Cousins Kyle, David Conway, Bradshaw Paul, Sherriff Andrea
School of Medicine, Dentistry, and Nursing, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Scottish Centre for Social Research, Edinburgh, UK.
Community Dent Oral Epidemiol. 2025 Oct;53(5):556-563. doi: 10.1111/cdoe.13051. Epub 2025 Jun 10.
This study aimed to explore the longitudinal impact of changes in household income poverty and area-based socioeconomic deprivation on dental caries prevalence in early childhood.
Data from the Growing Up in Scotland (GUS) longitudinal study (2005/6-2009/10) were linked to dental caries experience data at age 5 from Scotland's National Dental Inspection Programme. Latent Class Analysis identified trajectories of household poverty (income below 60% of the national median) and area-based deprivation across multiple time points between birth and age 5. Cumulative exposure scores were also calculated, and modified Poisson regression assessed associations between socioeconomic pathways and caries experience in 2893 children.
Children living in persistent household poverty or in socioeconomically deprived areas had the highest caries experience risk compared to children never in poverty or deprivation. Elevated caries risk was also observed in children falling into poverty (aRR = 1.4; 95% CI = [1.1-1.8]) and escaping poverty (aRR = 1.6; 95% CI = [1.3-2.1]). Children moving into more deprived areas had higher caries risk (aRR = 1.6; 95% CI = [1.2-2.2]), while moving out of deprived areas did not increase risk (aRR = 1.1; 95% CI = [0.8-1.7]). Caries risk increased with years spent in household poverty and in deprived areas.
Unstable poverty and downward socioeconomic deprivation mobility were associated with greater caries risk in early childhood, underscoring the importance of considering the duration and persistence of socioeconomic disadvantage in relation to oral health outcomes and should inform early-years focused policies to address these. Longitudinal data linkage combining representative surveys and routine data is a powerful way to uncover these issues.
本研究旨在探讨家庭收入贫困和基于地区的社会经济剥夺变化对幼儿龋齿患病率的纵向影响。
苏格兰成长纵向研究（GUS，2005/6 - 2009/10）的数据与苏格兰国家牙科检查计划中5岁儿童的龋齿经历数据相关联。潜在类别分析确定了出生至5岁期间多个时间点的家庭贫困（收入低于全国中位数的60%）和基于地区的剥夺轨迹。还计算了累积暴露分数，并采用修正泊松回归评估了2893名儿童的社会经济途径与龋齿经历之间的关联。
与从未处于贫困或剥夺状态的儿童相比，生活在持续家庭贫困或社会经济剥夺地区的儿童患龋齿的风险最高。陷入贫困（aRR = 1.4；95% CI = [1.1 - 1.8]）和摆脱贫困（aRR = 1.6；95% CI = [1.3 - 2.1]）的儿童也观察到龋齿风险升高。迁入更贫困地区的儿童患龋齿风险更高（aRR = 1.6；95% CI = [1.2 - 2.2]），而迁出贫困地区则不会增加风险（aRR = 1.1；95% CI = [0.8 - 1.7]）。龋齿风险随着在家庭贫困和贫困地区度过的年数增加而增加。
不稳定的贫困和社会经济剥夺的向下流动性与幼儿更高的龋齿风险相关，强调了在考虑社会经济劣势的持续时间和持久性与口腔健康结果关系方面的重要性，并且应为关注早期的政策提供信息以解决这些问题。将代表性调查和常规数据相结合的纵向数据关联是揭示这些问题的有力方法。
