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. 2022 Jul 23;22(1):443.
doi: 10.1186/s12887-022-03470-4.

Inequalities in caries among pre-school Italian children with different background

Guglielmo Campus #  1   2   3 , Fabio Cocco #  4 , Laura Strohmenger  5 , Thomas Gerhard Wolf  6   7 , Araxi Balian  5 , Antonella Arghittu  4   8 , Maria Grazia Cagetti #  5
Affiliations

Inequalities in caries among pre-school Italian children with different background

Guglielmo Campus et al. BMC Pediatr. .

Abstract

Background: The study was aimed to describe caries prevalence and severity and health inequalities among Italian preschool children with European and non-European background and to explore the potential presence of a social gradient.

Methods: The ICDAS (International Caries Detection and Assessment System) was recorded at school on 6,825 children (52.8% females). Caries frequency and severity was expressed as a proportion, recording the most severe ICDAS score observed. Socioeconomic status (SES) was estimated by mean a standardized self-submitted questionnaire filled-in by parents. The Slope Index of Inequality (SII) based on regression of the mid-point value of caries experiences score for each SES group was calculated and a social gradient was generated, children were stratified into four social gradient levels based on the number of worst options. Multivariate regression models (Zero-Inflated Negative Binomial logistic and logistic regression) were used to elucidate the associations between all explanatory variables and caries prevalence.

Results: Overall, 54.4% (95%CI 46.7-58.3%) of the children were caries-free; caries prevalence was statistically significant higher in children with non-European background compared to European children (72.6% vs 41.6% p < 0.01) and to the area of living (p = 0.03). A statistically significant trend was observed for ICDAS 5/6 score and the worst social/behavioral level (Z = 5.24, p < 0.01). Children in the highest household income group had lower levels of caries. In multivariate analysis, Immigrant status, the highest parents' occupational and educational level, only one kid in the family, living in the North-Western Italian area and a high household income, were statistically significant associated (p = 0.01) to caries prevalence. The social gradient was statistically significant associated (p < 0.01) to the different caries levels and experience in children with European background.

Conclusions: Data show how caries in preschool children is an unsolved public health problem especially in those with a non-European background.

Keywords: Caries; Children; Health care disparities; Inequalities; Pediatric dentistry; Social determinants.

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Conflict of interest statement

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Fig. 1
Fig. 1
Caries severity, expressed as caries free, enamel, pre-cavitated and cavitated lesions across the different Italian areas by European and non-European immigrant
Fig. 2
Fig. 2
Outcomes by quartiles of income regarding caries experience (ICDAS ≠ 0) and cavitated lesions (ICDAS 5–6) among children with European and non-European background
See this image and copyright information in PMC

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