Oral Health Status Of Children Research Articles

Evaluation of Oral Hygiene Status among 12-14-Year-Old School Children.

Background:Oral diseases such as dental caries, gingivitis, and periodontitis are common among population. The present study was conducted to assess dental caries status and oral hygiene practice among school children.Materials and Methods:This school-based study was conducted on 520 children of age group of 12–14 years of both genders. Location, education, and employment status of parents, use of toothbrush, frequency of brushing, dental floss, total number of meals in a day, number of snacks between meals and sugar consumption, and decayed, missing, filled teeth were recorded.Results:There were 266 males and 254 females. Age group 12 years had 80 males and 90 females, 13 years had 70 males and 60 females, and 14 years had 116 males and 104 females. Ninety-six males and 110 females were from urban and 170 males and 144 females were from rural. The mean plaque score in 12-year male children was 0.61 ± 0.32, in 13-year children was 0.68 ± 0.45, and in 14 years was 0.74 ± 0.48. In males, the mean plaque score was 0.70 ± 0.38 and in females was 0.66 ± 0.42. In children from urban area, the mean plaque score was 0.62 ± 0.34 and from rural area was 0.74 ± 0.40. Four hundred and eighteen children were using toothpaste and they had plaque score of 0.76 and 102 children were using floss and they had plaque score of 0.89. Three hundred and twenty children were brushing once, 90 twice, and 110 irregular and there mean plaque score was 0.70, 0.61, and 0.76, respectively. The difference was significant (P < 0.05).Conclusion:Authors found that oral health status of children consuming high sugar, more snacks per day, and brushing occasionally was poor.

Derivation of a Risk Score for High Caries Risk in 3- to 5-year-old Children in Sichuan Province.

To explore potential caries risk indicators in 3- to 5-year-old children, and develop a simple risk-score model to screen the children at high risk of caries with decayed, filled, and missing teeth (dmft) > 2. A cross-sectional study involving 2746 children 3 to 5 years of age was conducted in Sichuan province. Children were examined for dmft index, and sociodemographic and behavioural factors were acquried through a questionnaire completed by their caregivers. A prediction model was developed by backward multivariate logistic regression, and its overfitting degree was examined with 5-fold cross-validation. A simple risk-score model was derived to screen the children with dmft > 2 at high risk of caries with the β regression coefficient obtained from the multivariate regression model. A child's oral health status was identified as the highest risk indicator with a β regression coefficient of 1.093. The mean area under curve (AUC) from the 5-fold cross-validation was 0.7408 (95% CI: 72.21%, 75.95%), with a bias of only ca 1%. This result allowed us to eliminate substantial overfitting of the prediction model. The AUC of the risk scoring system was 0.7455 (95% CI: 72.70%, 76.40%), which indicated good screenability. This risk score model has the advantages of simplicity, low cost and relatively high accuracy, and is suitable for use in developing countries, especially for primary screening for high risk of caries. It shows that certain child behaviours and parental attitude play an important role in dental caries among preschool children.

Children's oral health-related behaviours and early childhood caries: A latent class analysis.

In this cross-sectional study in a large community-based sample of preschool-age children, we sought to identify distinct clusters of modifiable early childhood oral health-related behaviours (OHBs) and quantify their association with clinical and parent-reported measures of early childhood oral health. We relied upon a questionnaire (n=8033; 11% in Spanish) and clinical oral health data (n=6404; early childhood caries [ECC] prevalence=54%] collected in the context of an epidemiologic study of early childhood oral health among 3- to 5-year-old children in North Carolina. Latent class analysis was used to identify clusters of modifiable OHBs based on parents' responses to 6 questionnaire items pertaining to their children's oral hygiene, diet and dental home. The optimal number of clusters was determined based on measures of model fit and interpretability. We examined associations of OHB clusters with clinical and parent-reported child oral health status (ie, ECC prevalence, severity and proportion with untreated disease) using bivariate association tests and multivariable regression modelling with marginal effects estimation accounting for clustered data. We used Mplus v.8.6 (Muthén & Muthén, Los Angeles, CA, USA) and Stata v.16.1 (StataCorp, College Station, TX, USA) for data analyses. We identified 2 OHB clusters, a favourable (74%) and an unfavourable (26%) one. Children in the favourable OHB cluster had better oral hygiene practices (ie, tooth brushing frequency and fluoridated toothpaste use), lower consumption frequency of sugar-containing snacks and beverages, less frequent reports of night-time bottle-feeding history and a higher likelihood of a dental home. Children in the unfavourable cluster had significantly higher ECC prevalence (57% vs 53%), caries burden (mean dmfs=9.3 vs 7.6), untreated disease (43% vs 33%) and worse parent-reported oral health status than the favourable cluster. Our findings demonstrate the importance and utility of clustering common, modifiable ECC risk factors in population studies - health promotion efforts may centre on groups of people rather than individual behavioural risk factors.

