A life course approach to understanding oral health inequalities

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Preadolescent children in Australia have lower rates of dental decay than children in almost all other economically developed countries. This is not the case for Australian adults. In fact, Australian adults aged 35-44 years have higher rates of dental decay than adults of similar age in most other economically developed countries. Not only do Australian adults have comparatively poor oral health in the lead-up to midlife, but also socioeconomic inequalities in dental decay are more pronounced at this stage of life than at any other stage before or after. This study proposes to look at how oral health in young adults in shaped by their experiences across childhood, adolescence and early adulthood. This approach is based on recent evidence that points to the importance to adult health of the early years of life. In this life course perspective, the poorer health of disadvantaged individuals is seen to result from ongoing and cumulative exposure to difficult and disadvantaged circumstances across their life course. This study will trace and follow up a cohort of almost 10, 000 South Australians for whom social, familial, economic and dental behavioural information was collected in 1991-92 when these individuals were aged from five to 15 years. Now aged from 19 to 29 years, these individuals will be invited to attend a dental examination and complete a survey that will provide information on health behaviours and life circumstances shown to be important determinants of general and oral health status. One purpose will be to explore reasons for the comparatively poorer oral health status of Australian adults. A second purpose will be to investigate the magnitude of socioeconomic inequalities in oral disease at different life stages. The findings will add to the knowledge of the etiology of oral disease and open up opportunities to develop new methods of oral health promotion based on the understanding of accumulated risk across the life course.