Socio-demographic disparity in oral health among the poor: a cross sectional study of early adolescents in Kilwa district, Tanzania

Kijakazi O Mashoto,Joyce R Masalu,Marit S Skeie,Anne N Astrom

doi:10.1186/1472-6831-10-7

Abstract

BackgroundThere is a lack of studies considering social disparity in oral health emanating from adolescents in low-income countries. This study aimed to assess socio-demographic disparities in clinical- and self reported oral health status and a number of oral health behaviors. The extent to which oral health related behaviors might account for socio-demographic disparities in oral health status was also examined.MethodsA cross-sectional study was conducted in Kilwa district in 2008. One thousand seven hundred and forty five schoolchildren completed an interview and a full mouth clinical examination. Caries experience was recorded using WHO criteria, whilst type of treatment need was categorized using the ART approach.ResultsThe majority of students were caries free (79.8%) and presented with a low need for dental treatment (89.3%). Compared to their counterparts in opposite groups, rural residents and those from less poor households presented more frequently with caries experience (DMT>0), high need for dental treatment and poor oral hygiene behavior, but were less likely to report poor oral health status. Stepwise logistic regressions revealed that social and behavioral variables varied systematically with caries experience, high need for dental treatment and poor self reported oral health. Socio-demographic disparities in oral health outcomes persisted after adjusting for oral health behaviors.ConclusionsSocio-demographic disparities in oral health outcomes and oral health behaviors do exist. Socio-demographic disparities in oral health outcomes were marginally accounted for by oral health behaviors. Developing policies and programs targeting both social and individual determinants of oral health should be an urgent public health strategy in Tanzania.

Highlights

There is a lack of studies considering social disparity in oral health emanating from adolescents in lowincome countries
Oral health behavior have been demonstrated in developing countries and elsewhere, with oral health detrimental behaviors being most common in subjects of lower sociodemographic status [10,11,12]
It is assumed that inequality has multiple causes and that the effect on oral health of socio-economic and demographic factors is mediated through environmental exposure, psychosocial factors, lifestyle and availability of health care services [13]

Summary

Introduction

There is a lack of studies considering social disparity in oral health emanating from adolescents in lowincome countries. This study aimed to assess socio-demographic disparities in clinical- and self reported oral health status and a number of oral health behaviors. Petersen [8] presented a risk factor model for dental caries, suggesting that socio-environmental factors influence behavioral- and attitudinal factors which in turn impact on clinical- and subjective oral health outcomes. Sabbah et al [3] analyzed data from the US Third National Health and Nutrition Examination Survey focusing adults above 17 yrs and found attenuation of socio-economic disparities in oral health status after adjusting for various oral health related behaviors. Recent studies among US adolescents revealed that socio-economic disparities in caries experience could not be accounted for by similar disparities in oral health behaviors [5]

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Conclusion