Arora Garima, Mackay Daniel F, Conway David I, Pell Jill P
Institute of Health and Wellbeing, University of Glasgow, 1 Lilybank Gardens, Glasgow, G12 8RZ, UK.
Dental School, University of Glasgow, 378 Sauchiehall Street, Glasgow, G2 3JZ, UK.
BMC Oral Health. 2016 Jun 16;17(1):1. doi: 10.1186/s12903-016-0228-6.
Oral health impacts on general health and quality of life, and oral diseases are the most common non-communicable diseases worldwide. Non-White ethnic groups account for an increasing proportion of the UK population. This study explores whether there are ethnic differences in oral health and whether these are explained by differences in sociodemographic or lifestyle factors, or use of dental services.
We used the Adult Dental Health Survey 2009 to conduct a cross-sectional study of the adult general population in England, Wales and Northern Ireland. Ethnic groups were compared in terms of oral health, lifestyle and use of dental services. Logistic regression analyses were used to determine whether ethnic differences in fillings, extractions and missing teeth persisted after adjustment for potential sociodemographic confounders and whether they were explained by lifestyle or dental service mediators.
The study comprised 10,435 (94.6 %) White, 272 (2.5 %) Indian, 165 (1.5 %) Pakistani/Bangladeshi and 187 (1.7 %) Black participants. After adjusting for confounders, South Asian participants were significantly less likely, than White, to have fillings (Indian adjusted OR 0.25, 95 % CI 0.17-0.37; Pakistani/Bangladeshi adjusted OR 0.43, 95 % CI 0.26-0.69), dental extractions (Indian adjusted OR 0.33, 95 % CI 0.23-0.47; Pakistani/Bangladeshi adjusted OR 0.41, 95 % CI 0.26-0.63), and <20 teeth (Indian adjusted OR 0.31, 95 % CI 0.16-0.59; Pakistani/Bangladeshi adjusted OR 0.22, 95 % CI 0.08-0.57). They attended the dentist less frequently and were more likely to add sugar to hot drinks, but were significantly less likely to consume sweets and cakes. Adjustment for these attenuated the differences but they remained significant. Black participants had reduced risk of all outcomes but after adjustment for lifestyle the difference in fillings was attenuated, and extractions and tooth loss became non-significant.
Contrary to most health inequalities, oral health was better among non-White groups, in spite of lower use of dental services. The differences could be partially explained by reported differences in dietary sugar.
口腔健康影响总体健康和生活质量，口腔疾病是全球最常见的非传染性疾病。非白人族裔在英国人口中所占比例日益增加。本研究探讨口腔健康方面是否存在种族差异，以及这些差异是否可由社会人口统计学或生活方式因素的差异，或牙科服务的使用情况来解释。
我们利用2009年成人牙科健康调查对英格兰、威尔士和北爱尔兰的成年普通人群进行了一项横断面研究。比较了不同种族在口腔健康、生活方式和牙科服务使用方面的情况。采用逻辑回归分析来确定在对潜在的社会人口统计学混杂因素进行调整后，补牙、拔牙和缺牙方面的种族差异是否仍然存在，以及这些差异是否可由生活方式或牙科服务中介因素来解释。
该研究包括10435名（94.6%）白人、272名（2.5%）印度人、165名（1.5%）巴基斯坦/孟加拉裔和187名（1.7%）黑人参与者。在对混杂因素进行调整后，南亚参与者补牙的可能性显著低于白人（印度人调整后的比值比为0.25，95%置信区间为0.17 - 0.37；巴基斯坦/孟加拉裔调整后的比值比为0.43，95%置信区间为0.26 - 0.69），拔牙的可能性也较低（印度人调整后的比值比为0.33，95%置信区间为0.23 - 0.47；巴基斯坦/孟加拉裔调整后的比值比为0.41，95%置信区间为0.26 - 0.63），牙齿少于20颗的可能性也较低（印度人调整后的比值比为0.31，95%置信区间为0.16 - 0.59；巴基斯坦/孟加拉裔调整后的比值比为0.22，95%置信区间为0.08 - 0.57）。他们看牙医的频率较低，更有可能往热饮中加糖，但食用糖果和蛋糕的可能性显著较低。对这些因素进行调整后，差异有所减弱，但仍然显著。黑人参与者所有结果的风险都降低了，但在对生活方式进行调整后，补牙方面的差异减弱，拔牙和牙齿缺失变得不显著。
与大多数健康不平等情况相反，尽管牙科服务使用较少，但非白人群体的口腔健康状况更好。这些差异可能部分由报告的饮食糖分差异来解释。
