality, SII) and relative inequality (the Relative Index of Inequality, RII) for edentulism (the condition of having no natural teeth) by educational attainment and income. All analyses were adjusted for sex and age. Overall, 14% of the Japanese subjects and 21% of the English were edentulous. In both Japan and England, lower income and educational attainment were significantly associated with a higher risk of being edentulous. Education-based SII in Japan and England were 9.9% and 26.7%, respectively, and RII were 2.5 and 4.8, respectively. Income-based SII in Japan and England were 9.2% and 14.4%, respectively, and RII were 2.1 and 1.9, respectively. Social inequalities in edentulous individuals exist in both these high-income countries, but Japan, with wider coverage for dental care, had lower levels of inequality than England.


Author(s):  
Justyna Opydo-Szymaczek ◽  
Maria Borysewicz-Lewicka ◽  
Kinga Andrysiak ◽  
Zuzanna Witkowska ◽  
Alicja Hoffmann-Przybylska ◽  
...  

This cross-sectional study aimed to assess the occurrence of the consequences of dental caries and factors affecting dental service utilization in a population of 7-year-old children. The research included oral examination of 7-year-old schoolchildren and socio-medical study of their parents/legal caregivers. It was carried out in five primary schools of two provinces, i.e., Greater Poland and Lubusz. Dental examination was performed in accordance with World Health Organization (WHO) recommendations. The socio-medical study consisted of questionnaires with close-ended questions concerning socioeconomic characteristics of the family, reasons and time of the last visit at the dental office, consequences of child’s oral health problems, parents’ attitude towards dental visits, and parental opinion about their child’s teeth. Factors affecting utilization of dental services were statistically analyzed using univariate logistic regression assuming p < 0.05. The pufa index of examined children ranged from 0 to 7 (mean 0.80 ± 1.49), while the dmf index ranged from 0 to 14 (3.86 ± 3.32). Low financial burden of oral health expenditures and university education of at least one of the parents significantly increased the chance of visiting a dentist despite lack of pain (OR = 3.0 and 2.5, respectively). In spite of the availability of free dental care for children, socioeconomic factors still determine the utilization of dental services in Poland. Poor oral health status of examined population and negligence of regular dental check-ups emphasize a need to strengthen oral health literacy of parents and children, promoting proper attitudes towards dental care.


BDJ Open ◽  
2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Catalina Opazo-García ◽  
Jeel Moya-Salazar ◽  
Karina Chicoma-Flores ◽  
Hans Contreras-Pulache

Abstract Introduction Dental care is provided for high-performance athletes at national and international sports events. Elite athletes may seek care for sports-related injuries and pre-existing oral diseases. Previous studies indicate an association between oral health problems and negative performance impacts in elite athletes. Objectives To determine the prevalence of the most common oral pathologies in high-performance athletes during the emergency dental care performed at the Lima 2019 Pan American Games (JPL-19). Methodology All reports of athletes (≥18 years old, of both sexes, from 41 countries) who received emergency dental care at Pan American Villas during the JPL-19 were included. Injuries and types of oral diseases were classified according to the Injury and Disease Surveillance System proposed by the International Olympic Committee. Results Of the 6680 participating athletes, 76 (1.14%) presented as dental emergencies, 90.8% (69/76) of the athletes seen presented pre-existing oral pathological conditions, the most frequent were periodontal diseases (34%, 26/76) and dental caries (29%, 22/76). Among the sports with the most cases, there were 22 (29%) in athletics, 6 (8%) in soccer, and 6 (8%) in taekwondo. The most frequent dental emergencies came from Peru, Puerto Rico, Bahamas, Grenada, and Venezuela. Conclusions Pre-existing oral diseases were more frequent than sports-related accidents. The most prevalent diseases were periodontal disease and dental caries disease. It is necessary to implement new care strategies for athletes, based on prevention, before and during sports competitions.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e042908
Author(s):  
Tingting Zhang ◽  
Jialan Hong ◽  
Xueting Yu ◽  
Qiulin Liu ◽  
Andi Li ◽  
...  

