Justin T van der Tas1, Lea Kragt2, Marlies E C Elfrink3, Loes C M Bertens4, Vincent W V Jaddoe5, Henriëtte A Moll6, Edwin M Ongkosuwito7, Eppo B Wolvius8. 1. The Generation R Study Group, ErasmusMC University Medical Center Rotterdam, The Netherlands; Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, ErasmusMC University Medical Center Rotterdam, The Netherlands. Electronic address: j.vandertas@erasmusmc.nl. 2. The Generation R Study Group, ErasmusMC University Medical Center Rotterdam, The Netherlands; Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, ErasmusMC University Medical Center Rotterdam, The Netherlands. Electronic address: l.kragt@erasmusmc.nl. 3. Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, ErasmusMC University Medical Center Rotterdam, The Netherlands. Electronic address: marlieselfrink@gmail.com. 4. Department of Obstetrics and Gynaecology, ErasmusMC University Medical Center Rotterdam, The Netherlands. Electronic address: l.bertens@erasmusmc.nl. 5. The Generation R Study Group, ErasmusMC University Medical Center Rotterdam, The Netherlands; Department of Epidemiology, ErasmusMC University Medical Center Rotterdam, The Netherlands; Department of Paediatrics, ErasmusMC University Medical Center Rotterdam, The Netherlands. Electronic address: v.jaddoe@erasmusmc.nl. 6. The Generation R Study Group, ErasmusMC University Medical Center Rotterdam, The Netherlands; Department of Paediatrics, ErasmusMC University Medical Center Rotterdam, The Netherlands. Electronic address: h.a.moll@erasmusmc.nl. 7. The Generation R Study Group, ErasmusMC University Medical Center Rotterdam, The Netherlands; Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, ErasmusMC University Medical Center Rotterdam, The Netherlands. Electronic address: e.ongkosuwito@erasmusmc.nl. 8. The Generation R Study Group, ErasmusMC University Medical Center Rotterdam, The Netherlands; Department of Oral & Maxillofacial Surgery, Special Dental Care and Orthodontics, ErasmusMC University Medical Center Rotterdam, The Netherlands. Electronic address: e.wolvius@erasmusmc.nl.
Abstract
OBJECTIVES: The purpose of our study was to investigate the association of different socioeconomic and sociodemographic factors with dental caries in six-year-old children. Furthermore, we applied a district based approach to explore the distribution of dental caries among districts of low and high socioeconomic position (SEP). METHODS: In our cross-sectional study 5189 six-year-olds were included. This study was embedded in a prospective population-based birth cohort study in Rotterdam, the Netherlands, the Generation R Study. Parental education level, parental employment status, net household income, single parenting, and teenage pregnancy were considered as indicators for SEP. Dental caries was scored on intraoral photographs by using the decayed, missing, and filled teeth (dmft) index. We compared children without caries (dmft=0) to children with mild caries (dmft=1-3) or severe caries (dmft >3). Multinomial logistic regression analyses and binary logistic regression analyses were performed to study the association between SEP and caries, and between district and caries, respectively. RESULTS: Only maternal education level remained significantly associated with mild caries after adjusting for all other SEP-indicators. Paternal educational level, parental employment status, and household income additionally served as independent indicators of SEP in children with severe caries. Furthermore, living in more disadvantaged districts was significantly associated with higher odds of dental caries. CONCLUSION: Dental caries is more prevalent among six-year-old children with a low SEP, which is also visible at the district level. Maternal educational level is the most important indicator of SEP in the association with caries. CLINICAL SIGNIFICANCE: Our results should raise concerns about the existing social inequalities in dental caries and should encourage development of dental caries prevention strategies. New knowledge about the distribution of oral health inequalities between districts should be used to target the right audience for these strategies.