Oral Health Status of Children: Results of the 2018–2019 California Third Grade Smile Survey

This report presents findings from a survey of third grade children conducted during the 2018 and 2019 school years. The prevalence of tooth decay, untreated tooth decay and dental sealants was 61%, 22% and 37%, respectively. Overall achievements among third graders included a noticeable reduction in tooth decay experience (61% down from 71%) and untreated decay (22% down from 29%) and an increase in dental sealant prevalence (37% up from 28%) compared to the 2004-05 school year when this was last assessed. However, tooth decay remains a significant public health problem, especially among certain racial/ethnic and socioeconomically disadvantaged groups.

Salivary Biomarker Levels and Oral Health Status of Children with Cerebral Palsy and Their Healthy Siblings: A Comparative Study.

BackgroundThe dental needs of cerebral palsy children are an area of study much in need of attention. The neglect of this aspect should be rectified, and simpler diagnostic methodologies should be established and used to serve this purpose.AimThis study aimed to determine oral health status and salivary biomarkers (salivary flow rate, pH, buffering capacity) among children with cerebral palsy (CP), to compare their data with that of their healthy siblings, and to evaluate the relationship between salivary biomarkers and dental caries.MethodsA total of 30 CP children (study group) and 30 normal healthy siblings (controls) were selected between the ages of 5 and 12 years. Salivary biomarkers were assessed, and oral health status was examined.Statistical AnalysisChi-square test was used for comparison of oral health status. Unpaired t test was used to compare caries indexes (decay/filled teeth–primary dentition [dft] and decay/missing/filled teeth–permanent dentition [DMFT]) and salivary biomarkers between the groups. Pearson correlation was used to find the correlation between salivary biomarkers and caries.ResultsThe dft scores were significantly higher in the study group (P<0.05). The pH values and salivary flow rates were significantly lower in the study group (P<0.05 and P<0.001, respectively). There was a significant correlation between DMFT scores and salivary flow rate in the study group (P<0.05).ConclusionLow pH and low salivary flow rate might be risk factors for dental caries in CP populations; moreover, the significant correlation between DMFT score and salivary flow rate suggests that salivary flow rate could be used as a screening tool for assessing at-risk subjects in such populations.

Comparative Evaluation of Oral Health Status in Children With β-Thalassemia Major In Lattakia City - Syria

Comparative Evaluation of Oral Health Status in Children With β-Thalassemia Major In Lattakia City - Syria

Use of statistical models for predicting oral health status of children with cerebral palsy in Sri Lanka

Cerebral Palsy (CP) is the most common movement disorder in children, which is defined as ‘‘a group of permanent disorders of the development of movement and posture, causing activity limitations attributed to non-progressive disturbances occurred in developing fetal or infant brain. In this study, we consider the four most common CP types categorized by the location of movement problems named Monoplegia, Diplegia, Hemiplegia, and Quadriplegia. Oral health is a state of being free from the chronic mouth, facial pain, oral and throat cancer, oral sores, congenital disabilities such as cleft lip and palate, tooth decay and tooth loss, and other diseases disorders oral cavity. The main goal of the study is to create suitable statistical models for predicting the oral health status of children with CP using Silness-Löe plaque index and DMFT Index (DMFTI). Also, to identify the relationships between DMFTI and demographic, DMFTI and CP location, Silness-Loe plaque index and demographic data, Silness-Loe plaque index and CP location, Care index (CI) and demographic data, and the CI and CP location. This analysis was performed on a sample of 93 children with CP in the Central Province, Sri Lanka. The independent sample t-test and one-way ANOVA test were used to identify the relationship between variables, and effect sizes were calculated using partial Eta squared value to measure the strength of the relationship. Further Multiple Linear Regression (MLR) model, Random Forest Regression (RFR) model, and the Support Vector Regression (SVR) model were used to predict the oral health status using DMFTI and plaque index separately. A comparison was conducted for the fitted models using the Coefficient of determination (R-squared). There is a significant difference between the mean values of the plaque index for different CP locations. Children with diplegia have the lowest plaque index, while children with hemiplegia have the highest plaque index. The accuracy of the MLR model for predicting DMFTI is 23.60% and 20.80% for Permanent and primary teeth separately, and 20.00% for predicting Plaque Index. Those accuracies for the RFR model are 92.64%, 93.11% and 90.32%, while 95.36%, 85.65% and 80.07% for SVR model respectively. Therefore, the RFR Model was considered the best-fitted model for predicting oral health status using DMFTI and the plaque index of Sri Lankan children with CP. Besides, children with hemiplegia have a higher risk of having lower oral health status.

