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Soofi M, Karami-Matin B, Kazemi-Karyani A, et al. Socioeconomic inequality in dental caries experience expressed by the significant caries index: cross-sectional results from the RaNCD Cohort Study. Int Dent J. 2020;doi: 10.1111/idj.12612.
Soofi, M., Karami-Matin, B., Kazemi-Karyani, A., Soltani, S., Ameri, H., Moradi-Nazar, M., & Najafi, F. (2020). Socioeconomic inequality in dental caries experience expressed by the significant caries index: cross-sectional results from the RaNCD Cohort Study. International dental journal, . https://doi.org/10.1111/idj.12612
Soofi, Moslem, et al. "Socioeconomic inequality in dental caries experience expressed by the significant caries index: cross-sectional results from the RaNCD Cohort Study." International dental journal vol. (2020). doi: https://doi.org/10.1111/idj.12612
Soofi M, Karami-Matin B, Kazemi-Karyani A, Soltani S, Ameri H, Moradi-Nazar M, Najafi F. Socioeconomic inequality in dental caries experience expressed by the significant caries index: cross-sectional results from the RaNCD Cohort Study. Int Dent J. 2020 Sep 17; doi: 10.1111/idj.12612. Epub 2020 Sep 17. PMID: 32944969.
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Int Dent J. 2020 Sep 17; doi: 10.1111/idj.12612. Epub 2020 Sep 17.

Socioeconomic inequality in dental caries experience expressed by the significant caries index: cross-sectional results from the RaNCD Cohort Study.

International dental journal

Moslem Soofi, Behzad Karami-Matin, Ali Kazemi-Karyani, Shahin Soltani, Hosein Ameri, Mehdi Moradi-Nazar, Farid Najafi

Affiliations

  1. Social Development and Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
  2. Research Center for Environmental Determinants of Health, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran.
  3. Health Policy and Management Research Center, Department of Healthcare Management, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.

PMID: 32944969 DOI: 10.1111/idj.12612

Abstract

INTRODUCTION: Socioeconomic inequality in dental caries among Iranian middle-aged adults remains largely unstudied. This study aimed to measure socioeconomic inequality in dental caries experience and to identify determinants of this inequality.

MATERIALS AND METHODS: Data were obtained from the Ravansar Non-Communicable Diseases (RaNCD) Cohort Study. This cross-sectional analysis included 10,002 adults aged 35-65 years. Caries experience was dichotomised based on the decayed, missing and filled teeth (DMFT) of one-third of the population with the highest caries scores (i.e. significant caries index). Socioeconomic status (SES) was calculated using the principal component analysis. The concentration index (CI) was used to quantify the extent of socioeconomic inequality in dental caries experience. Decomposition analysis was conducted to quantify the contribution of each determinant to the observed inequality.

RESULTS: The mean DMFT for all individuals was 16.1(SD 9.1). The CI of having significant dental caries was -0.236 (95% CI: -0.0259, -0.213), indicating that having significant dental caries was more concentrated among low-SES individuals. SES (65.6%), age group (24.7%) and female gender (3.7%) were found to have the largest percentage of contributions to the observed inequality in dental caries.

CONCLUSION: This study indicates pro-rich inequalities in dental caries experience among middle-aged adults in Iran. The findings highlight the importance of early prevention of dental caries experience before it happens. To mitigate inequalities in dental caries experience, policy interventions should focus on females, older age groups, and low-SES individuals.

© 2020 FDI World Dental Federation.

Keywords: Dental caries; RaNCD; concentration index; decayed; decomposition analysis; missing and filled teeth; socioeconomic inequalities

