Exploring socioeconomic inequality in caries experience in an adult Norwegian population; the HUNT4 Oral Health Study.
DMFT
HUNT
adults
dental caries experience
epidemiology
socioeconomic inequality
Journal
Community dentistry and oral epidemiology
ISSN: 1600-0528
Titre abrégé: Community Dent Oral Epidemiol
Pays: Denmark
ID NLM: 0410263
Informations de publication
Date de publication:
02 Apr 2024
02 Apr 2024
Historique:
revised:
12
01
2024
received:
04
09
2023
accepted:
18
03
2024
medline:
3
4
2024
pubmed:
3
4
2024
entrez:
3
4
2024
Statut:
aheadofprint
Résumé
To investigate socioeconomic inequality in caries experience in an adult Norwegian population. This population-based study included 4549 dentate participants aged 25-94 years from the cross-sectional HUNT4 Oral Health Study conducted in Central Norway in 2017-2019. Participants were randomly sampled from the larger HUNT4 Survey and answered questionnaires and underwent clinical and radiographic examinations. Caries experience was measured as numbers of decayed, missing and filled teeth (DMFT index) and socioeconomic position was denoted by education and household income. Negative binomial regression models were used to estimate associations between caries experience and socioeconomic position. Lower levels of both education and income were associated with higher caries experience, particularly pronounced for missing teeth. Socioeconomic gradients were observed for all outcomes DMFT, DT, MT and FT (p-value linear trends <.001). Gradients were similar for both income and education and were apparent for all age groups but were most evident in middle-aged and older individuals. High level of education was associated with a 50% lower mean number of missing teeth compared with basic level education, whereas high income was associated with a 24% lower mean number of decayed teeth and a 15% higher mean number of filled teeth than low income. There was a socioeconomic gradient for caries experience in the study population that was present from early adulthood and increased with age. The gradient was particularly pronounced for missing teeth. Findings indicate that inequality was more associated with treatment given than with untreated disease.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.
Références
Schwendicke F, Dorfer CE, Schlattmann P, Foster Page L, Thomson WM, Paris S. Socioeconomic inequality and caries: a systematic review and meta‐analysis. J Dent Res. 2015;94(1):10‐18.
Costa SM, Martins CC, Pinto MQC, Vasconcelos M, Abreu M. Socioeconomic factors and caries in people between 19 and 60 years of age: an update of a systematic review and meta‐analysis of observational studies. Int J Environ Res Public Health. 2018;15(8):1775.
Cianetti S, Valenti C, Orso M, et al. Systematic review of the literature on dental caries and periodontal disease in socio‐economically disadvantaged individuals. Int J Environ Res Public Health. 2021;18(23):12360.
Bambra C, Riordan R, Ford J, Matthews F. The COVID‐19 pandemic and health inequalities. J Epidemiol Community Health. 2020;74(11):964‐968.
WHO Global Oral Health Strategy. 2022; https://apps.who.int/gb/ebwha/pdf_files/WHA75/A75_10Add1‐en.pdf.
Singh A, Peres MA, Watt RG. The relationship between income and Oral health: a critical review. J Dent Res. 2019;98(8):853‐860.
Sabbah W, Tsakos G, Sheiham A, Watt RG. The role of health‐related behaviors in the socioeconomic disparities in oral health. Soc Sci Med. 2009;68(2):298‐303.
Guarnizo‐Herreno CC, Watt RG, Garzon‐Orjuela N, Tsakos G. Explaining oral health inequalities in European welfare state regimes: the role of health behaviours. Community Dent Oral Epidemiol. 2019;47(1):40‐48.
Oscarson N, Espelid I, Jonsson B. Is caries equally distributed in adults? A population‐based cross‐sectional study in Norway—the TOHNN‐study. Acta Odontol Scand. 2017;75(8):557‐563.
Holst D, Schuller AA. Equality in adults' oral health in Norway. Cohort and cross‐sectional results over 33 years. Community Dent Oral Epidemiol. 2011;39(6):488‐497.
Skudutyte‐Rysstad R, Sandvik L, Aleksejuniene J, Eriksen HM. Dental health and disease determinants among 35‐year‐olds in Oslo, Norway. Acta Odontol Scand. 2009;67(1):50‐56.
Lyshol H, Grøtvedt L, Fagerhaug TN, Feuerherm AJ, Jakhelln G, Sen A. A study of socio‐economic inequalities in self‐reported oral and general health in south‐East Norway. Sci Rep. 2022;12(1):13721.
Jiang N, Grytten J, Kinge JM. Inequality in access to dental services in a market‐based dental care system: a population study from Norway 1975‐2018. Community Dent Oral Epidemiol. 2022;50(6):548‐558.