Are anxiety and the presence of siblings risk factors for dental neglect and oral health status in children?

ObjectiveNeglect has a negative effect on all aspects of a child's overall health. Dental neglect is the intentional failure of parents or caregivers to take precautions and ensure the necessary dental treatment, and is closely related to dental caries and anxiety. We aimed to determine whether the presence of siblings causes dental neglect, and whether there is a relationship between dental neglect and anxiety. MethodsThe cross-sectional study included 100 children and their parents. The children's oral health status was evaluated using the DMFT/dmft and PUFA/pufa indices. In addition, the parents completed the Dental Neglect Scale and a questionnaire, while the Modified Child Dental Anxiety Scale was administered to the children to assess their dental anxiety. ResultsMultivariate linear regression analysis showed that the number of children in the family was statistically significantly associated with DMFT/dmft (β=2.963; P<0.001), PUFA/pufa (β=1.271; P=0.005), and dental neglect scores (β=5.449; P<0.001). The PUFA/pufa scores were statistically higher among children who had visited a dentist before (β=1.181; P=0.043). ConclusionsThe high level of dental anxiety and neglect in children with more than one sibling indicates that families should be more aware of the importance of oral health.

Oral health status of children and young adults with maple syrup urine disease in Turkey

BackgroundMaple syrup urine disease (MSUD) is an inherited disorder clinically characterized by ketoacidosis, seizures, coma, psychomotor delay, and intellectual disability. The treatment requires a life-long protein-restricted diet, rich in carbohydrates and fats, supplemented with a medical amino acid formula. Diet, oral health and general health influence each other in a vicious cycle. The aim of this study was to investigate the oral health status of children and young adults with MSUD in Turkey.MethodsA descriptive study was conducted on patients with MSUD who applied for routine follow-up to the pediatric metabolic diseases clinic at Hacettepe University, Children's Hospital in Ankara, Turkey in a 12-month period. Patients with any other concomitant genetic diseases and acute infection were excluded. A total of twenty-five patients were enrolled and underwent oral examination including DMFT/S, dmft/s (decayed/missing/filled teeth/surfaces for deciduous and primary teeth, respectively), plaque and gingival indices. Panoramic radiographs were obtained in 12 cooperative patients.ResultsMean age was 9.88 ± 5.68 s.d years. More than half of the parents had only primary school level education, and low income. Fourteen patients consumed medical formula during or right before sleep. Fourteen patients reported caries-associated pain. Gingival inflammation was present in all 15 patients who cooperated for evaluation. Seven out of twelve patients had at least one dental anomaly or alterations in mandibular morphology. Five patients had previously been treated for caries under general anesthesia. To our knowledge, this is the first study to document oral clinical and radiologic findings in patients with MSUD.ConclusionsImpaired oral health was observed in this rare disease population. Regular dental referral by physicians, preventive measures and dental treatments should be included in multidisciplinary management of maple syrup urine disease to promote oral health.

Oral health status in children with familial Mediterranean fever.

