Socioeconomic inequalities in caries experience, care level and dental attendance in primary school children in Belgium: a cross-sectional survey

Abstract

ObjectivesOral health inequality in children is a widespread and well-documented problem in oral healthcare. However, objective and reliable methods to determine these inequalities in all oral health aspects, including both dental attendance and oral health, are rather scarce.AimsTo explore oral health inequalities and to assess the impact of socioeconomic factors on oral health, oral health behaviour and dental compliance of primary school children.MethodsData collection was executed in 2014 within a sample of 2216 children in 105 primary schools in Flanders, by means of an oral examination and a validated questionnaire. Intermutual Agency database was consulted to objectively determine individuals’ social state and frequency of utilisation of oral healthcare services. Underprivileged children were compared with more fortunate children for their mean DMFt, DMFs, plaque index, care index (C, restorative index (RI), treatment index (TI), knowledge and attitude. Differences in proportions for dichotomous variables (RI100%, TI100% and being a regular dental attender) were analysed. The present study was approved by the Ethics Committee of the University Hospital Ghent (2010/061). All parents signed an informed consent form prior to data collection. All schools received information about the study protocol and agreed to participate. Children requiring dental treatment or periodic recall were referred to the local dentist.ResultsUnderprivileged children had higher D1MFT (95% CI 0.87 to 1.36), D3MT (95% CI 0.30 to 0.64), plaque scores (95% CI 0.12 to 0.23) and lower care level (p<0.02). In the low-income group, 78.4% was caries-free, compared with 88.4% for the other children. Half of the low-income children could be considered as regular dental attenders, while 12.6% did not have any dental visit during a 5-year period.ConclusionOral health, oral hygiene, oral healthcare level and dental attendance patterns are negatively affected by children’s social class, leading to oral health inequalities in Belgian primary school children.

Enamel and Dentin Caries Risk Factors of Adolescents in the Context of the International Caries Detection and Assessment System (ICDAS): A Longitudinal Study

“…The present evidence shows that dental caries, when including enamel caries, could be very prevalent with a prevalence rate of over 80% among most populations aged 12–15 years, as was our population ( 55 – 57 ). The reason for a high prevalence rate could be insufficient awareness of initial caries in most adolescents, their guardians and even clinical dentists.…”

Prevalencia y Severidad de Caries Dental en los Niños Beneficiarios del Programa de Salud Oral Asociados a Escuelas de Chile

“…Reportes del Ministerio de Salud (MINSAL), indican que la caries dental se presenta desde los primeros años de vida; a los 2 años la prevalencia de caries es de un 17,5 %, de 49,6 % a los 4 años, de 70,4 % a los 6 años y a los 12 años la prevalencia de caries es de 62,5 Ministerio de Salud, 2011b). Existe evidencia que la prevalencia y severidad del daño por caries en la población infanto-adolescente están relacionados con inequidades en salud (Lambert et al, 2017), afectando a los más desfavorecidos e incrementando con la edad Fernández González et al, 2011). Otro factor analizado en los estudios nacionales es la mayor prevalencia que presentan los niños y adolescentes de zonas rurales en comparación con los que viven en zonas urbanas, con una diferencia desde un 18 % a un 38 % Giacaman et al, 2015;Cabrera et al, 2015).…”

Cost-effectiveness of caries preventive interventions – a systematic review

“…Dental caries is unevenly distributed in society and there is evidence, in both children and adults, of an association between socioeconomic status and dental caries [8,9]. The same pattern occurs regionally and nationally as well as globally: the oral health of the socially disadvantaged is poorer than that of those with better living conditions [9][10][11]. For all levels of society to have good dental health, effective oral health preventive interventions need to be implemented.…”