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. 2023 Oct;51(5):829-837.
doi: 10.1111/cdoe.12771. Epub 2022 Jul 7.

Income- and education-based inequalities of edentulism and dental services utilization in Brazil

Raquel Conceição Ferreira  1 , João Gabriel Silva Souza  1   2   3 , Anna Rachel Dos Santos Soares  1 , Renato Vitor Vieira  1 , Ichiro Kawachi  4
Affiliations

Income- and education-based inequalities of edentulism and dental services utilization in Brazil

Raquel Conceição Ferreira et al. Community Dent Oral Epidemiol. 2023 Oct.

Abstract

Objective: Tooth loss is a worldwide public health problem affecting mainly socioeconomically disadvantaged groups. Dental services utilization may increase access to preventive actions and conservative treatment, reducing the prevalence of tooth loss. This study evaluated the income- and education-based inequalities in edentulism according to the utilization of dental services among adults and older adults in Brazil.

Methods: Data from the National Oral Health Survey (SB Brazil, 2010) of adults (ages 35-44 years, n = 9779) and older adults (ages 65-74 years, n = 7619) were analysed. Socioeconomic indicators (SES) included education and income. The magnitude of inequality in edentulism by education and income levels was estimated by the Relative Index of Inequality (RII) and the Slope Index of Inequality (SII). The changes in the RII and SII according to the utilization of dental services were estimated. Regression models estimated the association between SES and edentulism and whether dental services utilization modified this association.

Results: Higher edentulism prevalence was observed among those with lower education and income levels. The utilization of dental services changed the education-based inequality index in edentulism for adults, with percentage changes of 17.4% (RII) and 56.8% (SII). For adults with low education (0-4 years of study), the odds of edentulism were 80% (OR 0.2; 95% CI 0.1-0.6) and 90% (OR 0.1; 95% CI 0.01-0.2) lower for those who had used dental services within the preceding year and within 1-2 years compared with those who had used such services within the preceding 3 or more years, respectively.

Conclusion: There was a social gradient in the prevalence of edentulism in adults and older adults, and the education-based inequalities in edentulism were lower among adults reporting utilization of dental services in the preceding year.

Keywords: adult; dental care; elders; inequalities; socioeconomic factors; tooth loss.

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References

REFERENCES

    1. Barbato PR, Peres MA, Hofelmann DA, Peres KG. Contextual and individual indicators associated with the presence of teeth in adults. Rev Saude Publica. 2015;49:27.
    1. Shen J, Listl S. Investigating social inequalities in older adults' dentition and the role of dental service use in 14 European countries. Eur J Health Econ. 2018;19(1):45-57.
    1. Lee H. A life course approach to total tooth loss: Testing the sensitive period, accumulation, and social mobility models in the health and retirement study. Community Dent Oral Epidemiol. 2019;47(4):333-339.
    1. Guarnizo-Herreno CC, Watt RG, Garzon-Orjuela N, Tsakos G. Explaining oral health inequalities in European welfare state regimes: the role of health behaviours. Community Dent Oral Epidemiol. 2019;47(1):40-48.
    1. Kassebaum NJ, Bernabe E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of severe tooth loss: a systematic review and meta-analysis. J Dent Res. 2014;93:20s-28s.

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