Familial Mediterranean fever (FMF) is the most common hereditary autoinflammatory disease. We aimed to investigate the oral health status and oral hygiene habits in children with FMF. In this cross-sectional study, 199 children with FMF, aged between 3-18 years, were included. Demographic findings and oral hygiene habits of children were questioned by face-to-face interview. Oral health status of patients was evaluated using decay-missing-filled index [DMFT (decay-missing-filled teeth), DMFS (decay-missing-filled teeth) for permanent; dmft, dmfs for primary teeth], the International Caries Detection and Assessment System (ICDAS-II) index, PUFA / pufa index [the presence of severely decayed teeth with visible pulpal involvement (P/p), ulceration caused by dislocated tooth fragments (U/u), fistula (F/f) and abscess (A/a)], gingival (GI) and plaque index (PI). In addition to these, occlusion, oral soft and hard tissues were examined. One-hundred-nine (54.8%) of children had at least one decayed permanent tooth and 81.2% of children had at least one decayed primary tooth. The mean DMFT was 1.91±2.45, DMFS was 3.1±4.49, dmft was 3.95±3.54, dmfs was 8.62±8.88, PI was 1.17±0.44, GI was 0.85±0.39. Aphthous mouth ulcer occurred in 19 (9.5%) patients. Recurrent aphthous mouth ulcers were more frequent among patients with one exon-ten and one exon-two mutations than patients with one exon-10 mutation, two exon-ten mutations, or two exon-2 mutations (61.1% vs. 47.9%, 26.1%, 20%, respectively p < 0.001). Tooth decay was more frequent among patients who had attacks in the last six months than those who did not have any attacks during the last six months (97.4% vs. 87.7%, p=0.017). Dental caries and periodontal disease, which are public health problems, were seen at a high percentage of children with FMF in our study.

Oral health status for primary dentition - A pilot study.

Formulating an oral health status which will include oral hygiene index (OHI) exclusively for children, deft index, and the incidence of white spot lesions (WSL) will make it easier for the examiner to assess the current oral health status of a child and help in planning preventive strategies. This index will provide a comprehensive yet quick way to assess the oral health status of children as it includes past caries experience, present oral hygiene status, and future prediction of caries. Two hundred children (100 male, 100 female) aged 3-5 years (primary dentition) were included in this study. OHI, recorded index tooth wise and segment wise, deft index, and the WSLs classification were recorded in all the children. Receiver operating characteristics (ROC) curve was used to evaluate the accuracy of recording OHI in children index tooth wise and segment wise. All the three indices were recorded for the 200 subjects, and based on the area under the curve of receiver operating characteristics, it was found that the OHI for primary dentition can be recorded tooth wise or segment wise. Index teeth chosen for primary dentition were labial surfaces of 54, 61, and 64, lingual surfaces of 82, 75, and 85. It includes the past caries experience, present hygiene status, and the future prediction of caries, making it a wholesome index. This cumulative index can be widely used in studies of epidemiology and ensure quicker evaluation during dental health programs in public school systems.

Oral Health Status of Children Undergoing Hemodialysis and Kidney Transplantation in Mansoura City, Egypt

Purpose: Evaluation of oral health status in children undergoing hemodialysis sessions and kidney transplantation and compared them with healthy children. Materials and Methods: This descriptive study was conducted on 250 children aged 6-18 years old (100 children undergoing hemodialysis, 50 children undergoing kidney transplantation and 100 healthy children as a control group). The oral health status was evaluated regarding to caries experience, gingivitis using PMA index, developmental defects using modified DDE index. Un-stimulated salivary flow rate and pH were also measured. Results: caries experience was significantly lower in both chronic kidney disease (CKD) groups compared to control group. Median PMA was significantly higher in hemodialysis and in transplantation groups compared to control group. The prevalence of developmental enamel defects was 41% in hemodialysis group and 58% in transplantation group compared to 11% in control group (P-value < 0.001). Regarding to saliva analysis, the flow rate was higher among healthy children while the salivary PH was higher among children with CKD. Conclusions: chronic kidney disease may decrease caries experience, increase gingival inflammation, in addition to increase prevalence of developmental defects. Furthermore, children with chronickidney disease have lower salivary flow rate and higher buffering capacity than healthy children.

Oral health status of children with autism spectrum disorder

Oral health status of children with autism spectrum disorder

Oral Health Status of Children with Cerebral Palsy who Have Dysphagia: A Comparative Study

Oral Health Status of Children with Cerebral Palsy who Have Dysphagia: A Comparative Study

THE PERCEPTION OF CAREGIVERS OF POOR ORAL HEALTH OF THEIR CHILDREN AND ITS RELATED CLINICAL CONDITIONS.