ObjectivesSocioeconomic inequalities in oral health are often neglected in oral health promotion. This cross-sectional study assessed the association between dental caries and socioeconomic status (SES) among preschool children in China.DesignCross-sectional study.SettingData from the Fourth National Oral Health Survey of China (2015), comprising of 40 360 children aged 3–5 years was used.MethodsDental caries indicators including prevalence of dental caries, dental pain experience and number of decayed, missing and filling teeth (dmft). SES indicators included parental education and household income. The associations between SES and dental caries were analysed by using negative binomial regression or Poisson regression models according to data distribution. Relative and absolute inequalities in dental caries were quantified by using the Relative Index of Inequality (RII) and Slope Index of Inequality (SII), respectively.ResultsThere were significant associations between SES and prevalence of dental caries and dmft (p<0.001). Children from lower educated (RII 1.36, 95% CI 1.3 to 1.43; SII 0.97, 95% CI 0.81 to 1.13) and lower household income (RII 1.17, 95% CI 1.11 to 1.24; SII 0.55, 95% CI 0.35 to 0.75) families had higher dmft than those from well-educated and most affluent families. Relative and absolute inequalities in dental caries were larger in urban areas by household income, and in rural areas by parental education.ConclusionsAssociation between dental caries and SES was demonstrated and socioeconomic inequalities in dental caries existed among Chinese preschool children.


PEDIATRICS ◽  
1987 ◽  
Vol 80 (1) ◽  
pp. 107-110 ◽  
Author(s):  
Henry J. Herrmann ◽  
Michael W. Roberts

The pediatrician can assist the dental profession in preventing dental disease and maintaining the oral health of children. Pediatricians are urged to counsel parents in dietary and oral hygiene practices that will prevent dental caries and to refer patients for professional dental care when appropriate. Systemic fluoride supplements should be prescribed when needed but only after a careful review of requirements and daily consumption.


2020 ◽  
Vol 99 (12) ◽  
pp. 1341-1347
Author(s):  
F. Bof de Andrade ◽  
J.L.F. Antunes ◽  
F.C.D. Andrade ◽  
M.F.F. Lima-Costa ◽  
J. Macinko

This study aimed to measure the magnitude of education-related inequalities in the use of dental services among older adults (aged 50 y or older) from a sizable multicountry sample of 23 upper-middle- and high-income countries. This study used cross-sectional data from nationally representative surveys of people aged 50 y and over. Countries included in the Health and Retirement Study surveys were the following: Brazil, China, South Korea, Mexico, United States, Austria, Belgium, Croatia, Czech Republic, Denmark, Estonia, France, Germany, Greece, Italy, Israel, Luxembourg, Poland, Portugal, Slovenia, Spain, Sweden, and Switzerland. The dependent variable was the use of dental services, based on the self-report of having had a dental visit within the previous year, except for the United States and South Korea, which used 2-y recall periods. Educational level was used as the measure of socioeconomic position and was standardized across countries. Multivariate logistic regression modeling was used to evaluate the factors associated with the use of dental services, and the magnitude of education inequalities in the use of dental services was assessed using the slope index of inequality (SII) to measure absolute inequalities and the relative index of inequality for relative inequalities. The pooled prevalence of the use of dental services was 31.7% and ranged from 18.7% in China to 81.2% in Sweden. In the overall sample, the absolute difference in the prevalence of use between the lowest and highest educational groups was 20 percentage points. SII was significant for all countries except Portugal. Relative educational inequalities were significant for all countries and ranged from 3.2 in Poland to 1.2 in Sweden. There were significant education-related inequalities in the use of dental care by older adults in all countries. Monitoring these inequalities is critical to the planning and delivery of dental services.


