Abstract
ABSTRACTOBJECTIVE To investigate the association between life course socioeconomic conditions and two oral health outcomes (edentulism and use of dental prostheses among individuals with severe tooth loss) among older Brazilian adults.METHODS This was a cross-sectional study with data from the Brazilian Longitudinal Study of Aging (ELSI-Brazil) which includes information on persons aged 50 years or older residing in 70 municipalities across the five great Brazilian regions. Regression models using life history information were used to investigate the relation between childhood (parental education) and adulthood (own education and wealth) socioeconomic circumstances and edentulism and use of dental prostheses. Slope index of inequality and relative index of inequality for edentulism and use of dental prostheses assessed socioeconomic inequalities in both outcomes.RESULTS Approximately 28.8% of the individuals were edentulous and among those with severe tooth loss 80% used dental prostheses. Significant absolute and relative inequalities were found for edentulism and use of dental prostheses. The magnitude of edentulism was higher among individuals with lower levels of socioeconomic position during childhood, irrespective of their current socioeconomic position. Absolute and relative inequalities related to the use of dental prostheses were not related to childhood socioeconomic position.CONCLUSIONS These findings substantiate the association between life course socioeconomic circumstances and oral health in older adulthood, although use of dental prostheses was not related to childhood socioeconomic position. The study also highlights the long-lasting relation between childhood socioeconomic inequalities and oral health through the life course.
Highlights
Oral diseases are among the most common chronic diseases worldwide[1]
The magnitude of edentulism was higher among individuals with lower levels of socioeconomic position during childhood, irrespective of their current socioeconomic position
These findings substantiate the association between life course socioeconomic circumstances and oral health in older adulthood, use of dental prostheses was not related to childhood socioeconomic position
Summary
Oral diseases are among the most common chronic diseases worldwide[1]. Poor oral health is a major global health burden[1]. Severe tooth loss is ranked in the 36th position among the 100 chronic diseases that affect life expectancy[1]. Impaired oral health is especially important among socioeconomic disadvantaged groups and follows a gradient in which lower socioeconomic groups have worse oral health[5]. A person’s socioeconomic position (SEP) at different stages of life course has been found to be associated with general health[6] and with an increased risk of tooth loss.[7] the life course approach has gained considerable attention in understanding social inequalities in oral conditions[8]
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