Hariyani Ninuk, Setyowati Dini, Listl Stefan, Nair Rahul
Oral Health Prev Dent. 2023 Mar 15;21:77-82. doi: 10.3290/j.ohpd.b3956549.
Education is well-known as a determinant of oral health and dental behaviours in high-income countries, but much less is known for countries with lower incomes. This study aimed to identify the extent to which education affects oral health and dental behaviours in Indonesia.
This study used data from the Indonesian Basic Health Survey 2013. From this nationally representative sample of 945,057 people 5-100 years old, a series of mixed-effects Poisson regression models that accounted for sampling weights estimated the effect of educational attainment on edentulism, dental care utilisation, and toothbrushing behaviour.
Consistent educational gradients were found for all outcomes and across all model specifications. People without a formal educational degree had a 1.03 (95% CI: 1.03-1.04) times higher risk of not utilising any dental care, a 3.15 (95% CI: 2.47-4.02) times higher risk of being edentulous, and a 15.6 (95% CI: 12.76-19.02) times higher risk of having low toothbrushing frequency than people having a university degree or higher.
Stark and consistent educational gradients were observed in the dentate status, dental services utilisation, and toothbrushing in Indonesia. Educational inequalities were much larger for toothbrushing behaviours than for dental care utilisation. Intervention points for health policy should urgently prioritise public health interventions to promote overall educational attainment, preventive services, and dental care targeted at those with lower educational attainment.
在高收入国家，教育作为口腔健康和口腔行为的一个决定因素广为人知，但在低收入国家，人们对此了解较少。本研究旨在确定教育在多大程度上影响印度尼西亚的口腔健康和口腔行为。
本研究使用了2013年印度尼西亚基本健康调查的数据。从这个全国代表性的945,057名5至100岁人群的样本中，一系列考虑抽样权重的混合效应泊松回归模型估计了教育程度对无牙状态、牙科护理利用和刷牙行为的影响。
在所有结果和所有模型规格中均发现了一致的教育梯度。未获得正规教育学位的人不使用任何牙科护理的风险比拥有大学学位或更高学历的人高1.03（95%可信区间：1.03 - 1.04）倍，无牙的风险高3.15（95%可信区间：2.47 - 4.02）倍，刷牙频率低的风险高15.6（95%可信区间：12.76 - 19.02）倍。
在印度尼西亚的牙齿状况、牙科服务利用和刷牙方面观察到了明显且一致的教育梯度。刷牙行为方面的教育不平等比牙科护理利用方面的更大。卫生政策的干预点应紧急优先考虑公共卫生干预措施，以提高整体教育程度、推广预防性服务以及针对低教育程度人群的牙科护理。