2017 ◽  
Vol 30 (7-8) ◽  
pp. 561 ◽  
Author(s):  
Joana Santos ◽  
Irina Kislaya ◽  
Liliana Antunes ◽  
Ana João Santos ◽  
Ana Paula Rodrigues ◽  
...  

Introduction: Diabetes is a major public health problem and it is related to socioeconomic factors. The aim of this study is to describe socioeconomic inequalities in the distribution of diabetes in the population with 25 years or more, resident in Portugal in 2014.Material and Methods: Data from the Health National Survey 2014 was analysed, n = 16 786. We estimated the prevalence of diabetes in the population and stratified by socioeconomic variables namely educational level and income. The extent of socioeconomic inequalities was assessed using concentration index and the relative index of inequality.Results: Diabetes was found to be concentrated among the people with lower educational levels (concentration index = -0.26) and lower income quintiles (concentration index = -0.14). Relative index of inequality also showed a lower degree of inequality among the most educated (0,20; CI 95% = [0,12; 0,32]) and with higher income (0,59; CI 95% = [0,48; 0,74]).Discussion: Distribution of diabetes is associated with education and income. Previous studies have shown that although income might reflect lifestyle patterns, education reflects better social factors that are important for establishing healthier behaviours. Also, the National Health Service, of universal coverage and free of charge, might have contributed to reduce inequalities in the access to health by those with the lowest income.Conclusion: Supporting ‘Health in All Policies’ might reduce inequalities, namely by improving population educational level and actions that promote health literacy.


2019 ◽  
Vol 52 (Suppl 2) ◽  
pp. 7s ◽  
Author(s):  
Fabíola Bof de Andrade ◽  
José Leopoldo Ferreira Antunes ◽  
Paulo Roberto Borges de Souza Junior ◽  
Maria Fernanda Lima-Costa ◽  
Cesar De Oliveira

OBJECTIVE: To investigate the association between life course socioeconomic conditions and two oral health outcomes (edentulism and use of dental prostheses among individuals with severe tooth loss) among older Brazilian adults. METHODS: This was a cross-sectional study with data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) which includes information on persons aged 50 years or older residing in 70 municipalities across the five great Brazilian regions. Regression models using life history information were used to investigate the relation between childhood (parental education) and adulthood (own education and wealth) socioeconomic circumstances and edentulism and use of dental prostheses. Slope index of inequality and relative index of inequality for edentulism and use of dental prostheses assessed socioeconomic inequalities in both outcomes. RESULTS: Approximately 28.8% of the individuals were edentulous and among those with severe tooth loss 80% used dental prostheses. Significant absolute and relative inequalities were found for edentulism and use of dental prostheses. The magnitude of edentulism was higher among individuals with lower levels of socioeconomic position during childhood, irrespective of their current socioeconomic position. Absolute and relative inequalities related to the use of dental prostheses were not related to childhood socioeconomic position. CONCLUSIONS: These findings substantiate the association between life course socioeconomic circumstances and oral health in older adulthood, although use of dental prostheses was not related to childhood socioeconomic position. The study also highlights the long-lasting relation between childhood socioeconomic inequalities and oral health through the life course.


UNICIÊNCIAS ◽  
2018 ◽  
Vol 22 (2) ◽  
pp. 92
Author(s):  
Karina Semencio Avelino ◽  
Ilma Carla de Souza Porcelli ◽  
Valéria Campos Mariano Francelino ◽  
Ermelinda Matsuura ◽  
Nathalia Maciel Corsi ◽  
...  

