Socioeconomic gradients in toothache experience among Australian adults: A time trend analysis from 1994 to 2013

Abstract

Objectives To identify time trend pattern in toothache and to estimate whether toothache prevalence differs by socioeconomic position and residential location over time. Methods Data from nine successive National Dental Telephone Interview Surveys (NDTIS) from 1994 (n = 6907) to 2013 (n = 6778) performed in Australia among individuals aged 15 years or over were used. The dependent variable was toothache reported very often, often or sometimes during the previous 12 months. Independent variables were age group, household income (tertiles), insurance/cardholder status and geographical remoteness. Prais‐Winsten analyses were performed, and the average annual percentage change (AAPC) for toothache prevalence was estimated. Results Toothache affected slightly more than 10% of the overall population in 1994 (11.6%) and 1995 (11.4%), reaching approximately one‐sixth (16.2%) of individuals in 2013. Overall, there was a significant increase in toothache prevalence over time (AAPC = 2.0% [95% CI 0.7;1.34]) and in those aged 25‐44 (AAPC 2.1% [95% CI 0.6;3.6]) and 45‐64 (AAPC 3.4% [95% CI 1.5;5.3]) years and markedly among those in the lowest income group (AAPC 3.4% [95% CI 0.1;6.7]). All geographic locations except for remote/very remote areas had upward toothache prevalence over time. Insured status was not associated with increased toothache prevalence during the investigated period. Conclusions Toothache prevalence increased from 1994 to 2013 in Australian adults particularly among the lowest socioeconomic group.

Twenty‐five‐year follow‐up of educational differences in toothache prevalence

“…After the reform, oral healthcare service use increased and socioeconomic differences within it decreased slightly . As access to oral healthcare services is seen as an important factor behind toothache prevalence and socioeconomic differences in it, our findings of increasing toothache prevalence and rather small education‐related differences in Finland during the last decades deserve consideration. It seems that deeper knowledge about connections between toothache experience and oral healthcare service use and organization is needed in order to understand and tackle increasing toothache prevalence in Finland and elsewhere.…”

“…However, in the case of toothache prevalence, findings are not that clear. A recent Australian study on socioeconomic gradients in toothache prevalence during 1994‐2013 detected two‐ to three‐fold differences in toothache prevalence between the highest and lowest household income tertiles. On the other hand, Finnish studies have found clearly smaller, even minimal, differences in toothache prevalence both by household income and by educational levels among + 30‐year‐olds in the 2000s .…”

“…On the other hand, Finnish studies have found clearly smaller, even minimal, differences in toothache prevalence both by household income and by educational levels among + 30‐year‐olds in the 2000s . However, in both countries, studies found that socioeconomic differences increased during the follow‐up . It has been found that perceived general health and income itself explained most of the income‐related differences in toothache prevalence in Finland, possibly due to differences in access to oral healthcare services by socioeconomic status .…”

“…Toothache is also behind a major number of visits to oral healthcare services and thus greatly burdens and affects (oral) health care worldwide. Studies conducted in Brazil, Australia, the USA and the UK imply that toothache prevalence and emergency visits because of toothache have been increasing at least during the last decades . Overall, toothache prevalence ranges greatly, being approximately 7%‐45%, depending on the population or country studied or reference period used (1‐24 months) …”

“…It is inevitable that information on toothache prevalence and distribution in population is necessary for rational health (care) policies. However, nationally representative studies, especially with long follow‐up, are very limited . In addition, socioeconomic differences in toothache prevalence have not been studied separately for men and women in long follow‐up periods, even though socioeconomic differences in health may differ considerably by sex .…”