It is now well established that oral diseases are more common among the socially disadvantaged. Oral health inequalities are not limited to the differences in oral health status between those at the top and bottom of the social hierarchy, but they exist across the entire social spectrum. 1 Irrespective of the indicators of socioeconomic position used, social gradients have been observed with regard to different oral health outcomes. [2][3][4] Several theoretical pathways have been proposed to explain social inequalities in oral health; they include material, cultural/ behavioral, psychosocial, and life-course explanations. 5 Of the different theories proposed, most studies have explored the contribution of behavioral and psychosocial factors on oral health. 2,6 According to the behavioral explanation, poorer oral health in lower socioeconomic groups is attributed to the high prevalence of oral health-compromising behaviors in these groups, while the psychosocial explanation argues that oral health inequalities arise due to Abstract Aims: The aims of the present study were to determine education inequalities in chronic periodontitis (CP) among Sri Lankan men and whether oral health behaviors explain education inequalities in CP. Methods: Data from 720 males who participated in a study to determine the prevalence of CP in 30-60-year-olds in Colombo district, Sri Lanka, were used for the present study. An interviewer administered a questionnaire obtained information about sociodemographics and oral health behaviors. Following the assessment of periodontal parameters, case definitions proposed by the Centers for Disease Control/ American Academy of Periodontology were used to define periodontitis.Results: Education gradients were observed in relation to CP, smoking, betel quid chewing, alcohol use, and dental utilization. Education gradients in CP remained, but attenuated after adjustments for smoking, betel quid chewing, alcohol use, and dental utilization. Current smoking and current alcohol use explained 4%-38% and 6%-15% of the associations between education and CP, respectively. The education gradient in CP remained following simultaneous adjustment for all behaviors, but lost significance for 11-13 years of education.
Conclusion:Of the oral health behaviors considered, current smoking contributed the most to education inequalities in CP, explaining 4%-38% of the education differences in CP. K E Y W O R D S betel quid chewing, chronic periodontitis, education inequalities, oral health-related behavior, smoking, Sri Lanka How to cite this article: Wellappuli N, Ekanayake L. Role of oral health-related behaviors in education inequalities in chronic periodontitis among Sri Lankan men. J Invest Clin