Department of Prosthodontics, Gerodontology and Dental Materials, Center of Oral Health, University of Greifswald, Rotgerberstraße 8, Greifswald,Germany.
Community Dent Oral Epidemiol. 2011 Oct;39(5):398-408. doi: 10.1111/j.1600-0528.2010.00607.x. Epub 2011 Jan 17.
Individual impact and the effect magnitude of socioeconomic key indicators (income, education and occupation) and of gender on oral health are ambiguous. In primary analyses of cross-sectional data among participants of the Study of Health in Pomerania (north-east Germany), women with low school education and low income were at highest risk for missing teeth, whereas being single was a risk indicator for missing teeth in men. Using the 5-year follow-up of this study, we aimed at verifying these findings and at investigating the gender-dependent impact of key socioeconomic indicators on tooth loss.
The longitudinal data originate from 1971 subjects (1062 women) aged 25-59 enrolled from 1997 to 2001 and again from 2002 to 2006. The effects of marital status, household income, school education and occupational prestige for tooth loss were examined by gender using negative binomial regression analyses.
Low education and low income were moderately [relative risks (RR) between 1.6 and 2.0] associated with tooth loss among both women and men, whereas occupational prestige was not. After multiple imputations of missing data, less-educated women with lower income exhibited the highest risk of tooth loss [RR=3.1; 95% confidence interval (CI)=1.7-5.5 for <10 years of school education and the lowest income tertile] and tooth loss was more likely in single men (RR=1.5; 95% CI=1.0-2.2) than in single women (RR=0.9; 95% CI=0.6-1.3).
The primary cross-sectional results were partly confirmed. Socioeconomic factors help to explain differences in tooth loss, although the causal pathways are speculative. To improve dental health, the policies should target not only the individual, e.g. oral health promotion, but also an entire population by better education and higher wage employment.
社会经济关键指标（收入、教育和职业）以及性别对口腔健康的个体影响和影响程度尚不清楚。在对德国东北部波罗的海地区健康研究（Study of Health in Pomerania）参与者的横断面数据进行的初步分析中，受教育程度低且收入低的女性缺牙风险最高，而单身是男性缺牙的风险指标。利用该研究的 5 年随访数据，我们旨在验证这些发现，并调查关键社会经济指标对牙齿缺失的性别依赖性影响。
纵向数据来自 1997 年至 2001 年和 2002 年至 2006 年期间登记的 1971 名 25-59 岁的参与者（女性 1062 人）。使用负二项回归分析，按性别检查婚姻状况、家庭收入、学校教育和职业声望对牙齿缺失的影响。
低教育和低收入与女性和男性的牙齿缺失中度相关（相对风险 [RR] 在 1.6 到 2.0 之间），而职业声望则没有。在对缺失数据进行多次插补后，受教育程度较低且收入较低的女性牙齿缺失风险最高[RR=3.1；95%置信区间（CI）=1.7-5.5，对于受教育年限不足 10 年且收入最低的三分之一人群]，单身男性牙齿缺失的可能性高于单身女性（RR=1.5；95%CI=1.0-2.2 比 RR=0.9；95%CI=0.6-1.3）。
初步的横断面结果得到了部分证实。社会经济因素有助于解释牙齿缺失的差异，尽管因果关系尚不确定。为了改善口腔健康，政策不仅应针对个人，例如口腔健康促进，还应通过更好的教育和更高的工资就业来针对整个人群。
