Inequality in oral health related to early and later life social conditions: a study of elderly in Norway and Sweden

Abstract

BackgroundA life course perspective recognizes influences of socially patterned exposures on oral health across the life span. This study assessed the influence of early and later life social conditions on tooth loss and oral impacts on daily performances (OIDP) of people aged 65 and 70 years. Whether social inequalities in oral health changed after the usual age of retirement was also examined. In accordance with “the latent effect life course model”, it was hypothesized that adverse early-life social conditions increase the risk of subsequent tooth loss and impaired OIDP, independent of later-life social conditions.MethodsData were obtained from two cohorts studies conducted in Sweden and Norway. The 2007 and 2012 waves of the surveys were used for the present study. Early-life social conditions were measured in terms of gender, education and country of birth, and later-life social conditions were assessed by working status, marital status and size of social network. Logistic regression and Generalized Estimating Equations (GEE) were used to analyse the data. Inverse probability weighting (IPW) was used to adjust estimates for missing responses and loss to follow-up.ResultsEarly-life social conditions contributed to tooth loss and OIDP in each survey year and both countries independent of later-life social conditions. Lower education correlated positively with tooth loss, but did not influence OIDP. Foreign country of birth correlated positively with oral impacts in Sweden only. Later-life social conditions were the strongest predictors of tooth loss and OIDP across survey years and countries. GEE revealed significant interactions between social network and survey year, and between marital status and survey year on tooth loss.ConclusionThe results confirmed the latent effect life course model in that early and later life social conditions had independent effects on tooth loss and OIDP among the elderly in Norway and Sweden. Between age 65 and 70, inequalities in tooth loss related to marital status declined, and inequalities related to social network increased.

Longitudinal evaluation of periodontitis and tooth loss among older adults

“…Our results are consistent with the results reported by Machtei et al () demonstrating a higher level of bone loss and clinical attachment loss at baseline in individuals losing teeth during the follow‐up period compared to the group of individuals not losing teeth. Our finding that people living alone lose more teeth is supported by Gulcan and coworkers demonstrating that major tooth loss was more likely to occur among singles than married individuals (Gulcan, Ekback, Ordell, Lie, & Astrom, ). Our study has numerous strengths including serial x‐rays, full‐mouth examinations and available demographic, social and medical variables.…”

Childhood socioeconomic conditions and teeth in older adulthood: Evidence from SHARE wave 5

“…The findings of this study add to the previous empirical evidence on the impact of childhood socioeconomic conditions on oral health in later life . Our analyses included different measures for childhood socioeconomic position.…”

“…The findings of this study add to the previous empirical evidence on the impact of childhood socioeconomic conditions on oral health in later life. [12][13][14][15][16][17][18][19]46 proposed to explain the role of financial conditions in childhood. On the one hand, unfavourable financial circumstances in early life could imply limited capacity to afford dental care and hence lead to restrictions in access to dental care.…”

“…However, the existing birth cohort studies are not yet able to follow up individuals’ oral health into later adulthood (age 50 and above) . Other studies based on cohort data that could have followed individuals into age 50+ have included relatively little detail about childhood conditions .…”

“…[12][13][14][15] However, the existing birth cohort studies are not yet able to follow up individuals' oral health into later adulthood (age 50 and above). 16 Other studies based on cohort data that could have followed individuals into age 50+ have included relatively little detail about childhood conditions. 17,18 The corresponding knowledge gap could be served by survey-based studies of older adults that contain information on current oral health status and, retrospectively, on circumstances in earlier life.…”