References

  1. Kassebaum N, Bernabé E, Dahiya M et al. Global burden of untreated caries: a systematic review and metaregression. J Dent Res 2015 94: 650-658. - PubMed
  2. Peres MA, Macpherson LM, Weyant RJ et al. Oral diseases: a global public health challenge. Lancet 2019 394: 249-260. - PubMed
  3. Marthaler T. Changes in dental caries 1953-2003. Caries Res 2004 38: 173-181. - PubMed
  4. Do L. Distribution of caries in children: variations between and within populations. J Dent Res 2012 91: 536-543. - PubMed
  5. Petersen PE, Bourgeois D, Ogawa H et al. The global burden of oral diseases and risks to oral health. Bull World Health Organ 2005 83: 661-669. - PubMed
  6. Masood M, Mnatzaganian G, Baker SR. Inequalities in dental caries in children within the UK: Have there been changes over time? Community Dent Oral Epidemiol 2019 47: 71-77. - PubMed
  7. Schwendicke F, Dörfer C, Schlattmann P et al. Socioeconomic inequality and caries: a systematic review and meta-analysis. J Dent Res 2015 94: 10-18. - PubMed
  8. Costa SM, Martins CC, Bonfim MdLC et al. A systematic review of socioeconomic indicators and dental caries in adults. Int J Environ Res Public Health 2012 9: 3540-3574. - PubMed
  9. Bastos JLD, Nomura LH, Peres MA. Dental pain, socioeconomic status, and dental caries in young male adults from southern Brazil. Cad Saude Publica 2005 21: 1416-1423. - PubMed
  10. Ditmyer M, Dounis G, Mobley C et al. Inequalities of caries experience in Nevada youth expressed by DMFT index vs. Significant Caries Index (SiC) over time. BMC Oral Health 2011 11: 12. - PubMed
  11. Pereira SM, da Silva Tagliaferro EP, Ambrosano GMB et al. Dental caries in 12-year-old schoolchildren and its relationship with socioeconomic and behavioural variables. Oral Health Prev Dent 2007 5: 299-306. - PubMed
  12. Nunes AMM, da Silva AAM, Alves CMC et al. Factors underlying the polarization of early childhood caries within a high-risk population. BMC Public Health 2014 14: 988. - PubMed
  13. Burt BA. Prevention policies in the light of the changed distribution of dental caries. Acta Odontol Scand 1998 56: 179-186. - PubMed
  14. Narvai PC, Frazao P, Age Roncalli et al. Dental caries in Brazil: decline, polarization, inequality and social exclusion. Rev Panam Salud Publica 2006 19: 385-393. - PubMed
  15. Sogi G, DJb B. Dental/caries and Oral Hygiene Status of school children in Davahgere related to their Socio Epidemiological. J Indian Soc Pedod Prev Dent 2002 20: 152-157. - PubMed
  16. Bratthall D. Introducing the Significant Caries Index together with a proposal for a new global oral health goal for 12-year-olds. Int Dent J 2000 50: 378-384. - PubMed
  17. Saied-Moallemi Z, Virtanen J, Tehranchi A et al. Disparities in oral health of children in Tehran, Iran. Eur Arch Paediatr Dent 2006 7: 262-264. - PubMed
  18. Pasdar Y, Najafi F, Moradinazar M et al. Cohort profile: Ravansar Non-Communicable Disease cohort study: the first cohort study in a Kurdish population. Int J Epidemiol 2019 48: 682-683f. - PubMed
  19. Poustchi H, Eghtesad S, Kamangar F et al. Prospective epidemiological research studies in Iran (the PERSIAN Cohort Study): rationale, objectives, and design. Am J Epidemiol 2018 187: 647-655. - PubMed
  20. Nishi M, Stjernswärd J, Carlsson P et al. Caries experience of some countries and areas expressed by the Significant Caries Index. Community Dent Oral Epidemiol 2002 30: 296-301. - PubMed
  21. Piovesan C, Mendes FM, Antunes JLF et al. Inequalities in the distribution of dental caries among 12-year-old Brazilian schoolchildren. Braz Oral Res 2011 25: 69-75. - PubMed
  22. Zemaitiene M, Grigalauskiene R, Andruskeviciene V et al. Dental caries risk indicators in early childhood and their association with caries polarization in adolescence: a cross-sectional study. BMC Oral Health 2017 17: 2. - PubMed
  23. Hugo FN, Vale GC, Ccahuana-Vásquez RA et al. Polarization of dental caries among individuals aged 15 to 18 years. J Appl Oral Sci 2007 15: 253-258. - PubMed
  24. Vyas S, Kumaranayake L. Constructing socio-economic status indices: how to use principal components analysis. Health Policy Plan 2006 21: 459-468. - PubMed
  25. Howe LD, Hargreaves JR, Huttly SR. Issues in the construction of wealth indices for the measurement of socio-economic position in low-income countries. Emerg Themes Epidemiol 2008 5: 3. - PubMed
  26. McKenzie DJ. Measuring inequality with asset indicators. J Popul Econ 2005 18: 229-260. - PubMed
