Ethnic Disparities in Dental Caries among Adolescents in China

Abstract

Comprehensive research on ethnic disparities in dental caries in China is limited. The aims of this cross-sectional study were to compare the levels of dental caries in adolescents between the Han ethnic group and ethnic minority groups in China and to explore the risk indicators for dental caries within ethnic subgroups. Data from the Fourth National Oral Health Survey in 2015, which covered all 31 province-level administrative divisions in mainland China, were used. The dental caries status in the permanent dentition of adolescents aged 12, 13, 14, and 15 y was measured using the decayed, missing, and filled teeth (DFMT) score, and sociodemographic characteristics and oral health–related behaviors were also collected. A total of 118,601 adolescents were included, with ethnic minority groups accounting for 13.15%. Of the Han and minority groups, the standardized prevalence of dental caries experience was 40.58% and 47.67%, and the mean DMFT scores were 0.97 and 1.28, respectively. According to the multivariate zero-inflated negative binomial regression analysis, the caries status of minorities was more severe than Han adolescents (adjusted prevalence rate ratio [PRR], 1.14; 95% confidence interval [CI], 1.10–1.18). This disparity was greater among adolescents who lived in rural areas, had mid-level economic status, and frequently consumed sugary beverages. After propensity score matchings, Uygur (PRR, 1.44; 95% CI, 1.25–1.67), Tibetan (PRR, 1.39; 95% CI, 1.3–1.48), and Yi (PRR, 1.24; 95% CI, 1.04–1.48) adolescents were significantly more likely to have caries than Han adolescents. Subgroup analyses revealed that gender, age, location of residence, economic status, region, consumption of sweet snacks and sugary beverages, and dental visit pattern were significantly associated with dental caries within ethnic minorities.

Trend on dental caries status and its risk indicators in children aged 12 years in China: a multilevel analysis based on the repeated national cross-sectional surveys in 2005 and 2015

“…To achieve the goal that the prevalence of dental caries among 12-year-old children reducing to 30% by 2030, it is essential to invest in more resources to expand the coverage of the school-based oral health intervention programme and to allow the use of medical insurance accounts for dental preventive car e[ 43 ].. It is very likely that these proposed measures would reduce the inequality in the dental caries prevalence among Chinese school children and particularly benefit those living in the southwest and northeast regions [ 44 ].…”

A predictive nomogram: a cross-sectional study on a simple-to-use model for screening 12-year-old children for severe caries in middle schools

“…To ensure intra-examiner reliability of oral examination, 5% of samples were selected for duplicate examination, then compared with the original data and with the calibrating examiner every day during the survey. Cohen’s kappa statistics assessing the consistency of inter- and intra-examiner were all exceeded 0.80 [ 19 ].…”

Periapical lesions in two inbred strains of rats differing in immunological reactivity

“…Genetic factors that may influence susceptibility to dental caries, pulpitis and development of periapical granulomas and periodontal inflammation are not fully understood (Nibali et al, 2017). Wu et al (2021) reported ethnic disparities in dental caries among adolescents in China even after propensity score matching. In periodontal disease, genetic and epigenetic factors have been reported to determine susceptibility to inflammation in periodontal tissue, emphasizing the importance of immune homeostasis (Loos & Van Dyke, 2020).…”