Grytten J, Skau I. Do patients with more education receive more subsidized dental care? Evidence from a natural experiment using the Introduction of a school reform in Norway as an instrumental variable. Med Care. 2018;56(10):877‐882.
Vikum E, Krokstad S, Holst D, Westin S. Socioeconomic inequalities in dental services utilisation in a Norwegian county: the third Nord‐Trondelag health survey. Scand J Public Health. 2012;40(7):648‐655.
Holst D. Oral health equality during 30 years in Norway. Community Dent Oral Epidemiol. 2008;36(4):326‐334.
Haugejorden O, Klock KS, Åstrøm AN, Skaret E, Trovik TA. Socio‐economic inequality in the self‐reported number of natural teeth among Norwegian adults ‐ an analytical study. Community Dent Oral Epidemiol. 2008;36(3):269‐278.
UCL/NTNU. Rapid review of inequalities in health and wellbeing in Norway since 2014. UCL Institute of Health Equity and Norwegian University of Science and Technology (NTNU). 2023 Accessed August 2023: https://www.instituteofhealthequity.org/resources‐reports/rapid‐review‐of‐inequalities‐in‐health‐and‐wellbeing‐in‐norway‐since‐2014
The Gini index Norway, The World Bank. 2023. Accessed August 2023 Website. https://data.worldbank.org/indicator/SI.POV.GINI?locations=NO.
Rødseth SC, Høvik H, Schuller AA, Bjertness E, Skudutyte‐Rysstad R. Dental caries in a Norwegian adult population, the HUNT4 oral health study; prevalence, distribution and 45‐year trends. Acta Odontol Scand. 2022;81:1‐9.
Åsvold BO, Langhammer A, Rehn TA, et al. Cohort profile update: the HUNT study, Norway. Int J Epidemiol. 2022;52(1):1‐12.
Amarante E, Raadal M, Espelid I. Impact of diagnostic criteria on the prevalence of dental caries in Norwegian children aged 5, 12 and 18 years. Community Dent Oral Epidemiol. 1998;26(2):87‐94.
Pitts N. Detection, Assessment, Diagnosis and Monitoring of Caries. Vol 21. Karger; 2009.
Fekedulegn D, Andrew M, Violanti J, Hartley T, Charles L, Burchfiel C. Comparison of statistical approaches to evaluate factors associated with metabolic syndrome. J Clin Hypertens (Greenwich). 2010;12(5):365‐373.
Textor J, van der Zander B, Gilthorpe MS, Liśkiewicz M, Ellison GTH. Robust causal inference using directed acyclic graphs: the R package ‘dagitty’. Int J Epidemiol. 2016;45(6):1887‐1894.
STROBE guidelines. Accessed March 2023 Website https://www.strobe‐statement.org/
Geyer S, Schneller T, Micheelis W. Social gradients and cumulative effects of income and education on dental health in the fourth German oral health study. Community Dent Oral Epidemiol. 2010;38(2):120‐128.
Steele J, Shen J, Tsakos G, et al. The interplay between socioeconomic inequalities and clinical oral health. J Dent Res. 2015;94(1):19‐26.
Mejia G, Jamieson LM, Ha D, Spencer AJ. Greater inequalities in dental treatment than in disease experience. J Dent Res. 2014;93(10):966‐971.
Mejia GC, Elani HW, Harper S, et al. Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States. BMC Oral Health. 2018;18(1):176.
Borgeat Meza M, Espinoza I, Carvajal P, Cuevas R. Changes in oral health inequalities in adults in Chile. Community Dent Oral Epidemiol. 2022;50(6):506‐512.
Edman K, Öhrn K, Nordström B, Holmlund A. Prevalence of dental caries and influencing factors, time trends over a 30‐year period in an adult population. Epidemiological studies between 1983 and 2013 in the county of Dalarna, Sweden. Acta Odontol Scand. 2016;74(5):385‐392.
Guarnizo‐Herreño CC, Watt RG, Pikhart H, Sheiham A, Tsakos G. Socioeconomic inequalities in oral health in different European welfare state regimes. J Epidemiol Community Health. 2013;67(9):728‐735.
Mackenbach JP. The persistence of health inequalities in modern welfare states: the explanation of a paradox. Soc Sci Med. 2012;75(4):761‐769.
Statistics Norway. Social inequality in use of health services ‐ 2 (in Norwegian). 2021 Accessed May 2023. https://www.ssb.no/helse/helsetjenester/artikler/sosial‐ulikhet‐i‐bruk‐av‐helsetjenester‐‐2/_/attachment/inline/000f4984‐ed11‐42d3‐b5cb‐ba9f3ce43847:29074da6c77dc56a92e1780ded59ccb2a973ff19/RAPP2021‐23_web.pdf