SOCIOECONOMIC INEQUALITIES IN ORAL HEALTH ASPECTS IN PRIMARY SCHOOL CHILDREN

Abstract

Oral health inequality in children is a widespread and well-documented problem in oral health care. However, objective and reliable methods to determine these inequalities in all oral health aspects, including both dental attendance and oral health, are rather scarce.

Aims: to explore oral health inequalities and to assess the impact of socio-economic factors on oral health, oral health behaviour and dental compliance of primary schoolchildren.

Methods: Data collection was executed in 2014 within a sample of 2,216 children in 105 primary schools in Flanders, by means of an oral examination and a validated questionnaire. Intermutual Agency database was consulted to objectively determine individuals social state and frequency of utilization of oral health care services. Underprivileged children were compared to more fortunate children for their mean DMFt, DMFs, Plaque index, Care Index (CI), Restorative Index (RI), Treatment Index (TI), knowledge and attitude. Differences in proportions for dichotomous variables (RI100%, TI100% and being a regular dental attender)were analysed. The present study was approved by the Ethics Committee of the University Hospital Ghent (2010/061). All parents signed an informed consent form prior to data collection. All schools received information about the study protocol and agreed to participate. Children requiring dental treatment or periodic recall were referred to the local dentist.

Results: Underprivileged children showed worse outcomes for all explanatory variables (p<0.05). In the low- income group, 78.4% was caries free, compared to 88.4% for the other children. Half of the low-income children could be considered as regular dental attenders, whether 12.6% did not have any dental visit during a five year period.

Conclusion: Oral health, oral hygiene, oral health care level and dental attendance patterns are strongly negatively affected by childrens social class, leading to oral health inequalities in Belgian primary school children. Methods of funding: The research presented in this report is part of the Glimlachen.be project (www.glimlachen. be), commissioned and financed by the Insurance Committee for Health Care of the Belgian National Institute for Health and Disability Insurance. The authors thank the Flemish Dental Association (VVT), the dentist examiners and all contributors.