  27. Schap T, Kuczynski K, Hiza H. Healthy Eating Index-beyond the score. J Acad Nutr Diet. 2017 117: 519-521. - PubMed
  28. Wagstaff A. The bounds of the concentration index when the variable of interest is binary, with an application to immunization inequality. Health Econ 2005 14: 429-432. - PubMed
  29. Wagstaff A, Paci P, Van Doorslaer E. On the measurement of inequalities in health. Soc Sci Med 1991 33: 545-557. - PubMed
  30. Kjellsson G, Gerdtham U-G. On correcting the concentration index for binary variables. J Health Econ 2013 32: 659-670. - PubMed
  31. Wagstaff A. The concentration index of a binary outcome revisited. Health Econ 2011 20: 1155-1160. - PubMed
  32. Wagstaff A, Doorslaer VE, Watanabe N. On decomposing the causes of health sector inequalities with an application to malnutrition inequalities in Vietnam. J Econom 2003 1: 227-223. - PubMed
  33. O'Donnell O, Doorslaer E, Wagstaff A et al. Analyzing Health Equity using Household Survey Data: a Guide to Techniques and Their Implementation. Washington, DC: The World Bank; 2008. - PubMed
  34. Moradi G, Moinafshar A, Adabi H et al. Socioeconomic inequalities in the oral health of people aged 15-40 years in Kurdistan, Iran in 2015: a cross-sectional study. J Prev Med Public Health 2017 50: 303. - PubMed
  35. Capurro DA, Davidsen M. Socioeconomic inequalities in dental health among middle-aged adults and the role of behavioral and psychosocial factors: evidence from the Spanish National Health Survey. Int J Equity Health 2017 16: 34. - PubMed
  36. Hessari H, Vehkalahti MM, Eghbal MJ et al. Oral health among 35-to 44-year-old Iranians. Med Princ Pract 2007 16: 280-285. - PubMed
  37. Murakami K, Ohkubo T, Nakamura M et al. Socioeconomic inequalities in oral health among middle-aged and elderly Japanese: NIPPON DATA2010. J Epidemiol 2018 28(Suppl 3): S59-S65. - PubMed
  38. Bof de Andrade F. Drumond Andrade FC, Noronha K. Measuring socioeconomic inequalities in the use of dental care services among older adults in Brazil. Community Dent Oral Epidemiol 2017 45: 559-566. - PubMed
  39. Baskaradoss JK. Relationship between oral health literacy and oral health status. BMC Oral Health 2018 18: 172. - PubMed
  40. Ev Doorslaer, Koolman X. Explaining the differences in income-related health inequalities across European countries. Health Econ 2004 13: 609-628. - PubMed
  41. Safiri S, Kelishadi R, Heshmat R et al. Socioeconomic inequality in oral health behavior in Iranian children and adolescents by the Oaxaca-Blinder decomposition method: the CASPIAN-IV study. Int J Equity Health 2016 15: 143. - PubMed
  42. Al-Ansari AA. Prevalence, severity, and secular trends of dental caries among various Saudi populations: a literature review. Saudi J Med Med Sci 2014 2: 142. - PubMed
  43. Eslamipour F, Borzabadi-Farahani A, Asgari I. The relationship between aging and oral health inequalities assessed by the DMFT index. Eur J Paediatr Dent 2010 11: 193. - PubMed
  44. Saravanan S, Kalyani V, Vijayarani M et al. Caries prevalence and treatment needs of rural school children in Chidambaram Taluk, Tamil Nadu, South India. Indian J Dent Res 2008 19: 186. - PubMed
  45. García-Cortés JO, Medina-Solís CE, Loyola-Rodriguez JP et al. Dental caries' experience, prevalence and severity in Mexican adolescents and young adults. Rev Salud Publica (Bogota) 2009 11: 82-91. - PubMed
  46. Rigi Ladez M, Ghanbariha M, Badiee M et al. The Relationship between Dental Caries and Some socio-economic Factors in 35-44 years old Adults in some urban Areas of Sistan & Baluchestan. JSSU 2012 20:454-463.[In Persian]. - PubMed
  47. Kiadaliri AA, Hosseinpour R, Haghparast-Bidgoli H et al. Pure and social disparities in distribution of dentists: a cross-sectional province-based study in Iran. Int J Environ Res Public Health 2013 10: 1882-1894. - PubMed
  48. Perera I, Ekanayake L. Influence of oral health-related behaviours on income inequalities in oral health among adolescents. Community Dent Oral Epidemiol 2011 39: 345-351. - PubMed
  49. Sabbah W, Tsakos G, Sheiham A. The role of health-related behaviors in the socioeconomic disparities in oral health. Soc Sci Med 2009 68: 298-303. - PubMed
  50. Sanders AE, Spencer AJ, Slade GD. Evaluating the role of dental behaviour in oral health inequalities. Community Dent Oral Epidemiol 2006 34: 71-79. - PubMed
  51. Nakre PD, Harikiran A. Effectiveness of oral health education programs: A systematic review. J Int Soc Prev Community Dent 2013 3: 103. - PubMed

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