Ethnic disparities in children’s oral health: findings from a population-based survey of grade 1 and 2 schoolchildren in Alberta, Canada

Abstract

Background: Although oral health has improved remarkably in recent decades, not all populations have benefited equally. Ethnic identity, and in particular visible minority status, has been identified as an important risk factor for poor oral health. Canadian research on ethnic disparities in oral health is extremely limited. The aim of this study was to examine ethnic disparities in oral health outcomes and to assess the extent to which ethnic disparities could be accounted for by demographic, socioeconomic and caries-related behavioral factors, among a population-based sample of grade 1 and 2 schoolchildren (age range: 5-8 years) in Alberta, Canada. Methods: A dental survey (administered during 2013-14) included a mouth examination and parent questionnaire. Oral health outcomes included: 1) percentage of children with dental caries; 2) number of decayed, extracted/missing (due to caries) and filled teeth; 3) percentage of children with two or more teeth with untreated caries; and 4) percentage of children with parental-ratings of fair or poor oral health. We used multivariable regression analysis to examine ethnic disparities in oral health, adjusting for demographic, socioeconomic and caries-related behavioral variables. Results: We observed significant ethnic disparities in children's oral health. Most visible minority groups, particularly Filipino and Arab, as well as Indigenous children, were more likely to have worse oral health than White populations. In particular, Filipino children had an almost 5-fold higher odds of having severe untreated dental problems (2 or more teeth with untreated caries) than White children. Adjustment for demographic, socioeconomic, and caries-related behavior variables attenuated but did not eliminate ethnic disparities in oral health, with the exception of Latin American children whose outcomes did not differ significantly from White populations after adjustment. Conclusions: Significant ethnic disparities in oral health exist in Alberta, Canada, even when adjusting for demographic, socioeconomic and caries-related behavioral factors, with Filipino, Arab, and Indigenous children being the most affected.

An overview of reviews on strategies to reduce health inequalities

“…The category of interventions targeting specific practices and conditions was the most frequent (Table 2 ). Among these, effective strategies were identified in oral health care in the immigrant population [ 60 ] and the reduction of infant mortality in low- and middle-income countries [ 45 ]. Some programs aimed at specific conditions such as unemployment and its impact on health issues, such as reemployment and rapid job search, showed positive effects on outcomes such as quality of life [ 61 ].…”

Complementary Feeding Practices for South Asian Young Children Living in High-Income Countries: A Systematic Review

“…Data showing that South Asian mothers are more likely to offer sweetened foods at initiation of CF is especially relevant given the high rates of obesity and dental caries amongst South Asian children [ 7 , 9 , 10 , 36 , 37 ]. Appropriate CF is important both in preventing undernutrition and being overweight [ 62 ].…”

“…In addition to obesity, inappropriate nutrition can result in dental caries, micronutrient deficiency and also low weight gain. South Asian infants in high-income countries have been reported as having a higher prevalence of caries compared to white infants [ 9 , 10 ]. In a 2011 report, SA infants had lower intakes of iron, sodium, thiamine, and magnesium relative to white infants, amongst other dietary differences [ 11 ].…”

Ethnic background and children’s oral health-related quality of life

“…However, differences in the prevalence of several clinical oral health outcomes still exist in western countries, including the Netherlands, disfavoring children from ethnic minority groups [ 1 – 3 ]. At present, there is no full understanding of the pathway driving these oral health inequalities [ 4 ]. In the last 20 years, the proportion of migrants in the Dutch population increased from 17 to 23% [ 5 ].…”