van der Tas Justin T, Kragt Lea, Veerkamp Jaap J S, Jaddoe Vincent W V, Moll Henriette A, Ongkosuwito Edwin M, Elfrink Marlies E C, Wolvius Eppo B
Department of The Generation R Study Group, Erasmus University Medical Centre, Rotterdam, The Netherlands.
Caries Res. 2016;50(5):489-497. doi: 10.1159/000448663. Epub 2016 Sep 6.
The aim of this study was to investigate potential differences in caries prevalence of children from ethnic minority groups compared to native Dutch children and the influence of socio-economic status (SES) and parent-reported oral health behaviour on this association. The study had a cross-sectional design, embedded in a population-based prospective multi-ethnic cohort study. 4,306 children with information on caries experience, belonging to 7 different ethnic groups, participated in this study. The decayed, missing, and filled teeth (dmft) index was assessed at the age of 6 and categorized in two ways for analysis: children without caries (dmft = 0) versus any caries experience (dmft >0) and children without caries (dmft = 0) versus children with mild caries (dmft = 1-3) or severe caries (dmft >3). Compared to native Dutch children, children with a Surinamese-Hindustani, Surinamese-Creole, Turkish, Moroccan, and Cape Verdean background had significantly higher odds for dental caries. Especially the Surinamese-Hindustani, Turkish, and Moroccan group had significantly higher odds for severe dental caries. Household income and educational level of the mother explained up to 43% of the association between ethnicity and dental caries, whereas parent-reported oral health behaviour did not mediate the association. Alarming disparities in caries prevalence between different ethnic (minority) groups exist, which cannot be fully explained by social inequalities. Public health strategies can apply this new knowledge and specifically focus on the reduction of ethnic disparities in oral health. More research is needed to explain the high caries prevalence among different ethnic minority groups.
本研究的目的是调查少数族裔儿童与荷兰本土儿童相比在龋齿患病率方面的潜在差异，以及社会经济地位（SES）和家长报告的口腔健康行为对这种关联的影响。该研究采用横断面设计，嵌入一项基于人群的前瞻性多族裔队列研究中。4306名有龋齿经历信息、分属7个不同族裔群体的儿童参与了本研究。在6岁时评估龋失补牙（dmft）指数，并以两种方式进行分类分析：无龋齿儿童（dmft = 0）与有任何龋齿经历的儿童（dmft >0），以及无龋齿儿童（dmft = 0）与有轻度龋齿（dmft = 1 - 3）或重度龋齿（dmft >3）的儿童。与荷兰本土儿童相比，有苏里南印度斯坦、苏里南克里奥尔、土耳其、摩洛哥和佛得角背景的儿童患龋齿的几率显著更高。尤其是苏里南印度斯坦、土耳其和摩洛哥群体患重度龋齿的几率显著更高。母亲的家庭收入和教育水平最多可解释种族与龋齿之间关联的43%，而家长报告的口腔健康行为并未介导这种关联。不同（少数）族裔群体之间在龋齿患病率方面存在惊人差异，社会不平等无法完全解释这些差异。公共卫生策略可以应用这一新知识，并特别关注减少口腔健康方面的种族差异。需要更多研究来解释不同少数族裔群体中龋齿患病率高的原因。
