Ethnic Disparities in Dental Caries among Six-Year-Old Children in the Netherlands

Abstract

The aim of this study was to investigate potential differences in caries prevalence of children from ethnic minority groups compared to native Dutch children and the influence of socio-economic status (SES) and parent-reported oral health behaviour on this association. The study had a cross-sectional design, embedded in a population-based prospective multi-ethnic cohort study. 4,306 children with information on caries experience, belonging to 7 different ethnic groups, participated in this study. The decayed, missing, and filled teeth (dmft) index was assessed at the age of 6 and categorized in two ways for analysis: children without caries (dmft = 0) versus any caries experience (dmft >0) and children without caries (dmft = 0) versus children with mild caries (dmft = 1-3) or severe caries (dmft >3). Compared to native Dutch children, children with a Surinamese-Hindustani, Surinamese-Creole, Turkish, Moroccan, and Cape Verdean background had significantly higher odds for dental caries. Especially the Surinamese-Hindustani, Turkish, and Moroccan group had significantly higher odds for severe dental caries. Household income and educational level of the mother explained up to 43% of the association between ethnicity and dental caries, whereas parent-reported oral health behaviour did not mediate the association. Alarming disparities in caries prevalence between different ethnic (minority) groups exist, which cannot be fully explained by social inequalities. Public health strategies can apply this new knowledge and specifically focus on the reduction of ethnic disparities in oral health. More research is needed to explain the high caries prevalence among different ethnic minority groups.

Socioeconomic Factors and Oral Health-Related Behaviours Associated with Dental Caries in Preschool Children from Central Italy (Province of Ascoli Piceno)

“…A similar result was also reported in northern Europe (the Netherlands) by van der Tas et al [3,7] that observed a similar result in a greater sample than the present one.…”

“…Previous studies enlightened a gap between Italy and other EU countries, where there is a screening program across the population (infantile, adolescent, and adult) at regular intervals of ten years, which allowed, from 1973, to reduce drastically the prevalence of caries, especially in preschool age [27][28][29]. On the contrary, the preschool caries risk pattern in Italy appears to be similar to that reported by van der Tas et al [3] and the caries-free participants percentage even higher in Italy (81.6% vs 77.1%). is is still far from what was asked by the World Health Organization (WHO) targets for 2010, which were to provide for a reduction of caries, with an average of caries-free participants equal to approximately 90% among preschool children [30].…”

“…Although over the last decades, epidemiological data reveal a significant decline in caries prevalence in children and adolescents from industrialized Western countries [1,2], dental caries is still a common oral disease, with a prevalence ranging around 60-90% [3,4], even diffused among preschool children. Dental caries negatively affects children's quality of life by their psychological and social relations, also causing feelings of discomfort from an early age [5,6].…”

“…In the literature, there are few studies based on European samples assessing that SES significantly influence the development of dental caries in preschool children [3,10,19].…”

Parents’ willingness to invest in their children's oral health

“…Studies are needed in which more confounders are controlled for to determine how parents' WTI is affected by ethnicity, education level, income, and other cultural and sociodemographic factors. From the literature, it is known that children from lower educated parents and immigrants have a higher risk of dental caries compared to children from higher educated parents and Western background (25,26). An interesting research question to investigate is whether parents' WTI in their children's oral health plays an intermediating role in the explanation of socioeconomic and ethnic inequalities in children's dental caries experience.…”