Socioeconomic position and subjective oral health: findings for the adult population in England, Wales and Northern Ireland

Abstract

BackgroundThe objective of this study was to assess socioeconomic inequalities in subjective measures of oral health in a national sample of adults in England, Wales and Northern Ireland.MethodsWe analysed data from the 2009 Adult Dental Health Survey for 8,765 adults aged 21 years and over. We examined inequalities in three oral health measures: self-rated oral health, Oral Health Impact Profile (OHIP-14), and Oral Impacts on Daily Performance (OIDP). Educational attainment, occupational social class and household income were included as socioeconomic position (SEP) indicators. Multivariable logistic regression models were fitted and from the regression coefficients, predictive margins and conditional marginal effects were estimated to compare predicted probabilities of the outcome across different SEP levels. We also assessed the effect of missing data on our results by re-estimating the regression models after imputing missing data.ResultsThere were significant differences in predicted probabilities of the outcomes by SEP level among dentate, but not among edentate, participants. For example, persons with no qualifications showed a higher predicted probability of reporting bad oral health (9.1 percentage points higher, 95% CI: 6.54, 11.68) compared to those with a degree or equivalent. Similarly, predicted probabilities of bad oral health and oral impacts were significantly higher for participants in lower income quintiles compared to those in the highest income level (p < 0.001). Marginal effects for all outcomes were weaker for occupational social class compared to education or income. Educational and income-related inequalities were larger among young people and non-significant among 65+ year-olds. Using imputed data confirmed the aforementioned results.ConclusionsThere were clear socio-economic inequalities in subjective oral health among adults in England, Wales and Northern Ireland with stronger gradients for those at younger ages.Electronic supplementary materialThe online version of this article (doi:10.1186/1471-2458-14-827) contains supplementary material, which is available to authorized users.

The roles of contextual and individual social determinants of oral health-related quality of life in Brazilian adults

“…Previous studies in different countries have shown variations on OHRQoL measures in adults [19,29,30,41]. In the UK, OHRQoL measures were lower than in our study (15.6 vs 21.3 %, based on OIDP extent of 3 or higher) [19], while in India the prevalence of oral impacts affecting daily performances was higher than in Brazil (71.2 vs 46.9 %) [41].…”

“…Consistent findings on this association have been found in children [24][25][26][27][28], adults [19] and older adults [19,20,29,30]. However, little attention has been paid on the possible influence of contextual and individual social determinants on OHRQoL.…”

“…More recently, studies of oral health inequalities have been given a new perspective by the use of patient-oriented oral health outcomes, such as self-perceived oral health and oral health-related quality of life [17][18][19][20][21]. Oral health-related quality of life (OHRQoL) is a multidimensional indicator assessing the extent to which oral diseases impact on daily functioning, social, emotional and psychological well-being of the individuals [22].…”

Inequalities in oral health: Understanding the contributions of education and income

“…Income and education represent different domains of socio-economic position, where both play a role in the distribution of oral health in society. 30 In our study, the influence of material resources (income) consistently contributed to education inequalities in oral health. This suggests that access to material resources and social standing associated with income may be required in order to enable healthy lifestyle choices.…”

Validation of the Oral Hygiene Habits Scale: Relationships with sociodemographic variables in the general and clinical population of Monterrey, Mexico.

“…[1][2][3][4][5][6][7][8][9] Brushing two or more times a day with fluoride toothpaste has been found to reduce caries by 40%. A large amount of bacterial plaque is a strong predictor of caries, consequently, limited access to dental care and oral hygiene products results in greater severity of caries and periodontal disease.…”