SES conditions at the neighborhood-level, independently or jointly with individual-level income, appear to be important in evaluating racial/ethnic differences in self-rated oral health. Neighborhood conditions could tap into constructs not captured by individual-level variables on self-rated oral health.
Teachers at elementary schools in two areas (urban and rural) of Michigan were surveyed to determine their sources of information about oral health and their knowledge and attitudes about dental diseases and disease prevention. Questionnaires were completed by 404 teachers (62% response rate). More than 80 percent of respondents from both areas were female. Demographic characteristics that were significantly different between groups included: median ages of urban and rural respondents (P less than .01), median numbers of years in teaching (P less than .01), and median years in residence (P less than .03). Despite these differences, responses to the questionnaire varied little. For both groups, the most frequently cited sources of information about dental health were dentist's office (82%), followed by magazines and books (74%). The teachers considered preventing tooth decay as the most important reason for good oral hygiene. When asked to rank the effectiveness of ten methods of preventing caries in children, teachers ranked efficacious methods such as fluoridated water and pit and fissure sealants lower than making regular dental visits and reducing intake of sugared foods. Asked to rank the most effective method for children to receive fluoride, urban respondents ranked fluoridated water first, while rural respondents ranked this measure third. Findings suggest that teachers' knowledge about oral health and current methods of prevention is incomplete, is inaccurate in some instances, and varies little by geographic area.
Choosing an indicator of oral health status likely will depend upon the characteristics of the population to be studied. As a composite measure of oral health status, the OHSI performed acceptably; however, missing teeth, an index component, also worked well. Continued evaluation of the OHSI is warranted.
This analysis supports the disparity in periodontal health as part of the black:white health disparity when taking other factors into account. However, periodontal health disparities may be more complex than previously recognized, requiring greater understanding of factors related to dental care utilization in future studies evaluating this disparity.
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