人生历程中的社会流动、种族与成年后的牙齿缺失：牙科保健服务的作用。

Life course social mobility, race and tooth loss in adulthood: The role of dental health services.

机构信息

Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.

Department of Public Health, Federal University of Santa Catarina, Florianópolis, Brazil.

出版信息

Oral Dis. 2024 Oct;30(7):4782-4791. doi: 10.1111/odi.14918. Epub 2024 Mar 4.

DOI:10.1111/odi.14918

PMID:38438701

Abstract

OBJECTIVES

To evaluate the extent to which dental care factors in adulthood modify and, at the same time, mediate the association between race/ethnicity and social mobility from childhood to adulthood with two oral health outcomes in adults.

METHODS

In 2012, 1222 individuals 20-59 years old participated in the second wave of the Epi-Floripa Study in Florianopolis, Brazil. Exposures included social mobility based on adulthood and childhood events, dental care in previous years, type of dental care coverage, reason for dental visits and race. The number of missing and decayed teeth were dichotomised as MT >0 and DT >0.

RESULTS

The prevalence of missing and decayed teeth was 61.9% and 23.0%, respectively. Age-sex adjusted inequalities in decayed and missing teeth among Black and White individuals were 41.2 percentage points (pp) (95% CI: 3.9-78.7) and 53.1 pp (19.5:86.7), respectively. Inequalities between those persistently higher and lower in socioeconomic position were 42.6 pp (14.6-70.7) and 90.0 pp (62.1-100). The Relative Excess of Risk due to Interaction (RERI) was not statistically significant (p < 0.05). Oaxaca-Blinder decomposition analyses showed that dental care variables accounted for a small proportion of inequalities.

CONCLUSIONS

This result implies that dental care is unlikely to significantly reduce or increase oral health inequalities in this particular population.

摘要

目的

评估成年后的口腔保健因素在多大程度上改变了，并同时调节了种族/民族与儿童期到成年期的社会流动性之间的关联，以及这一关联与两个成年人的口腔健康结果之间的关联。

方法

2012 年，1222 名 20-59 岁的个体参加了巴西弗洛里亚诺波利斯的 Epi-Floripa 研究的第二波调查。暴露因素包括基于成年期和儿童期事件的社会流动性、前几年的口腔保健、口腔保健覆盖类型、看牙原因和种族。缺失牙和龋齿的数量被分为 MT>0 和 DT>0。

结果

缺失牙和龋齿的患病率分别为 61.9%和 23.0%。在年龄和性别调整后，黑人和白人在龋齿和缺失牙方面的不平等程度分别为 41.2 个百分点（95%CI：3.9-78.7）和 53.1 个百分点（19.5-86.7）。社会经济地位始终较高和较低的个体之间的不平等程度分别为 42.6 个百分点（14.6-70.7）和 90.0 个百分点（62.1-100）。交互的相对超额风险（RERI）不具有统计学意义（p<0.05）。Oaxaca-Blinder 分解分析表明，口腔保健变量只解释了不平等现象的一小部分。