Department of Preventive Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
Department of General Dentistry, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China.
BMJ Open. 2017 Sep 24;7(9):e016557. doi: 10.1136/bmjopen-2017-016557.
As a vulnerable group, the elders' oral health gained less attention, particularly the relationship between socioeconomic status (SES) and dental caries. This study aimed to assess the associations and to explore the effects of confounders on the associations in elderly people.
Cross-sectional study.
3 neighbourhood committees and 3 village committees in Sichuan Province, China.
744 people (362 men and 382 women) aged 65-74 years were included.
Oral health outcomes included the decayed, missing and filled teeth (DMFT) index and its components. SES was assigned by educational level, household income and type of household. The bivariate association between the participants' characteristics and DMFT was analysed using non-parametric tests. Four logistic regression models were used to analyse the associations between SES and dental caries by regulating confounders.
Poor oral health was observed in these participants. Bivariate analysis showed a significant association between SES and DMFT (p﹤0.05). Only adjusting gender, high educational level (adjusted (AOR)=0.34, 95% CI 0.17 to 0.66), high household income (AOR=0.47, 95% CI 0.41 to 0.77) were protective factors against dental caries, and living in agricultural families (AOR=1.86, 95% CI 1.32 to 2.63) was risk factor (p﹤0.05). After adjusting other confounders, SES was partly related to the dental caries. Moreover, an interaction existed among SES indicators.
SES is associated with dental caries, and older people with low SES have poor oral health. The associations were explained partly by diet, behaviour and awareness. Our results provide effective evidence in targeted policy-making and intervention measures and implicate that pertinence measures, economic assistance and medical insurance funds should be provided to older people of low SES. Furthermore, a follow-up design should attempt to confirm the causal relationship between SES and dental caries and evaluate the effect of intervention.
老年人作为一个弱势群体，其口腔健康往往得不到足够的重视，尤其是社会经济地位（SES）与龋齿之间的关系。本研究旨在评估两者之间的关联，并探讨混杂因素对这种关联的影响。
横断面研究。
中国四川省的 3 个居委会和 3 个村委会。
纳入 744 名 65-74 岁的老年人（男 362 名，女 382 名）。
口腔健康结局包括龋失补（DMFT）指数及其组成部分。SES 由教育程度、家庭收入和家庭类型来确定。采用非参数检验分析参与者特征与 DMFT 之间的双变量关联。通过调节混杂因素，使用 4 个 logistic 回归模型分析 SES 与龋齿之间的关联。
这些参与者的口腔健康状况较差。双变量分析显示 SES 与 DMFT 之间存在显著关联（p﹤0.05）。仅调整性别、高教育程度（调整比值比（AOR）=0.34，95%置信区间（CI）0.17 至 0.66）、高家庭收入（AOR=0.47，95%CI 0.41 至 0.77）是龋齿的保护因素，而居住在农业家庭（AOR=1.86，95%CI 1.32 至 2.63）则是龋齿的危险因素（p﹤0.05）。调整其他混杂因素后，SES 与龋齿有一定关联。此外，SES 指标之间存在交互作用。
SES 与龋齿有关，SES 较低的老年人口腔健康状况较差。这些关联部分可以通过饮食、行为和意识来解释。我们的研究结果为有针对性的政策制定和干预措施提供了有效的证据，暗示应该为 SES 较低的老年人提供针对性措施、经济援助和医疗保险资金。此外，应采用随访设计来尝试确定 SES 与龋齿之间的因果关系，并评估干预措施的效果。
