Abstract
Background: Having in mind that macro level factors such as social, political and economic determinants strongly impact occurrence of chronic NCDs, it might be beneficial to enlarge scarce level of data on the influence of these factors on children’s oral health. The aim of the present study was to test association between macro level factors and oral health in a nationally representative sample of preschoolers involving all preschooler’s age groups from the beginning to compulsory Preschool Preparatory Program. Method: Oral health data derived from cross sectional study involving nationally representative sample of preschool children. Dependent, oral health variables included prevalence of primary teeth caries, untreated caries, and caries on permanent first molars. Data on macro level factors included regional information on economic, population, and healthcare factors: population density, density of physicians and dentists, district share in national gross domestic product (GDP), social and health care expenditures, local self-government budget, employment rate in public, private and agricultural sector. In order to have nationally representative sample we used stratified cluster sampling method proposed by World Health Organization. Results: Final sample included 1665 preschoolers aged 36 to 91 months. Observed prevalence of ECC was 57.8%. Of these, 90.4% had untreated caries. Furthermore, 11.1% of examined preschoolers already had lesions on permanent first molar. All ECC related oral health outcomes were statistically significantly associated with regional social economic indicators – poor oral health was more frequently observed in regions and districts with lower economic performance. Conclusions: The results of this study displayed first nationally representative data on prevalence of primary teeth caries in preschool children. Noteworthy findings confirmed highly statistically significant association of economic macro level factors with prevalence of primary teeth caries, untreated caries, and caries on permanent first molars. Upstream preventive interventions especially targeted at population living in districts with lower economic indicators might seem as most appropriate strategy.