Department of Behavioral and Community Dentistry, Institute of Odontology, Sahlgrenska Academy, University of Gothenburg, Göteborg,
Statistiska Konsultgruppen, Göteborg, Sweden.
Caries Res. 2019;53(1):96-106. doi: 10.1159/000489570. Epub 2018 Jul 12.
The objective was to investigate the variability in dental caries experience in Swedish children and adolescents, at two different area levels: dental clinics and SAMS (small areas for market statistics), with respect to multiple individual socioeconomic factors (SES). Records of manifest caries using the DMFT indices (decayed, missing, filled teeth, dependent variables) were collected from electronic dental records for 300,988 individuals aged 3-19 years (97.3% coverage) from the Region Västra Götaland, Sweden. SES data were obtained from official registers and covered ethnicity, wealth, parental education, and employment. The SES variables were used as an independent aggregated variable - an in dex - categorized in deciles. Age and gender were independently included in the multilevel models. Two-level logistic regression analyses explored the probability of a dental caries experience and the variability (intracluster correlation) within dental clinic areas and SAMS, respectively. The most deprived (10th decile, SAMS level) 3- to 6-year-old children had an OR of 5.00 (95% CI 4.61-5.43) for dental caries experience (deft), compared with children in the 1st to 5th deciles. For older children and adolescents (≥7 years), the corresponding OR (DFT) was 2.25 (95% CI 2.15-2.35). Small geographical areas explained more of the variance in caries experience compared with the more aggregated level dental clinics. SES was more strongly related to the risk of dental caries experience than age and gender. In conclusion, the associations between SES and dental caries experience in Swedish children and adolescents were strong in the study and strongest in young children at a low level.
目的在于研究在两个不同的区域层面（牙科诊所和 SAMS（市场统计小区域）），与多个个体社会经济因素（SES）相关的瑞典儿童和青少年龋齿经历的变异性。从瑞典西约塔兰地区收集了 300988 名 3-19 岁个体（覆盖率为 97.3%）的电子牙科记录中使用 DMFT 指数（龋齿、缺失、填补的牙齿，因变量）记录的明显龋齿的信息。SES 数据来自官方登记处，涵盖种族、财富、父母教育和就业情况。SES 变量被用作独立的聚合变量-指数-分为十分位数。年龄和性别分别独立包含在多水平模型中。两层逻辑回归分析分别探索了龋齿经历的可能性以及在牙科诊所区域和 SAMS 内的变异性（簇内相关）。最贫困（SAMS 水平的第 10 十分位数）的 3-6 岁儿童与第 1-5 十分位数的儿童相比，患龋齿（deft）的可能性 OR 为 5.00（95%CI 4.61-5.43）。对于年龄较大的儿童和青少年（≥7 岁），相应的 OR（DFT）为 2.25（95%CI 2.15-2.35）。与更聚合的牙科诊所水平相比，较小的地理区域可以更好地解释龋齿经历的变异性。SES 与龋齿经历的风险比年龄和性别更密切相关。总之，SES 与瑞典儿童和青少年龋齿经历之间的关联在研究中很强，在低 SES 水平的幼儿中最强。
