Academic Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK.
College of Health Science, University of Bahrain, Manama, Kingdom of Bahrain.
Int Dent J. 2019 Apr;69(2):119-129. doi: 10.1111/idj.12420. Epub 2018 Aug 27.
To evaluate whether socioeconomic position exerts a mediating and/or moderating effect on the association between oral clinical measures and oral health-related quality of life (OHRQoL) in adolescents.
The study analysed data on 5,445 adolescents aged 15-19 years from the Brazilian Oral Health Survey (SBBrasil Project). The numbers of decayed and missing teeth, number of sextants with gingivitis and malocclusion were assessed through oral clinical examinations. Participant's age, sex, OHRQoL and socioeconomic position were also collected. Monthly family income was used to indicate the participant's socioeconomic position, and OHRQoL was assessed using the Oral Impacts on Daily Performance. Moderation was tested using Poisson regression models. Structural equation modelling and Sobel's test assessed the mediation effects.
Oral clinical measures, OHRQoL and socioeconomic position were significantly correlated (P < 0.001). The moderator effect of socioeconomic position on the association between all oral clinical measures and OHRQoL was observed. The impact of all oral clinical conditions on adolescents' OHRQoL was lower in the low-family-income groups compared with those with a better income. Socioeconomic position partially mediated the relationship between the four oral clinical measures and OHRQoL. Sobel's test confirmed these findings (P < 0.001).
The findings suggest the importance of socioeconomic position as a moderator and mediator factor between oral clinical measures and OHRQoL. Disadvantaged adolescents are likely to experience poor OHRQoL due to oral conditions. The reduction of the impact of oral conditions on quality of life in adolescents may be enhanced by addressing social inequalities related to oral health.
评估社会经济地位是否对口腔临床指标与青少年口腔健康相关生活质量（OHRQoL）之间的关联具有中介和/或调节作用。
本研究分析了来自巴西口腔健康调查（SBBrasil 项目）的 5445 名 15-19 岁青少年的数据。通过口腔临床检查评估龋齿和失牙数量、患有牙龈炎的六面区数量和错畸形数量。还收集了参与者的年龄、性别、OHRQoL 和社会经济地位。月家庭收入用于表示参与者的社会经济地位，使用日常活动口腔影响量表评估 OHRQoL。使用泊松回归模型检验调节作用。结构方程模型和 Sobel 检验评估中介效应。
口腔临床指标、OHRQoL 和社会经济地位之间存在显著相关性（P<0.001）。观察到社会经济地位对所有口腔临床指标与 OHRQoL 之间的关联具有调节作用。与收入较好的群体相比，低家庭收入群体中所有口腔临床状况对青少年 OHRQoL 的影响较低。社会经济地位部分中介了四项口腔临床指标与 OHRQoL 之间的关系。Sobel 检验证实了这些发现（P<0.001）。
这些发现表明社会经济地位作为口腔临床指标与 OHRQoL 之间的调节和中介因素的重要性。由于口腔状况，处境不利的青少年可能会经历较差的 OHRQoL。通过解决与口腔健康相关的社会不平等问题，可能会增强减少口腔状况对青少年生活质量的影响。
