Trends in Oral Health by Poverty Status as Measured by Healthy People 2010 Objectives
Trends in Oral Health by Poverty Status as Measured by Healthy People 2010 Objectives
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DOI：
10.1177/003335491012500609
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发表时间：
2010-11-01
影响因子：
3.3
通讯作者：
Thornton-Evans, Gina
中科院分区：
文献类型：
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作者：
Dye, Bruce A.;Thornton-Evans, Gina
Objective.贫困是口腔健康的一个重要社会决定因素，但2010年健康人群（HP 2010）没有监测贫困对口腔健康状况的影响。我们通过贫困状况评估了HP 2010年6个口腔健康目标的近期趋势。我们使用1988-1994年和1999-2004年国家健康和营养调查的数据，分析HP 2010年特定年龄目标的趋势，这些目标与龋齿经历、未经治疗的蛀牙、牙科密封剂、牙周病、牙齿保留和牙齿完全脱落有关。2-4岁儿童的龋齿从19%显著增加到2 - 4%，但按贫困程度分层时，只有非贫困的2- 4岁儿童的龋齿显著增加（10%至15%）（目标21-1a）。非贫困男孩的龋齿增长率最高（9%至18%）。在美国，牙科密封剂的使用继续增长。两个调查期间，密封剂使用（目标21-8）的最大百分比增长是针对所有8岁的贫困儿童（3%至21%）。在35-44岁的成年人中，美国的牙周病患病率从22%显着下降到16%（目标21- 5 b），并且更多的成年人保留了所有天然牙齿（30%至38%）（目标21-3）。然而，只有非贫困成年人，特别是非贫困男性（34%至48%）的牙齿保留率才有显著增加。总体而言，美国人的口腔健康状况，如HP 2010年的目标，大多数显示改善或保持不变，1998-1994年和1999-2004年之间。然而，一些传统上低风险群体（如非贫困儿童）的口腔健康状况的一些变化可能会逆转过去几十年来一直观察到的口腔健康改善。这些结果表明，贫困状况是规划和监测未来国家口腔健康目标的一个重要因素。
Objective. Poverty is a significant social determinant for oral health, yet Healthy People 2010 (HP 2010) does not monitor changes in oral health status by poverty. We assessed recent trends for six HP 2010 oral health objectives by poverty status.Methods. We used data from the 1988-1994 and 1999-2004 National Health and Nutrition Examination Surveys to analyze trends for HP 2010 age-specific objectives relating to caries experience, untreated tooth decay, dental sealants, periodontal disease, tooth retention, and complete tooth loss by poverty status.Results. Dental caries significantly increased from 19% to 24% for children aged 2-4 years, but when stratified by poverty, caries only increased significantly for non-poor 2- to 4-year-old children (10% to 15%) (Objective 21-1a). The largest percentage point increase in dental caries was for non-poor boys (9% to 18%). The use of dental sealants continues to grow in the U.S. The largest percentage point increase in sealant use (Objective 21-8) between the two survey periods was for all poor children aged 8 years (3% to 21%). Among adults aged 35-44 years, periodontal disease significantly declined in the U.S. from 22% to 16% (Objective 21-5b) and more adults retained all of their natural teeth (30% to 38%) (Objective 21-3). However, the increase in tooth retention was significant only for non-poor adults, particularly non-poor men (34% to 48%).Conclusions. Overall, the oral health status of Americans as measured by HP 2010 objectives mostly showed improvement or remained unchanged between 1998-1994 and 1999-2004. However, some changes in oral health status for some traditionally low-risk groups, such as non-poor children, may be reversing improvements in oral health that have consistently been observed in previous decades. These results suggest that poverty status is an important factor for planning and monitoring future national oral health goals.