OBJECTIVES: The purpose of our study was to investigate the association of different socioeconomic and sociodemographic factors with dental caries in six-year-old children. Furthermore, we applied a district based approach to explore the distribution of dental caries among districts of low and high socioeconomic position (SEP). METHODS: In our cross-sectional study 5189 six-year-olds were included. This study was embedded in a prospective population-based birth cohort study in Rotterdam, the Netherlands, the Generation R Study. Parental education level, parental employment status, net household income, single parenting, and teenage pregnancy were considered as indicators for SEP. Dental caries was scored on intraoral photographs by using the decayed, missing, and filled teeth (dmft) index. We compared children without caries (dmft=0) to children with mild caries (dmft=1-3) or severe caries (dmft >3). Multinomial logistic regression analyses and binary logistic regression analyses were performed to study the association between SEP and caries, and between district and caries, respectively. RESULTS: Only maternal education level remained significantly associated with mild caries after adjusting for all other SEP-indicators. Paternal educational level, parental employment status, and household income additionally served as independent indicators of SEP in children with severe caries. Furthermore, living in more disadvantaged districts was significantly associated with higher odds of dental caries. CONCLUSION: Dental caries is more prevalent among six-year-old children with a low SEP, which is also visible at the district level. Maternal educational level is the most important indicator of SEP in the association with caries. CLINICAL SIGNIFICANCE: Our results should raise concerns about the existing social inequalities in dental caries and should encourage development of dental caries prevention strategies. New knowledge about the distribution of oral health inequalities between districts should be used to target the right audience for these strategies.
Authors: Paula A Braveman; Catherine Cubbin; Susan Egerter; Sekai Chideya; Kristen S Marchi; Marilyn Metzler; Samuel Posner Journal: JAMA Date: 2005-12-14 Impact factor: 56.272
Authors: Marlies E C Elfrink; Annemarie A Schuller; Jaap S J Veerkamp; Jan H G Poorterman; Henriette A Moll; Bob J M ten Cate Journal: Int J Paediatr Dent Date: 2010-03 Impact factor: 3.455
Authors: Jonathan A C Sterne; Ian R White; John B Carlin; Michael Spratt; Patrick Royston; Michael G Kenward; Angela M Wood; James R Carpenter Journal: BMJ Date: 2009-06-29
Authors: Bruna Galobardes; Mary Shaw; Debbie A Lawlor; John W Lynch; George Davey Smith Journal: J Epidemiol Community Health Date: 2006-01 Impact factor: 3.710
Authors: Carlo Eduardo Medina-Solís; Leticia Ávila-Burgos; María de Lourdes Márquez-Corona; June Janette Medina-Solís; Salvador Eduardo Lucas-Rincón; Socorro Aida Borges-Yañez; Miguel Ángel Fernández-Barrera; América Patricia Pontigo-Loyola; Gerardo Maupomé Journal: Int J Environ Res Public Health Date: 2019-06-05 Impact factor: 3.390
Authors: Simon Haworth; Dmitry Shungin; Justin T van der Tas; Strahinja Vucic; Carolina Medina-Gomez; Victor Yakimov; Bjarke Feenstra; John R Shaffer; Myoung Keun Lee; Marie Standl; Elisabeth Thiering; Carol Wang; Klaus Bønnelykke; Johannes Waage; Leon Eyrich Jessen; Pia Elisabeth Nørrisgaard; Raimo Joro; Ilkka Seppälä; Olli Raitakari; Tom Dudding; Olja Grgic; Edwin Ongkosuwito; Anu Vierola; Aino-Maija Eloranta; Nicola X West; Steven J Thomas; Daniel W McNeil; Steven M Levy; Rebecca Slayton; Ellen A Nohr; Terho Lehtimäki; Timo Lakka; Hans Bisgaard; Craig Pennell; Jan Kühnisch; Mary L Marazita; Mads Melbye; Frank Geller; Fernando Rivadeneira; Eppo B Wolvius; Paul W Franks; Ingegerd Johansson; Nicholas J Timpson Journal: Hum Mol Genet Date: 2018-09-01 Impact factor: 6.150
Authors: Daniela Carmagnola; Gaia Pellegrini; Matteo Malvezzi; Elena Canciani; Dolaji Henin; Claudia Dellavia Journal: Int J Environ Res Public Health Date: 2020-09-11 Impact factor: 3.390