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The influence of social deprivation on dental caries in Swedish children and adolescents, as measured by an index for primary health care: The Care Need Index.

Artikel i vetenskaplig tidskrift
Författare Anna-Lena Östberg
Anna N Kjellström
Max Petzold
Publicerad i Community dentistry and oral epidemiology
Volym 45
Nummer/häfte 3
Sidor 233–241
ISSN 1600-0528
Publiceringsår 2017
Publicerad vid Institutionen för odontologi
Hälsometri
Sidor 233–241
Språk en
Länkar dx.doi.org/10.1111/cdoe.12281
www.ncbi.nlm.nih.gov/entrez/query.f...
Ämnesord area analysis, dental caries, multilevel analysis, social deprivaiton
Ämneskategorier Övrig annan medicin och hälsovetenskap, Samhällsmedicin

Sammanfattning

The objective was to examine associations between a primary Care Need Index (CNI) and dental caries experience.Dental journal records for 300 988 individuals in western Sweden, aged 3-19 years in 2007-09, were completed with official socioeconomic information. The CNI (independent variable), originally developed for assessing primary care need, was calculated for residential areas (small areas, parishes, dental clinics) based on markers of material deprivation, sociodemographic characteristics, social instability and cultural needs. Dental caries (dependent variable) was registered using the decayed, missing, filled teeth (DMFT) system. Multilevel Poisson regression and logistic regression models were used. All analyses were adjusted for age and gender.In the most deprived areas, the incidence rate ratio (IRR) for dental caries was up to five times higher than in the most affluent areas (reference); in small areas, the IRR for decayed teeth (DT) was 3.74 (95% CI: 3.39-4.12) and 5.11 (CI: 4.45-5.87) for decayed surfaces approximally (DSa). Caries indices including fillings (decayed filled teeth [DFT], decayed filled surfaces approximally [DFSa]) produced lower IRRs, with similar pictures at the parish and dental clinic level. The intracluster correlation was low overall, but stronger at lower geographical levels. The odds ratios for ≥3 caries lesions in the two most deprived areas of the CNI deciles were high, with a DT OR of 3.55 in small areas (95% CI: 3.39-3.73), compared with the eight more affluent deciles.There were strong associations between an index for assessing need in primary care, the CNI and dental caries in Swedish children and adolescents.

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