Dental caries experience and socio-economic status among Iranian children: a multilevel analysis
Dental caries experience and socio-economic status among Iranian children: a multilevel analysis
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DOI：
10.1186/s12889-019-7693-1
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发表时间：
2019-11-27
影响因子：
4.5
通讯作者：
Ghasemian, Anoosheh
中科院分区：
文献类型：
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作者：
Ghasemianpour, Majid;Bakhshandeh, Soheila;Ghasemian, Anoosheh
背景 社会经济因素被认为是造成不同国家口腔健康差异的主要决定因素。本研究的目的是调查社会和经济因素与 6 岁和 12 岁伊朗儿童的龋齿经历之间的关系。方法 在这项横断面研究中，来自伊朗所有（31）个省份的 31,146 名学生，年龄分别为 6 岁和 12 岁。根据世界卫生组织（WHO）口腔健康调查的标准化标准，通过学校临床检查评估乳牙和恒牙的龋齿指数。社会经济状况数据来自修改后的世界卫生组织调查问卷和国家数据库。使用多级回归分析在个人和省级层面上比较了乳牙列和恒牙列的蛀牙、缺失和补牙（dmft/DMFT）指数。泊松回归分析用于评估社会（人口和行为）决定因素与个体龋齿指数的关联。为了评估各省龋齿指数差异的原因，还利用泊松回归分析了合理的经济因素。结果 6 岁和 12 岁儿童的 dmft 和 DMFT 平均值 (SE) 分别为 5.84 (0.05) 和 1.84 (0.03)。各省间龋齿指数差异有统计学意义。父母受教育程度较高与两个年龄段的龋齿指数呈负相关。 6岁儿童dmft指数与农村户口呈正相关，使用牙线呈负相关。研究发现，刷牙频率和预防性牙科使用与 DMFT 和 DMFT 指数呈负相关。两个年龄段的国内生产总值 (GDP) 指数与 DMFT 和 DMFT 指数呈负相关，消费者价格指数 (CPI) 与 DMFT 呈正相关。然而，12岁儿童的基尼指数与DMFT指数之间存在正相关关系；以及6岁儿童人均牙医数量与dmft指数之间的关系。结论发现社会人口和行为因素与龋齿经历有关。然而，经济指标最为重要。
Background Socio-economic factors are considered as main determinants causing disparities in oral health across different countries. The aim of the present study was to investigate the associations of social and economic factors with dental caries experience among 6- and 12-year-old Iranian children. Methods In this cross-sectional study, a total of 31,146 students, aged 6 and 12 years old, were enrolled from all (31) provinces in Iran. Based on the standardized World Health Organization (WHO) criteria for oral health surveys, dental caries indices in primary and permanent teeth were assessed by clinical examination in schools. Data on socio-economic status was obtained from the modified WHO questionnaire and national data bank. The decayed, missing and filled teeth (dmft/DMFT) indices for primary and permanent dentition were compared at the individual and provincial levels using multilevel regression analysis. Poisson regression analysis was used to evaluate the association of social (demographic and behavioral) determinants with dental caries indices among individuals. To assess the causes of difference in dental caries indices across provinces, justifiable economic factors were also analyzed using poisson regression analysis. Results The mean (SE) of dmft and DMFT were 5.84 (0.05) and 1.84 (0.03), for 6-and 12-year-old children, respectively. The differences of dental caries indices were statistically significant among provinces. Higher level of parental education was negatively related to dental caries indices of both age groups. Rural residency was positively and dental flossing was reversely associated with dmft index of 6-year-old children. Negative associations were found between frequency of tooth brushing and preventive dental utilization with dmft and DMFT indices. Gross Domestic Product (GDP) index had negative and Consumer Price Index (CPI) had positive associations with dmft and DMFT indices in both age groups. However, positive relationships were observed between Gini index with DMFT index among 12-year-old children; as well as between the number of dentists per capita with dmft index among 6-year-old children. Conclusion Socio-demographic and behavioral factors were found to be associated with dental caries experience. However, economic indicators had the greatest importance.