Number of remaining teeth and its association with educational level in Chilean adults: data from the National Health Survey 2016-2017

Abstract

Background: Several population studies have addressed oral health inequity-related issues. Edentulism, functional dentition and number of remaining teeth have been linked to different socioeconomic level measurements. The aim of this study was to evaluate the association between educational level (EL) and tooth loss in the Chilean population aged 15 years old and above, based on the recent data collected from the 2016-2017 National Health Survey (ENS 2016-2017). Methods: The sample for this cross-sectional study comprised 5473 subjects. The main independent variable in the study was educational level (LEL: low, MEL: medium, HEL: high). In order to measure tooth loss number of remaining teeth, edentulism and functional dentition were considered. Based on a multivariate logistic regression, it was possible to obtain odds ratios (OR) and, therefore, to assessing the condition of dentition according to the subject’s EL. As to the number of teeth variable, multiple linear regressions were conducted. The analyses were carried out in the SPSS 24.0 program considering the complex sampling design of ENS 2016-2017. Results: When comparing LEL subjects with HEL subjects, the adjusted difference in the number of remaining teeth was 3.11 for maxilla and 1.72 for mandible. An individual with a LEL had a 7.51 [3.50-16.10] and 6.06 [2.68-13.68] times higher risk of upper edentulism and lower edentulism than a HEL individual respectively. Regarding functional dentition, the adjusted OR in HEL subjects was 13.33 [8.02-22.15] and in MEL subjects was 2.81 [2.03-3.87], compared to LEL results. Conclusions: LEL was associated with a significant tooth loss in the Chilean population. Regardless of age, subjects with a LEL obtained a lower mean of number of remaining teeth, higher prevalence of edentulism and lower prevalence of functional dentition.

Changes in oral health inequalities in adults in Chile

“…This sample design achieved a national, urban, rural and regional representativity. The NHS 2016–2017 response rate was 90.2% 6 . The final sample included in this study was 5306 participants with oral examination.…”

“…The NHS 2016-2017 response rate was 90.2%. 6 The final sample included in this study was 5306 participants with oral examination.…”

“…In NHS 2003, the interexaminer reliability measured with kappa was 0.75 and in NHS 2016-2017 it was 0.85. 6 The NHS were approved by the Ethics Committee of the Catholic University of Chile. 6 For this study, seven oral health outcomes were considered:…”

“…6 The NHS were approved by the Ethics Committee of the Catholic University of Chile. 6 For this study, seven oral health outcomes were considered:…”

“…Between the first 2003 National Health Survey (2003 NHS) and the 2016–2017 National Health Survey (2016–17 NHS), untreated caries decreased from 67.7% to 54.6% 5 and the prevalence of non‐functional dentition decreased from 29.7% to 24.8%, 5 but these prevalences are still higher than global averages. On the other hand, social inequalities in tooth loss in Chile are marked by education level 6 and are higher than in USA, Canada, Australia and New Zealand 7 …”