The Socioeconomic Inequality in Increment of Caries and Growth among Chinese Children

Abstract

Background: This study aimed at assessing socioeconomic inequalities in the increment of dental caries and growth among preschool Chinese children, and to assess the best predictor of socioeconomic inequality for each of these conditions. Methods: This is a longitudinal population-based study. The sample data included preschool children living in three cities of the Liaoning Province, China. At baseline, 15 kindergartens with 1111 participants were included and dropped to 772 with a response rate of 70% at follow-up. Mean ages at baseline and follow-up were 50.82 and 60.55 months, respectively. Median follow-up time was 10.12 months. Data were collected through structured questionnaire, oral examination and anthropometric measurement. The questionnaire collected information on sex, age, family income, mother’s education and children’s dietary habits. The numbers of decayed, missing and filled teeth (DMFT) was used to indicate dental caries. Weight- and height-for-age z-scores were calculated using the WHO Growth Standard. Multilevel analysis was used to assess the association between baseline socioeconomic position and each of dental caries and child’s growth. Results: Mother’s education was negatively associated with increments of DMFT. Family income was not significantly associated with DMFT in the fully adjusted model. The association persisted after accounting for other socioeconomic and dietary factors. Higher income was positively related to an increase in the weight-for-age z-score. The relationship between income and changes in the height-for-age z-score was positive and significant in the second highest income group. Conclusions: Mother’s education appeared to be the strongest predictor of increments of dental caries. Only income was significantly associated with an increase in children’s weight and height.

Self-Reported Dental Caries by Mexican Elementary and Middle-School Schoolchildren in the Context of Socioeconomic Indicators: A National Ecological Study

“…Conceptually, individual and area socioeconomic characteristics do not necessarily belong to the same constructs, and thus, they may be affecting health through diverse mechanisms [59]. Our results are aligned with prior research reports from Mexico [6,7,38] and other countries [23,25,[27][28][29][30][31] where socioeconomic inequalities have been associated to oral health indicators. Studies on dental caries inequalities in low-and middle-income countries are relatively scarce [25], and there are even fewer studies about the spatial distribution pertaining specifically to caries [29].…”

“…Many causes of inequalities are difficult to identify, in part because they change in relation to their social context [22]. Several studies found significant associations between lower socioeconomic status and higher risk of dental caries [23][24][25][26][27][28][29]. Social factors influence variables associated with caries through modifying living conditions of the individual; it is feasible to gain a more accurate understanding of caries distribution through examining such a relationship.…”

Early Childhood Junk Food Consumption, Severe Dental Caries, and Undernutrition: A Mixed-Methods Study from Mumbai, India

“…This highlights the opportunity to prevent severe ECC by incorporating oral health promotion, fluoride varnish, and caries arrest treatments into well-child medical care in the first three years of life. These interventions could potentially prevent a substantial amount of suffering from chronic oral infection, mouth pain and associated undernutrition [ 11 , 12 , 42 , 43 ].…”

Income Inequality and Health Disparities in China’s Urban and Rural

“…Another article [21] interestingly used the sum of decayed, missing and filled teeth (DMFT) index as a parameter to represent the health inequality. The study observed 772 preschool children from 15 kindergartens distributed in urban and rural areas in northeast China.…”