Small-area contextual effects on children’s dental caries in Alberta: a multilevel analysis

Shi, Congshi; Aparicio-Ting, Fabiola; Faris, Peter; Patterson, Steven; McLaren, Lindsay

doi:10.17269/s41997-021-00485-9

Cited by 2 publications

(2 citation statements)

References 24 publications

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“…Social inequities in health may be defined as unfair and avoidable differences in health outcomes between social groups that are driven by the inequitable distribution of power, money, and resources and favour socioeconomically advantaged groups (Commission on Social Determinants of Health, 2008 ). Consistent with international literature (Schwendicke et al, 2015 ), we have observed inequities in dental caries (tooth decay), by socioeconomic circumstances and by ethnicity, in our setting of Alberta, Canada (Shi et al, 2018 ; 2021 ).…”

Section: Introductionsupporting

confidence: 91%

Fluoridation cessation and oral health equity: a 7-year post-cessation study of Grade 2 schoolchildren in Alberta, Canada

McLaren

Patterson

Faris

et al. 2022

Can J Public Health

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Objective Community water fluoridation, because of its universal scope and passive mechanism of uptake, is one component of a multifaceted approach to promoting equity in dental health. The objective of this study was to examine social inequities in children’s dental health in the Canadian cities of Calgary (fluoridation cessation in 2011) and Edmonton (still fluoridated). Methods We analyzed data from surveys of population-based samples of Grade 2 (approx. age 7) children in Calgary in 2009/2010 (pre-cessation; n=557) and in both Calgary and Edmonton in 2013/2014 (Calgary, n=3230; Edmonton, n=2304) and 2018/2019 (Calgary, n=2649; Edmonton, n=2600) (post-cessation). We estimated associations between several socioeconomic indicators and dental caries indicators (i.e., dental caries experience [deft, DMFT] and untreated decay in two or more teeth [untreated decay]) using zero-inflated Poisson, binary logistic regression, and the concentration index of inequality. We compared those associations over time (between survey waves) and between cities at post-cessation. Results Persistent social inequities in deft and untreated decay were evident; for example, having no dental insurance was significantly associated with higher odds of untreated decay across city and survey wave. In most (but not all) cases, differences between cities and survey waves were consistent with an adverse effect of fluoridation cessation on dental health inequities. For example, the association between no dental insurance and higher odds of untreated decay in Calgary was greater in 2018/2019 (later post-cessation) than in 2009/2010 (pre-cessation; odds ratio [OR] for comparison of coefficients = 1.89 [1.36–2.63], p<0.001) and 2013/2014 (early post-cessation; OR for comparison of coefficients = 1.67 [1.22–2.28], p=0.001); that same association in 2018/2019 was greater in Calgary (fluoridation cessation) than in Edmonton (still fluoridated) (OR for comparison of coefficients = 1.44 [1.03–2.02], p=0.033). Conclusion Social inequities in dental caries were present in both Calgary and Edmonton. Those inequities tended to be worse in Calgary where fluoridation was ceased. Our findings may be relevant to other settings where income inequality is high, dental services are costly, and dental public health infrastructure is limited.

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Section: Introductionsupporting

confidence: 91%

Fluoridation cessation and oral health equity: a 7-year post-cessation study of Grade 2 schoolchildren in Alberta, Canada

McLaren

Patterson

Faris

et al. 2022

Can J Public Health

Self Cite

View full text Add to dashboard Cite

show abstract

“…This study was conducted in the province of Alberta, where dental care costs are among the highest in Canada 16 . Income inequality in the province is high, 17 and significant social inequities in children's dental problems exist 18,19 . In such a setting, one might predict that a universal primary prevention measure like fluoridation would be beneficial, and its cessation problematic, for dental health.…”

Section: Introductionmentioning

confidence: 99%

Fluoridation cessation and children’s dental caries: A 7‐year follow‐up evaluation of Grade 2 schoolchildren in Calgary and Edmonton, Canada

McLaren

Patterson

Faris

et al. 2021

Comm Dent Oral Epid

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Small-area contextual effects on children’s dental caries in Alberta: a multilevel analysis

Cited by 2 publications

References 24 publications

Fluoridation cessation and oral health equity: a 7-year post-cessation study of Grade 2 schoolchildren in Alberta, Canada

Fluoridation cessation and oral health equity: a 7-year post-cessation study of Grade 2 schoolchildren in Alberta, Canada

Fluoridation cessation and children’s dental caries: A 7‐year follow‐up evaluation of Grade 2 schoolchildren in Calgary and Edmonton, Canada

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