Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States

Abstract

BackgroundSocioeconomic inequalities are associated with oral health status, either subjectively (self-rated oral health) or objectively (clinically-diagnosed dental diseases). The aim of this study is to compare the magnitude of socioeconomic inequality in oral health and dental disease among adults in Australia, Canada, New Zealand and the United States (US).MethodsNationally-representative survey examination data were used to calculate adjusted absolute differences (AD) in prevalence of untreated decay and fair/poor self-rated oral health (SROH) in income and education. We pooled age- and gender-adjusted inequality estimates using random effects meta-analysis.ResultsNew Zealand demonstrated the highest adjusted estimate for untreated decay; the US showed the highest adjusted prevalence of fair/poor SROH. The meta-analysis showed little heterogeneity across countries for the prevalence of decayed teeth; the pooled ADs were 19.7 (95% CI = 16.7–22.7) and 12.0 (95% CI = 8.4–15.7) between highest and lowest education and income groups, respectively. There was heterogeneity in the mean number of decayed teeth and in fair/poor SROH. New Zealand had the widest inequality in decay (education AD = 0.8; 95% CI = 0.4–1.2; income AD = 1.0; 95% CI = 0.5–1.5) and the US the widest inequality in fair/poor SROH (education AD = 40.4; 95% CI = 35.2–45.5; income AD = 20.5; 95% CI = 13.0–27.9).ConclusionsThe differences in estimates, and variation in the magnitude of inequality, suggest the need for further examining socio-cultural and contextual determinants of oral health and dental disease in both the included and other countries.

Self-Reported Oral Health, Oral Hygiene and Associated Factors in Lithuanian Adult Population, 1994–2014

“…A lot of studies revealed that the prevalence of oral diseases is associated with socioeconomic status [7,9,33]. Education is the most common indicator used for the evaluation of socioeconomic differences in oral health.…”

“…Socioeconomic factors are associated with oral health status. Individuals from lower income and education groups experienced poorer oral health and a higher burden of untreated oral diseases [ 7 , 8 , 9 ]. Socioeconomic differences in oral health may be related to differences in access to dental care because in many countries, a high proportion of dental care expenditure is out-of-pocket payments.…”

Demonstration of high value care to improve oral health of a remote Indigenous community in Australia

“…Similar to other countries, the prevalence of caries lesions in Australia shows a consistent social pattern [4]. Low socioeconomic factors and specific geographical areas have a strong association with high rates of dental caries, thereby increasing the plight of Indigenous children [3,[5][6][7]. Lack of water fluoridation is cited as part of the explanation for the high caries experience observed in children living in remote Indigenous communities [8].…”

Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry

“…Many factors impact caries risk, including saliva flow and composition, diet and nutrition, parental education, socioeconomics, age at transmission and acquisition of cariogenic species, oral hygiene, fluoride exposure, tooth anatomy, and enamel composition. [358][359][360][361][362][363][364][365][366][367][368] The tridimensional crystal structure of dental enamel is nonhomogeneous, differs between individuals, differs from tooth to tooth, and differs from site to site on the same tooth, thus influencing acid sensitivity. Furthermore, host genetics plays a determinant role.…”