Ju Xiangqun, Luzzi Liana, Chrisopoulos Sergio, Mejia Gloria C, Jamieson Lisa M
Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.
Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia.
Int Dent J. 2025 Aug 23;75(5):103860. doi: 10.1016/j.identj.2025.103860.
In contemporary society, social inequality in tooth loss is a significant and often overlooked issue. This study aimed to describe and examine social differentials in tooth loss among Australian adults over time.
This analysis used data from the National Survey of Adult Oral Health (NSAOH), which was conducted in Australia in 2 waves: NSAOH-1 (2004-2006) and NSAOH-2 (2017-2018). The study employed a population-based cross-sectional design, with adults aged 15 years and older randomly selected using a 3-stage, stratified sampling method across metropolitan and regional areas in each state and territory. The primary outcomes were self-reported edentulism and non-functional dentition (<21 teeth). Explanatory variables included socioeconomic status, assessed using equivalized household income and grouped into approximate quartiles from lowest to highest, along with sociodemographic factors, CALD (Culturally and Linguistically Diverse) status, and oral health-related behaviour. Unadjusted and adjusted absolute prevalence differences (PDs) were calculated to assess income-related inequality. Adjustments were made for age and sex using the average covariate distribution across all income groups.
Data were available for 14,123 participants in NSAOH-1 and 15,731 participants in NSAOH-2. The prevalence of edentulism declined from 6.4% to 4.0%, and non-functional dentition decreased from 17.1% to 13.8% over time. These reductions were observed across all household income quartiles, with lower prevalence rates for both conditions in NSAOH-2 compared to NSAOH-1. The adjusted model showed that the prevalence decreases were most marked for the lowest household income group, from 15.3 to 6.5 (PD = 8.8, 95% CI: 8.3-9.4) for edentulism and from 35.0 to 21.3 (PD = 13.7, 95% CI: 13.4-14.0) for non-functional dentition.
Our study indicated social inequalities in both edentulism and non-functional dentition among Australian adults over time. Age, sex, place of residence, irregular dental visits, and lack of dental insurance were important factors associated with tooth loss.
在当代社会，牙齿缺失方面的社会不平等是一个重大且常常被忽视的问题。本研究旨在描述和考察澳大利亚成年人牙齿缺失情况随时间变化的社会差异。
本分析使用了澳大利亚全国成人口腔健康调查（NSAOH）的数据，该调查分两波进行：NSAOH - 1（2004 - 2006年）和NSAOH - 2（2017 - 2018年）。该研究采用基于人群的横断面设计，15岁及以上成年人通过三阶段分层抽样方法在每个州和领地的大都市和地区随机选取。主要结局指标为自我报告的无牙状态和无功能牙列（牙齿少于21颗）。解释变量包括社会经济地位，用等效家庭收入评估并从最低到最高分为近似四分位数，以及社会人口学因素、文化和语言多样化（CALD）状态和口腔健康相关行为。计算未调整和调整后的绝对患病率差异（PDs）以评估与收入相关的不平等。使用所有收入组的平均协变量分布对年龄和性别进行调整。
NSAOH - 1有14,123名参与者的数据可用，NSAOH - 2有15,731名参与者的数据可用。随着时间推移，无牙状态患病率从6.4%降至4.0%，无功能牙列患病率从17.1%降至13.8%。在所有家庭收入四分位数中均观察到这些下降，与NSAOH - 1相比，NSAOH - 2中这两种情况的患病率均较低。调整后的模型显示患病率下降在最低家庭收入组最为明显，无牙状态从15.3降至6.5（PD = 8.8，95% CI：8.3 - 9.4），无功能牙列从35.0降至21.3（PD = 13.7, 95% CI：13.4 - 14.0）。
我们的研究表明，随着时间推移，澳大利亚成年人在无牙状态和无功能牙列方面均存在社会不平等。年龄、性别、居住地点、不定期看牙和缺乏牙科保险是与牙齿缺失相关的重要因素。
