Multiple Socioeconomic Factors and Dental Caries in Swedish Children and Adolescents

Abstract

The study aimed to explore associations between multiple socioeconomic factors and dental caries experience in Swedish children and adolescents (3-19 years old). Electronic dental records from 300,988, in a Swedish region (97.3% coverage) were collected using the DMFT indices (decayed, missing, filled teeth: dependent variables). Socioeconomic status (SES) data (ethnicity, wealth, parental education, and employment) for individuals, parents, and families were obtained from official registers. Principal component analysis was used to explore SES data. Scores based on the first factor were used as an independent aggregated socioeconomic variable in logistic regression analyses. Dental caries experience was low in the participants: 16% in 3- to 6-year-olds (deft index: decayed, extracted, filled teeth) and 47% in 7- to 19-year-olds (DFT index). Both separate and aggregated socioeconomic variables were consistently associated with the dental caries experience irrespective of the caries index used: the crude odds ratio (OR) for having at least 1 caries lesion in 3- to 6-year-olds (deft index) in the lowest SES quintile was 3.26 (95% confidence interval [CI] 3.09-3.43) and in ≥7-year-olds (DFT index) OR 1.80 (95% CI 1.75-1.84) compared with children in the 4 higher SES quintiles. Overall, associations were stronger in the primary dentition than in the permanent dentition. Large SES models contributed more to explaining the caries experience than slim models including fewer SES indicators. In conclusion, socioeconomic factors were consistently associated with dental caries experience in the children and adolescents both as single factors and as multiple factors combined in an index. Socioeconomic inequalities had stronger associations to caries experience in young children than in older children and adolescents.

A longitudinal study of the impact of change in socioeconomic status on dental caries in the permanent dentition of Swedish children and adolescents

“…The proportions of changed SES in the study (improved or worsened) during the period could be seen as the result of environmental and political measures to improve the living conditions for exposed cohorts 47 . The results strengthen our earlier findings about the association between SES and dental caries development and occurrence 8,45 . In the current study, we could show that this association remains over time, even if the follow‐up period was fairly short.…”

“…The setting (Region Västra Götaland) comprises one‐sixth of the total Swedish population with a mixture of rural and urban settings and could be considered fairly representative of Sweden as a whole. This is seen in statistics on the proportions of the population receiving social welfare allowances (6.7% in our study, 7% nationally), as well as with low educational level father (14.6% and 15.9%, respectively) and mother (11.4% and 13.2%, respectively) 8,27 . Thus, the results of this study could be generalized to similar contexts, at least nationally.…”

“…Most studies in the field utilize a cross‐sectional design, indicating association but not causation 7‐11 . Longitudinal studies often entail administrative and economic challenges and are thus rare 12‐17 .…”

Potential risk factors for dental caries in Type 2 diabetic patients

“…The frequent intake of milk, fruit and vegetables was found to protect against dental caries, whereas the consumption of chocolate and soft drinks for the same period was found to be a risk factor for dental caries among undergraduate university women from Saudi Arabia . Studies on diverse global populations have also linked multiple socio‐economic factors including male gender, education, income, dietary habits and medication, with the occurrence of dental caries . Interestingly, we observed a significant association between teeth restorations and nephropathy in diabetic patients (Table ).…”

Structural equation modelling for associated factors with dental caries among 3–5-year-old children: a cross-sectional study

“…To explore factors related to children’s dental caries and the direct or indirect relationship, we proposed to build alternative models of the complex relationship between SES, knowledge, attitudes, behaviour (including dietary behaviour, tooth brushing behaviour and dental attendance) and dental caries based on theoretical framework [11, 15] and literature using a SEM. Model 1:We assumed that dental caries (dmft) were directly influenced by SES [16], oral health knowledge, oral health attitudes [8, 17–19], dietary behaviours [20], tooth brushing behaviours [21] and dental attendance. Simultaneously, SES, oral health knowledge and oral health attitudes directly affected dietary behaviours and tooth brushing and dental attendance [22].…”