Tooth loss in the United Kingdom--trends in social inequalities: an age-period-and-cohort analysis.
Tooth loss in the United Kingdom--trends in social inequalities: an age-period-and-cohort analysis.
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DOI：
10.1371/journal.pone.0104808
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Sheiham A
中科院分区：
文献类型：
--
作者：
Bernabé E;Sheiham A
这项研究评估了1988年至2009年间英国牙齿脱落的社会不平等趋势。该研究使用了来自20,126名成年人的数据，这些成年人参加了英格兰、威尔士和北爱尔兰最近三次全国成人牙齿健康调查。社会阶层是用6分的注册总干事社会阶层来确定的。对牙齿脱落的三个指标进行分析；有牙齿的人占所有成年人的比例，牙齿数量和有牙齿的成年人中具有功能牙列的比例（定义为拥有20颗以上牙齿）。使用偏最小二乘回归（PLSR）在年龄、时期和队列框架内对趋势进行建模。采用非参数自助法获得PLSR估计的置信区间。使用斜率和相对不平等指数（SII和RII）来量化牙齿脱落的社会不平等。1988年至2009年间，全牙脱落的绝对不平等缩小（SII从- 28.4%变为- 15.3%），而相对不平等扩大（RII从6.21变为20.9）。另一方面，随着时间的推移，牙齿脱落的绝对和相对社会不平等在有牙齿的成年人中保持相当稳定。社会最底层与最高阶层的牙齿数量绝对差异为2.5 ~ 2.9，功能牙列绝对差异为22 ~ 26%。相对而言，社会地位最高的人比社会地位最低的人拥有多10-11%的牙齿和25-28%的牙齿功能。调查结果显示，尽管近年来几代人在牙齿固位方面有了显著改善，但英国成年人的牙齿脱落情况普遍存在社会阶层差异。在整个成年人口中，牙齿脱落的绝对不平等已经缩小，而相对不平等却在稳步增加。在有牙齿的成年人中，牙齿数量和牙齿功能比例的绝对和相对不平等仍然很明显，但随着时间的推移没有改变。
This study assessed trends in social inequalities in tooth loss in the United Kingdom between 1988 and 2009. Data from 20,126 adults who participated in the latest three national Adult Dental Health Surveys in England, Wales and Northern Ireland were used. Social class was determined using the 6-point Registrar General’s Social Class. Three indicators of tooth loss were analysed; the proportion of edentate people among all adults and the number of teeth and the proportion with functional dentition (defined as having 20+ teeth) among dentate adults. Trends were modelled within an age, period and cohort framework using partial least squares regression (PLSR). Confidence intervals for PLSR estimates were obtained using non-parametric bootstrapping. The Slope and Relative Index of Inequality (SII and RII) were used to quantify social inequalities in tooth loss. Between 1988 and 2009, absolute inequalities in total tooth loss narrowed (SII changed from −28.4% to −15.3%) while relative inequalities widened (RII from 6.21 to 20.9) in the whole population. On the other hand, absolute and relative social inequality in tooth loss remained fairly stable over time among dentate adults. There was an absolute difference of 2.5–2.9 in number of teeth and 22–26% in the proportion with functional dentition between the lowest and highest social classes. In relative terms, the highest social class had 10–11% more teeth and 25–28% higher probability of having functional dentition than the lowest social class. The findings show pervasive inequalities in tooth loss by social class among British adults despite marked improvements in tooth retention in recent years and generations. In the whole adult population, absolute inequalities in tooth loss have narrowed while relative inequalities have increased steadily. Among dentate adults, absolute and relative inequalities in number of teeth and proportion of people with functional dentition have remained significant but unchanged over time.
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