ABSTRACTObjective: To determine the association between the perception of caregivers regarding the oral health of their children and socio-demographic characteristics, report of dental pain, and clinical oral conditions.Methods: A cross-sectional study was conducted with 570 children aged two to five years old, enrolled at public preschools, and with their caregivers. Data regarding perceptions of oral health status in children, socio-demographic characteristics, and dental pain were collected from a questionnaire. Three examiners (Kappa>0.7) evaluated children’s oral health status using the dmft index, pufa index, and the Andreasen classification for traumatic dental injury (TDI). The occurrence of open bite and overjet was also investigated. Descriptive analyses, and unadjusted and adjusted logistic regression were used, considering a 5% significance level.Results: A total of 24.7% of children had poor oral health status, which increased 4.92-fold (95% confidence interval [95%CI] 3.05-7.93) when children had dental caries, and 3.78-fold (95%CI 1.63-8.76) when there were consequences from dental caries. The perception of poor oral health was also associated to open bite (Odds Ratio [OR] 1.98; 95%CI 1.16-3.38) and TDI (OR 1.68; 95%CI 1.06-2.68). No associations were found between the perception of caregivers and socio-demographic variables or overjet.Conclusions: The perception of caregivers of poor oral health in their children was associated to dental caries, its consequences, TDI, and open bite.

A prospective case-control study to evaluate oral health status before and after intervention using different dental aids in children with visual impairment.

Background:A major dental concern in children with special health-care needs is poor oral hygiene, which results in increased incidences of dental caries, gingivitis, and periodontal disease.Aims:The study intended to determine if there was a difference in the oral health status of children with visual impairment and normal children and to evaluate the efficacy of the frequently used dental aids.Settings and Design:The study population included 90 children, 45 children with visual impairment (study group) with age- and sex-matched 45 normal children (control group). Both the groups were further divided into three intervention subgroups. Subgroup A: manual toothbrushes, Subgroup B: manual toothbrush with medicated mouthwashes, and Subgroup C: powered toothbrushes.Materials and Methods:For each subject, oral hygiene index simplified (OHIS), Turesky-Gilmore-Glickman modification of the Quigley-Hein Plaque Index (TQPHI), and decayed missing filled teeth (DMFT) indices were recorded at baseline, i.e., before any intervention. This was followed by oral prophylaxis by ultrasonic scaling. The three indices were recorded in 0 (baseline), 30 days (1 month), 90 days (3 months), and 180 days (6 months), respectively.Statistical Analysis Used:ANOVA test, Chi-square test, and student paired test were used for statistical analysis.Results:The mean TQHPI and OHIS values of mouthwashes at the end of 6 months were 1.01 and 1.60, respectively, which were lower than manual and power brushes. No statistically significant reduction in the DMFT scores with the use of any of the adjuncts was noted.Conclusions:Among the dental aids used in the study, mouthwash showed a significant reduction in plaque and oral hygiene scores as compared to powered toothbrushes and manual brushes alone.

Oral Health of Autistic Children and Awareness of Care Providers towards their Oral Hygiene

Introduction: Autism is a lifelong neurodevelopmental disease characterised by qualitative abnormalities in reciprocal social interaction and patterns of communication. The incidence of autism has increased in recent years and therefore, the possibility of dentists encountering children with autism is higher. Knowledge about the prevalence of dental disease in these children and the awareness of their care providers towards oral health is crucial to provide quality dental healthcare. Aim: To evaluate the oral health status of children with Autism Spectrum Disorder (ASD) and to assess the awareness of the parents/care providers regarding their oral health. Materials and Methods: This study was a two-stage cross-sectional study carried out in July, August 2015 at AB Shetty Memorial Institute of Dental Sciences, affiliated to NITTE Deemed to be University. Twenty children diagnosed with ASD formed the study group while 20 healthy children formed the control group. A clinical examination assessed dental caries (DMFT/dft). Gingival disease and oral hygiene of all children were evaluated using the Loe and Sillness gingival index and simplified oral hygiene index, respectively. Parents/care providers of the autistic children were asked to complete a questionnaire regarding the oral hygiene practices and oral health problems of the children. Descriptive statistics were performed for continuous variables, frequencies and percentages for categorical variables and comparisons were made using the Mann-Whitney U test, independent t-test and Chi-square test. Statistical analyses were conducted using EZR software (R version 3.6.3© 2020) and significance level was set at p&lt;0.05. Results: The dft values in the children with autism were significantly lower than the control group (p=0.035). Children with autism had higher DMFT values, however this difference was not found to be significant (p=0.757). No statistically significant differences were found in the gingival and oral hygiene indices amongst the children with autism and their healthy controls, (p=0.811, 0.365, respectively). An 85% (n=17) of children were found to use tooth brush and paste for oral hygiene procedures. An 85% (n=17) of children with autism had supervised tooth brushing while only 20% (n=4) of the children with autism had previously visited a dentist. Most care providers of children with ASD seemed to be unaware of the causative factors of dental disease. Pouching of food was not seen in most of the autistic children. Conclusion: Caries experience in the permanent dentition in the autistic children and healthy children were comparable while autistic children had a lower caries experience in the primary dentition. Both autistic children and healthy children exhibited mild gingival inflammation. Whereas, the oral hygiene status was comparable amongst the two groups of children. Most of the autistic children had assisted tooth brushing (parental), however there were significant lacunae of knowledge in the oral health awareness of the parents/care providers.

