Brennan David Simon, Spencer A John
Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, SA, Australia.
Community Dent Oral Epidemiol. 2015 Jun;43(3):262-71. doi: 10.1111/cdoe.12150. Epub 2015 Feb 2.
To assess income-based life-course models between the age of 13 and 30 years and caries in young adults.
In 1988-89, n = 7673 South Australian school children aged 13 years were sampled with n = 4604 children (60.0%) and n = 4476 parents (58.3%) returning questionnaires. In 2005-06, n = 632 baseline study participants aged 30 years responded (43.0% of those traced and living in Adelaide). Life-course models representing critical period, cumulative risk and social mobility were constructed using income tertiles at ages 13 and 30 years. Critical period was evaluated by comparing the low tertile with the middle and higher tertiles at age 13. Cumulative risk was evaluated by coding the low tertile as 2, the middle tertile as 1 and highest tertile as 0, and summing to produce a cumulative risk score categorized into lower (score 0-1), moderate (score of 2) and higher risk (scores 3-4). Social mobility was classified using tertiles into stable disadvantaged, downwardly mobile, stable middle income, upwardly mobile and stable advantaged.
Models adjusting for sex, visiting and toothbrushing at age 30 showed no association between caries at age 30 and low income at age 13 years (critical period model). Compared to the low cumulative risk group based on income, decayed teeth (RR = 1.6) and missing teeth (RR = 7.2) were higher (P < 0.05) in the higher risk group, and missing teeth (RR = 6.0) were higher in the moderate risk group (cumulative risk model). There were more (P < 0.05) decayed teeth in the disadvantaged (RR = 3.1) and stable middle income groups (RR = 2.2), more missing teeth for those classified as disadvantaged (RR = 6.4), stable middle (RR = 6.3) and downwardly mobile (RR = 2.8), and higher DMFT for the disadvantaged group (RR = 1.5) compared to the upwardly mobile group (social mobility model).
Socioeconomic advantage and upward mobility were associated with fewer decayed and missing teeth at age 30 years. Life-course models of cumulative risk and social mobility influenced oral health outcomes across childhood to adulthood.
评估13至30岁基于收入的生命历程模型与年轻成年人龋齿情况之间的关系。
在1988 - 1989年，对7673名南澳大利亚州13岁的在校儿童进行抽样，4604名儿童（60.0%）和4476名家长（58.3%）返回了问卷。在2005 - 2006年，632名30岁的基线研究参与者做出了回应（占追踪到并居住在阿德莱德者的43.0%）。使用13岁和30岁时的收入三分位数构建了代表关键期、累积风险和社会流动性的生命历程模型。通过比较13岁时低三分位数与中、高三分位数来评估关键期。通过将低三分位数编码为2、中三分位数编码为1、高三分位数编码为0，并求和得出累积风险分数，将其分为低风险（分数0 - 1）、中度风险（分数为2）和高风险（分数3 - 4）来评估累积风险。使用三分位数将社会流动性分为稳定劣势、向下流动、稳定中等收入、向上流动和稳定优势。
对30岁时的性别、看牙和刷牙情况进行调整后的模型显示，30岁时的龋齿与13岁时的低收入之间无关联（关键期模型）。与基于收入的低累积风险组相比，高风险组的龋坏牙（RR = 1.6）和缺失牙（RR = 7.2）更多（P < 0.05），中度风险组的缺失牙（RR = 6.0）更多（累积风险模型）。劣势组（RR = 3.1）和稳定中等收入组（RR = 2.2）的龋坏牙更多（P < 0.05），被归类为劣势组（RR = 6.4）、稳定中等收入组（RR = 6.3）和向下流动组（RR = 2.8）的缺失牙更多，与向上流动组相比，劣势组的龋失补牙指数（DMFT）更高（RR = 1.5）（社会流动性模型）。
社会经济优势和向上流动与30岁时较少的龋坏牙和缺失牙相关。累积风险和社会流动性的生命历程模型影响了从儿童期到成年期的口腔健康结果。