A cárie precoce repercute, negativamente, na vida da criança. Este estudo avaliou o nível de conhecimento, práticas maternas e o padrão de saúde bucal de crianças assistidas pela rede pública de saúde de um município do Sul do Brasil. Foram analisados 279 prontuários de crianças que estavam sendo atendidas na clínica de bebê de uma Unidade Básica de Saúde. O conhecimento, as práticas nos cuidados com a saúde bucal infantil e o perfil sócio demográfico das famílias foram identificados em entrevistas realizadas com as mães no início do atendimento. Verificou-se os procedimentos clínicos-preventivos realizados, número de consultas e faltas e se avaliou a condição de saúde bucal da criança na última consulta. Foram aplicados os testes Mann-Whitney e Kruskal-Wallis, fixando-se o nível de significância em 5%. As mães apresentaram um conhecimento razoável, porém suas práticas, principalmente, com cuidados alimentares das crianças eram precárias. Procedimentos preventivos predominaram na atenção odontológica oferecida, contudo, 20,8% das crianças desenvolveram cárie dentária, sendo o índice ceo-d médio igual a 0,53 (DP=1,35). A maior severidade de cárie se associou à maior idade da criança (<0,001) e da mãe (p=0,006), menor renda familiar (0.036), maior tempo de tratamento (<0,001) e maior número de faltas às consultas (<0,001). A atenção odontológica é importante a partir do primeiro ano de vida, assim como as ações em saúde bucal, com atividades educativas direcionadas aos programas pré-natais, além do desenvolvimento de estratégias para aumentar a adesão das mães/ crianças aos programas promocionais em saúde bucal que são oferecidos pela rede pública de saúde. Palavras-chave: Criança. Saúde Bucal. Mães. Cárie Dentária. Conhecimento. AbstractEarly caries has a negative impact on the child's life. This study evaluated the level of knowledge, maternal practices and oral health pattern of children assisted by the public health network of a municipality in the south of Brazil. Information was analyzed from 279 medical records of children treated at the baby clinic of a Basic-Health-Unit. The knowledge, practices in care of children's oral health and sociodemographic profile of families were identified in interviews with mothers at the beginning of care. The clinical-preventive procedures performed, number of consultations, absences were checked and the child's oral health condition was evaluated at the last visit. The Mann-Whitney and Kruskal-Wallis tests were applied, setting the level of significance at 5%. The mothers presented a reasonable level of knowledge, however, their practices,particularly those about care related to feeding their children were precarious. Preventive procedures predominated the offered dental care, however, 20.8% of the children developed dental caries - mean dmf-t index 0.53 (SD = 1.35). The highest level of caries severity was associated with the highest age of both the child (<0.001) and mother (p = 0.006), lower family income (0.036), longer treatment time (<0.001) and higher number absences to the appointments. Dental care is important from the first year of life onwards, as well as oral health actions, with educational activities directed towards prenatal programs and the development of strategies to increase the adherence of mothers /children to the promotional programs offered by the public health network. Keywords: Child. Oral health. Mothers. Dental Caries. Knowledge. 


1997 ◽  
Vol 11 (2) ◽  
pp. 254-262 ◽  
Author(s):  
P.L. Davidson ◽  
R.M. Andersen

Dental services utilization in the past 12 months was compared across population-based samples of African-American, Navajo, Lakota, Hispanic, and White adults participating in the WHO International Collaborative Study of Oral Health Outcomes (ICS-II) at USA research locations. Bivariate results revealed that ethnic minority groups in both age cohorts reported significantly fewer dental visits in the past 12 months compared with White adults. When dentate status was controlled for, age cohort differences were not significant in Baltimore (African-American and White) and San Antonio (Hispanic and White) research locations. In contrast, older Native Americans (65-74 years) reported visiting the dentist significantly less often compared with their middle-aged (35-44 years) counterparts. Multivariate results indicated that generalizable variables were associated with dental contact in every ICS-II USA ethnic group (i.e., dentate, usual source of dental care, oral pain). Among the diverse ethnic groups, other determinants presented a varied pattern of risk factors for underutilizing dental care. Information on ethnic-specific risk factors can be used to design culturally appropriate and acceptable oral health promotion programs. Generalizable risk factors across ethnic groups inform oral health policy-makers about changing national priorities for promoting oral health.


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