Oral Health Status in Children with Autism Spectrum Disorder: A Cross Sectional Study from Turkey

Aim: In this study, it was aimed to investigate the oral and dental health status of children with Autism Spectrum Disorder (ASD) and the clinical and sociodemographic factors that might be associated with it. Methods: This cross-sectional study included 83 children with ASD (3-18 years old). ASD diagnosis was based on DSM-5 criteria. Autism Behavior Checklist (ABC) and Personal Information Form were filled by the parents. Oral examination of each patient was performed by the same experienced dentist and the presence of dental caries and dental plaque was recorded. Results: The mean ± SD age of subjects was 8.10±4.14 years and the male gender was 78.3% (n = 65). It was determined that 81.9% of the patients had caries and the mean total DMFT/dmft value of the subjects was 4,75 ± 3,66. In the linear multiple regression model, the relationship of the child's age (p = 0.0) and the ABC total score (p = 0.02) to the DMFT score were found statistically significant. Conclusion: Healthcare professionals should take into consideration that dental health problems can be observed more in cases that show the symptoms of ASD are severe. It would be beneficial for them to adopt a multidisciplinary approach in the management of cases during the evaluation process.

Knowledge, Attitude, and Practices of Parents on the Importance of Their Children's Oral Health in Greater Noida, India

Background: Parents and family members are considered the primary source for knowledge about child rearing and health habits for children. Young children's oral health maintenance and outcomes are influenced by their parent's knowledge and beliefs, which affect oral hygiene and healthy eating habits. Parental perception has a long-term influence in determining a child's oral health status. Aim: The aim of this study is to assess the oral health-related knowledge, attitude, and practices (KAP) of parents with children aged 3–5 years. Materials and Methods: A total of 500 parents of children aged 3 to 5 years were included in the study. A self-administered questionnaire, written both in English and local language (Hindi), validated through pre-tested survey, was given to the parents to assess the oral health related KAP. The results were calculated on the basis of frequency and percentages using the SPSS software. Results: Males comprised 49.8% and females comprised 50.2% of the respondents of questionnaire. Majority of fathers and mothers of the study population agreed for the importance of primary teeth. Almost all the participants in this study agreed that a child's teeth should be brushed/cleaned. A little less than half of study population considered 1 year as the suitable age for the child's first dental visit. A higher proportion of females as compared to males felt that night time bottle/breastfeeding leads to caries. Conclusion: Parental attitude, knowledge, and practices are responsible for their child's oral health. No statistical significance was seen between mothers and fathers on perception of their child's oral health care.

Did the Expansion of Insurance Coverage for Oral Health Reduce Self-reported Oral Health Inequalities in Korea? Results of Repeated Cross-Sectional Analysis, 2007-2015.

BackgroundIn 2009, the South Korean government expanded universal health insurance to include oral health services. In the present study, we sought to examine whether improved access resulted in a reduction in income-based self-reported oral health inequalities.MethodsWe analyzed repeated cross-sectional data from the Korea National Health and Nutrition Examination Survey (KNHANES) waves IV through VI (2007–2015). We analyzed self-reported oral health status among 68,431 subjects. Changes in oral health inequalities across four income levels (low, middle-low, middle-high, and high) were assessed with the Slope Index of Inequality (SII) and the Relative Index of Inequality (RII).ResultsThe average oral health status of children and adolescents improved the most over the observation period. The absolute magnitude of oral health inequalities (measured by the SII) improved for most groups, with the notable exception of young male adults. By contrast, the ratio of poor oral health between high- and low-income groups (measured by the RII) changed little over time, indicating that relative inequalities remained resistant to change.ConclusionsThe expansion of dental health insurance may not be sufficient to move the needle on self-reported oral health inequalities among adults.