Department of Behavioral and Community Dentistry, Institute of Odontology, Göteborg, Sweden.
Caries Res. 2018;52(1-2):42-50. doi: 10.1159/000481411. Epub 2017 Dec 14.
The study aimed to explore associations between multiple socioeconomic factors and dental caries experience in Swedish children and adolescents (3-19 years old). Electronic dental records from 300,988, in a Swedish region (97.3% coverage) were collected using the DMFT indices (decayed, missing, filled teeth: dependent variables). Socioeconomic status (SES) data (ethnicity, wealth, parental education, and employment) for individuals, parents, and families were obtained from official registers. Principal component analysis was used to explore SES data. Scores based on the first factor were used as an independent aggregated socioeconomic variable in logistic regression analyses. Dental caries experience was low in the participants: 16% in 3- to 6-year-olds (deft index: decayed, extracted, filled teeth) and 47% in 7- to 19-year-olds (DFT index). Both separate and aggregated socioeconomic variables were consistently associated with the dental caries experience irrespective of the caries index used: the crude odds ratio (OR) for having at least 1 caries lesion in 3- to 6-year-olds (deft index) in the lowest SES quintile was 3.26 (95% confidence interval [CI] 3.09-3.43) and in ≥7-year-olds (DFT index) OR 1.80 (95% CI 1.75-1.84) compared with children in the 4 higher SES quintiles. Overall, associations were stronger in the primary dentition than in the permanent dentition. Large SES models contributed more to explaining the caries experience than slim models including fewer SES indicators. In conclusion, socioeconomic factors were consistently associated with dental caries experience in the children and adolescents both as single factors and as multiple factors combined in an index. Socioeconomic inequalities had stronger associations to caries experience in young children than in older children and adolescents.
本研究旨在探讨多种社会经济因素与瑞典儿童和青少年(3-19 岁)龋齿经历之间的关系。使用 DMFT 指数(龋齿、缺失、填充的牙齿:因变量)从瑞典一个地区的 300,988 名电子牙科记录中收集数据(覆盖率为 97.3%)。个体、父母和家庭的社会经济地位(SES)数据(种族、财富、父母教育程度和就业状况)从官方登记处获得。采用主成分分析方法对 SES 数据进行分析。基于第一因子的得分被用作逻辑回归分析中独立的综合社会经济变量。参与者的龋齿经历较低:3-6 岁儿童中 16%(deft 指数:龋齿、拔除、填充的牙齿),7-19 岁儿童中 47%(DFT 指数)。无论使用何种龋齿指数,单独和综合的社会经济变量都与龋齿经历密切相关:最低 SES 五分位数组中至少有 1 个龋齿病变的 3-6 岁儿童(deft 指数)的粗比值比(OR)为 3.26(95%置信区间 [CI] 3.09-3.43),≥7 岁儿童(DFT 指数)的 OR 为 1.80(95% CI 1.75-1.84),与较高的 SES 五分位数组中的儿童相比。总体而言,在乳牙期的关联比在恒牙期更强。较大的 SES 模型比仅包含较少 SES 指标的苗条模型更有助于解释龋齿经历。总之,社会经济因素与儿童和青少年的龋齿经历密切相关,无论是作为单一因素还是作为综合指数中的多个因素。社会经济不平等与幼儿龋齿经历的关联比与较大儿童和青少年的关联更强。