Abstract
IntroductionThe distribution and severity of dental caries among preschool children vary according to the socio-economic and ethnic differences within and between countries. Understanding socio-economic influences on child oral health could inform early interventions to reduce the oral health burden throughout the life-cycle. The aim of this study is to examine the socio-economic and ethnic influences on oral health among preschoolers in Kegalle, Sri Lanka.MethodsThe study involved 784 children aged between 48–72 months recruited from 84 pre-schools in the Kegalle district in Sri Lanka. Cross-sectional data were collected by means of an oral examination of the children and a self-administered questionnaire to their parents/caregivers. The Early Childhood Oral Health Impact Scale (ECOHIS) was used to assess Oral Health related Quality of Life (OHQoL). Univariate and multivariate models of Poisson regression were used to investigate the associations between the variables.ResultsCompared to children whose fathers had tertiary education, those whose fathers did not study beyond grade 5, had more caries measured in terms of decayed, missing and filled surfaces (dmfs) (IRR = 2.30; 95% CI: 1.30, 4.06; p < 0.01) and experienced poor OHQoL at child (IRR = 2.52; 95% CI: 1.20, 5.31; p < 0.05) and family (IRR = 1.59; 95% CI: 1.11, 2.27; p < 0.05) levels. However, lower educational attainment among mothers was associated with better OHQoL among children. Compared to the Sinhalese ethnic group, Tamils had more gingival bleeding (bleeding surfaces) (IRR = 3.04; 95% CI: 1.92, 4.81; p < 0.001) and poor OHQoL at child level (IRR = 2.07; 95% CI: 1.19, 3.60; p < 0.01), whereas Muslims had poor OHQoL at family level (IRR = 1.42; 95% CI: 1.10, 1.84; p < 0.01). Children of low-income families had more gum bleeding (IRR = 1.00; 95% CI: 0.99, 1.00; p < 0.05) compared to children of high-income families.ConclusionsSocio-economic and ethnic differences in oral health outcomes exist among this population of preschoolers. Interventions targeting children of fathers with low educational levels and ethnic minority groups are required to reduce inequalities in oral health in Sri Lanka and other similar countries.
Highlights
The distribution and severity of dental caries among preschool children vary according to the socio-economic and ethnic differences within and between countries
In several Asian and African countries the level of caries is higher in the primary dentition than in the permanent dentition in children [11,12], and poor oral health is unequally distributed in these countries, with those from socially-disadvantaged communities among the most affected [13]
The aim of the present study was to assess the effect of selected socio-demographic factors on dental caries, gingival bleeding and Oral Health related Quality of Life (OHQoL) in preschool children in the Kegalle district in Sri Lanka
Summary
The distribution and severity of dental caries among preschool children vary according to the socio-economic and ethnic differences within and between countries. The aim of this study is to examine the socio-economic and ethnic influences on oral health among preschoolers in Kegalle, Sri Lanka. The distribution and severity of oral diseases vary within and between countries depending on socio-economic status and ethnic differences [6,7,8,9,10]. In Sri Lanka, the prevalence of dental caries in primary dentition of 5 years old children is 65% [12], while the national figure for the prevalence of bleeding gums for the same age group is 46.3% [14]. In the USA it has been demonstrated that the prevalence of dental caries among 12–60 month old children is 28% [18], and in Brisbane, Australia among 4–6 year olds caries prevalence is 33.7% [19]
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