Shi Congshi, Faris Peter, McNeil Deborah A, Patterson Steven, Potestio Melissa L, Thawer Salima, McLaren Lindsay
Department of Community Health Sciences, University of Calgary, TRW3, 3280 Hospital Dr. NW, Calgary, AB, T2N 4Z6, Canada.
Alberta Health Services, Calgary, AB, Canada.
BMC Oral Health. 2018 Jan 4;18(1):1. doi: 10.1186/s12903-017-0444-8.
Although oral health has improved remarkably in recent decades, not all populations have benefited equally. Ethnic identity, and in particular visible minority status, has been identified as an important risk factor for poor oral health. Canadian research on ethnic disparities in oral health is extremely limited. The aim of this study was to examine ethnic disparities in oral health outcomes and to assess the extent to which ethnic disparities could be accounted for by demographic, socioeconomic and caries-related behavioral factors, among a population-based sample of grade 1 and 2 schoolchildren (age range: 5-8 years) in Alberta, Canada.
A dental survey (administered during 2013-14) included a mouth examination and parent questionnaire. Oral health outcomes included: 1) percentage of children with dental caries; 2) number of decayed, extracted/missing (due to caries) and filled teeth; 3) percentage of children with two or more teeth with untreated caries; and 4) percentage of children with parental-ratings of fair or poor oral health. We used multivariable regression analysis to examine ethnic disparities in oral health, adjusting for demographic, socioeconomic and caries-related behavioral variables.
We observed significant ethnic disparities in children's oral health. Most visible minority groups, particularly Filipino and Arab, as well as Indigenous children, were more likely to have worse oral health than White populations. In particular, Filipino children had an almost 5-fold higher odds of having severe untreated dental problems (2 or more teeth with untreated caries) than White children. Adjustment for demographic, socioeconomic, and caries-related behavior variables attenuated but did not eliminate ethnic disparities in oral health, with the exception of Latin American children whose outcomes did not differ significantly from White populations after adjustment.
Significant ethnic disparities in oral health exist in Alberta, Canada, even when adjusting for demographic, socioeconomic and caries-related behavioral factors, with Filipino, Arab, and Indigenous children being the most affected.
尽管近几十年来口腔健康状况有了显著改善，但并非所有人群都能平等受益。种族身份，尤其是少数族裔身份，已被确定为口腔健康状况不佳的一个重要风险因素。加拿大有关口腔健康方面种族差异的研究极为有限。本研究的目的是在加拿大艾伯塔省以一年级和二年级学童（年龄范围：5至8岁）为基础的样本中，考察口腔健康结果方面的种族差异，并评估人口统计学、社会经济和与龋齿相关的行为因素在多大程度上可以解释种族差异。
一项牙科调查（于2013年至2014年期间进行）包括口腔检查和家长问卷。口腔健康结果包括：1）患龋齿儿童的百分比；2）龋坏、拔除/缺失（因龋齿）和补牙的牙齿数量；3）有两颗或更多颗牙齿患有未经治疗龋齿的儿童百分比；4）家长评定口腔健康为中等或较差的儿童百分比。我们使用多变量回归分析来考察口腔健康方面的种族差异，并对人口统计学、社会经济和与龋齿相关的行为变量进行了调整。
我们观察到儿童口腔健康方面存在显著的种族差异。大多数少数族裔群体，特别是菲律宾裔和阿拉伯裔，以及原住民儿童，其口腔健康状况比白人更差的可能性更大。特别是，菲律宾儿童患有严重未经治疗牙齿问题（两颗或更多颗牙齿患有未经治疗龋齿）的几率几乎是白人儿童的5倍。对人口统计学、社会经济和与龋齿相关的行为变量进行调整后，口腔健康方面的种族差异有所减弱，但并未消除，拉丁裔儿童是个例外，调整后其结果与白人没有显著差异。
在加拿大艾伯塔省，即使对人口统计学、社会经济和与龋齿相关的行为因素进行调整后，口腔健康方面仍存在显著的种族差异，受影响最大的是菲律宾裔、阿拉伯裔和原住民儿童。
