Socioeconomic gradients in general and oral health of primary school children in Shiraz, Iran

Abstract

Background: Health status is largely determined by socio-economic status. The general health of individuals at higher social hierarchy is better than people in lower levels. Likewise, people with higher socio-economic status have better oral health than lower socio-economic groups. There has not been much work regarding the influence of socio-economic status on the health conditions of children in developing countries, particularly in Iran. The aim of this study was to compare the oral and general health conditions of primary school children of three different socio-economic areas in the city of Shiraz, Iran. Methods: This cross-sectional study was conducted on 335, 8- to 11-year-old primary schoolchildren in Shiraz. The children were selected by a three-stage cluster sampling method from three socio-economically different areas. Tools and methods used by the United Kingdom’s Medical Research Council were used to obtain anthropometric variables as indicators of general health. The Decay, Missing, Filled Teeth (DMFT) Index for permanent teeth, dmft Index for primary teeth, the Modified Developmental Defects of Enamel (DDE) Index, the Gingival Index (GI) and the Debris Index-Simplified (DI-S) were used for oral health assessment. Results: Height (P<0.001), weight (P<0.001), and BMI (P=0.001) significantly increased as the socio-economic status of area increased. GI score (P<0.001), DI-S score (P<0.001), number of permanent teeth with DDE (P=0.008), and number of DDE lesions in permanent teeth (P=0.008) significantly decreased as the socio-economic status of area increased. Discussion: Findings of this study generally confirmed that social gradients exist in both general and oral health status of the primary schoolchildren of Shiraz. The influence of socio-economic status on health condition means children have different life chances based on their socio-economic conditions. These findings emphasize the significance of interventions for tackling socio-economic inequalities in order to improve the health status of children in lower socio-economic areas.

Evaluation of Dental Status and Its Association with Oral Health-Related Quality of Life in Preschool Children in Zahedan City, Iran: A Cross-Sectional Study

“…In the present study, no significant difference was found between two genders in terms of the mean DMFT, which is consistent with some of the studies conducted in Iran on DMFT (17,19,20).…”

“…However, in our study, the relationship between socioeconomic status of the family and the quality of life and the DMFT index was not significant. In Golkari et al study in Shiraz city, a direct relationship was found between the socioeconomic level of family and OHRQOL (17). Also, in the study conducted by Nanayakkara et al there was a direct relationship between low family income and low education of parents with increased dental caries (16).…”

Does a social/behavioural gradient in dental health exist among adults? A cross-sectional study

“…In addition to the social gradient, health behaviours are also involved in the development of diseases, suggesting the existence of a social/behavioural gradient. 1 , 2 …”

Malnutrition‐related early childhood exposures and enamel defects in the permanent dentition: A longitudinal study from the Bolivian Amazon

“…A disproportionate burden of defects is shouldered by marginalized, low-income populations (Psoter et al 2005; Golkari et al 2016). There is evidence that systemic factors associated with developmental enamel defects include disease, macronutrient and micronutrient deficiencies, chronic conditions, excessive fluoride exposure, and/or prolonged use of certain medications.…”