Abstract
BackgroundAlthough oral health has improved remarkably in recent decades, not all populations have benefited equally. Ethnic identity, and in particular visible minority status, has been identified as an important risk factor for poor oral health. Canadian research on ethnic disparities in oral health is extremely limited. The aim of this study was to examine ethnic disparities in oral health outcomes and to assess the extent to which ethnic disparities could be accounted for by demographic, socioeconomic and caries-related behavioral factors, among a population-based sample of grade 1 and 2 schoolchildren (age range: 5-8 years) in Alberta, Canada.MethodsA dental survey (administered during 2013-14) included a mouth examination and parent questionnaire. Oral health outcomes included: 1) percentage of children with dental caries; 2) number of decayed, extracted/missing (due to caries) and filled teeth; 3) percentage of children with two or more teeth with untreated caries; and 4) percentage of children with parental-ratings of fair or poor oral health. We used multivariable regression analysis to examine ethnic disparities in oral health, adjusting for demographic, socioeconomic and caries-related behavioral variables.ResultsWe observed significant ethnic disparities in children’s oral health. Most visible minority groups, particularly Filipino and Arab, as well as Indigenous children, were more likely to have worse oral health than White populations. In particular, Filipino children had an almost 5-fold higher odds of having severe untreated dental problems (2 or more teeth with untreated caries) than White children. Adjustment for demographic, socioeconomic, and caries-related behavior variables attenuated but did not eliminate ethnic disparities in oral health, with the exception of Latin American children whose outcomes did not differ significantly from White populations after adjustment.ConclusionsSignificant ethnic disparities in oral health exist in Alberta, Canada, even when adjusting for demographic, socioeconomic and caries-related behavioral factors, with Filipino, Arab, and Indigenous children being the most affected.
Highlights
Oral health has improved remarkably in recent decades, not all populations have benefited
Description of the sample: Missing data, ethnic identity distribution, and comparison with national population estimates Of the 6884 participants who had the data from both parent questionnaire and mouth examination, our analytic sample size was n = 5600
For purpose of comparison with population estimates, we examined the ethnicity distribution across the full sample (i.e., sample including those whose ethnicity fell into a smaller group (n < 100), and those whose ethnicity was recorded as “other” and could not be reclassified into an existing category, see Additional file 2: Figure S1)
Summary
Oral health has improved remarkably in recent decades, not all populations have benefited . In particular visible minority status, has been identified as an important risk factor for poor oral health. Canadian research on ethnic disparities in oral health is extremely limited. The aim of this study was to examine ethnic disparities in oral health outcomes and to assess the extent to which ethnic disparities could be accounted for by demographic, socioeconomic and caries-related behavioral factors, among a population-based sample of grade 1 and 2 schoolchildren (age range: 5-8 years) in Alberta, Canada. Remarkable progress has been made in improving oral health; not all populations have benefited . One important contributor to poor dental health among socially disadvantaged populations in Canada is limited access to dental care. A small proportion of dental services are federally or provincially funded, not all vulnerable Canadians are eligible [8]
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