How much does household food insecurity explain income inequalities in untreated dental caries?

Abstract

Background The pathway by which socioeconomic disadvantages are manifested in the occurrence of dental caries remains unclear. Aim To explore how much the association between untreated dental caries and income inequalities is related to household food insecurity (HFI). Design A population‐based study was conducted with a sample of 466 12‐year‐old students. Dental caries was evaluated by an examiner who had undergone calibration exercises. HFI was assessed using the Food Insecurity Scale validated for Brazilian Portuguese. Poisson regression models were created to determine associations between dental caries and both household income and HFI. The proportion of the income effect on dental caries explained by HFI was determined by the variation in percentages between the crude prevalence ratio (PRc) for dental caries and this measure adjusted by HFI (PRa). Results The prevalence of dental caries was higher among children from families with a per capita household income lower than US$ 71 (PR: 1.69; 95%CI: 1.15‐2.49) or from US$ 71 to US$ 142 (PR: 1.50; 95%CI: 1.04‐2.17). Moreover, 14% of the association between a low income and dental caries was explained by HFI. Conclusions Differences in the prevalence of dental caries in schoolchildren related to socioeconomic inequalities could partially be attributed to HFI in low‐income families.

Food insecurity is associated with self-reported oral health in school-age Ecuadorian children and is mediated by dietary and non-dietary factors

“…Consistent with our main hypothesis, the finding from this nationally representative study of 5-17 year old children was that those living in food insecure households reported having significantly poorer oral health than their food secure counterparts. This finding is also consistent with prior studies reporting on similarly aged children from Brazil (10)(11)(12) and several high-income countries (13)(14)(15)(16)(17)(18)(19) despite differences in study designs, methods used to assess HFI and oral health, and data analysis. The study also provided insights about potential dietary and non-dietary mediators of the HFI-child oral health relationship.…”

“…However, the relationship of HFI with oral health is understudied in school-age children especially those from low-and-middle income countries (LMIC). Except for Brazil, (10)(11)(12) published studies are limited to three high-income countries, i.e., the U.S. (13)(14)(15)(16) , New Zealand (17)(18) and South Korea (19) . This is an important gap in knowledge since both the population burdens of HFI (20) and childhood oral disease are elevated in Latin American and other LMICs compared to high-income countries (5,21) .…”

“…As noted previously, the important question of whether HFI is associated with poorer oral health in school-aged children has not been examined in Latin American populations except for Brazil (10)(11)(12) . Ecuador is a middle-income Latin American country with a high documented population prevalence of both HFI (20) and untreated childhood caries and periodontal disease (30) .…”

“…those from low-and-middle income countries (LMIC). Except for Brazil (10)(11)(12) , published studies are limited to three high-income countries, i.e. the USA (13)(14)(15)(16) , New Zealand (17,18) and South Korea (19) .…”

Frequency and Determinants of Dental Caries in Local Inhabitants of a Rural District of Khyber Pakhtunkhwa Pakistan

“…In our study, 83.22% had a monthly income of more than PKR 15000. This population showed a lower frequency of caries which is consistent with international studies that highlight the relationship of high income with lower risk of dental caries 17,18 . Moreover, the education status played a great role in the development of dental caries, as educated families had better opportunities and had less prevalence of dental caries as was reported by our study in which more than half of the study population was educated and thus showed less prevalence 12 .…”