Global Health and Society Unit, Department of Epidemiology and Preventive Medicine, Monash University, Level 3, Burnet Building, 89 Commercial Rd, Melbourne, Victoria 3004, Australia.
Int J Equity Health. 2013 Nov 14;12:89. doi: 10.1186/1475-9276-12-89.
The distribution and severity of dental caries among preschool children vary according to the socio-economic and ethnic differences within and between countries. Understanding socio-economic influences on child oral health could inform early interventions to reduce the oral health burden throughout the life-cycle. The aim of this study is to examine the socio-economic and ethnic influences on oral health among preschoolers in Kegalle, Sri Lanka.
The study involved 784 children aged between 48-72 months recruited from 84 pre-schools in the Kegalle district in Sri Lanka. Cross-sectional data were collected by means of an oral examination of the children and a self-administered questionnaire to their parents/caregivers. The Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess Oral Health related Quality of Life (OHQoL). Univariate and multivariate models of Poisson regression were used to investigate the associations between the variables.
Compared to children whose fathers had tertiary education, those whose fathers did not study beyond grade 5, had more caries measured in terms of decayed, missing and filled surfaces (dmfs) (IRR = 2.30; 95% CI: 1.30, 4.06; p < 0.01) and experienced poor OHQoL at child (IRR = 2.52; 95% CI: 1.20, 5.31; p < 0.05) and family (IRR = 1.59; 95% CI: 1.11, 2.27; p < 0.05) levels. However, lower educational attainment among mothers was associated with better OHQoL among children. Compared to the Sinhalese ethnic group, Tamils had more gingival bleeding (bleeding surfaces) (IRR = 3.04; 95% CI: 1.92, 4.81; p < 0.001) and poor OHQoL at child level (IRR = 2.07; 95% CI: 1.19, 3.60; p < 0.01), whereas Muslims had poor OHQoL at family level (IRR = 1.42; 95% CI: 1.10, 1.84; p < 0.01). Children of low-income families had more gum bleeding (IRR = 1.00; 95% CI: 0.99, 1.00; p < 0.05) compared to children of high-income families.
Socio-economic and ethnic differences in oral health outcomes exist among this population of preschoolers. Interventions targeting children of fathers with low educational levels and ethnic minority groups are required to reduce inequalities in oral health in Sri Lanka and other similar countries.
学龄前儿童的龋齿分布和严重程度因国家内部和国家之间的社会经济和种族差异而有所不同。了解社会经济因素对儿童口腔健康的影响，可以为减少整个生命周期的口腔健康负担提供早期干预措施。本研究旨在探讨科加勒地区学龄前儿童社会经济和种族因素对口腔健康的影响。
本研究涉及斯里兰卡科加勒地区 84 所幼儿园的 784 名 48-72 个月大的儿童。通过对儿童进行口腔检查和对其父母/照顾者进行自我管理问卷调查收集横断面数据。使用幼儿口腔健康影响量表（ECOHIS）评估口腔健康相关生活质量（OHQoL）。采用泊松回归的单变量和多变量模型来研究变量之间的关联。
与父亲接受过高等教育的儿童相比，那些父亲未接受过 5 年级以上教育的儿童，其龋齿严重程度（dmfs）更高（IRR=2.30；95%CI：1.30，4.06；p<0.01），并且儿童自身（IRR=2.52；95%CI：1.20，5.31；p<0.05）和家庭（IRR=1.59；95%CI：1.11，2.27；p<0.05）的 OHQoL 较差。然而，母亲教育程度较低与儿童的 OHQoL 较好有关。与僧伽罗族相比，泰米尔族儿童的牙龈出血（出血表面）更多（IRR=3.04；95%CI：1.92，4.81；p<0.001），并且儿童自身的 OHQoL 较差（IRR=2.07；95%CI：1.19，3.60；p<0.01），而穆斯林家庭的 OHQoL 较差（IRR=1.42；95%CI：1.10，1.84；p<0.01）。与高收入家庭的儿童相比，低收入家庭的儿童牙龈出血更多（IRR=1.00；95%CI：0.99，1.00；p<0.05）。
在该学龄前人群中，口腔健康结果存在社会经济和种族差异。需要针对教育程度低的父亲和少数民族群体的儿童开展干预措施，以减少斯里兰卡和其他类似国家的口腔健康不平等现象。
