Inequalities in self-rated oral health in adults

Luchi, Carla Antoni; Peres, Karen Glazer; Bastos, João Luiz; Peres, Marco Aurélio

doi:10.1590/S0034-8910.2013047004364

OBJECTIVE

To investigate the link between self-rated oral health and socio-demographic inequalities.

METHODS

Cross-sectional study, carried out with 2,016 adults between 20 and 59 years of age in 2009, in Florianopolis, SC, Southern Brazil. We adopted a two-stage sampling design (census tracts and households). Data were collected through face-to-face interviews, conducted in the participants’ households. The outcome was self-rated oral health. The exploratory variables were demographic characteristics, indicators of socioeconomic position, dental service utilization and adverse self-reported oral health conditions. Analysis was performed using multivariable poisson regression, which allowed the estimation of prevalence ratios and 95% confidence intervals.

RESULTS

The prevalence of negative self-rated oral health was 33.2% (95%CI 29.8;36.6). In the adjusted analysis, being of an older age, self-classifying as light-skinned black, lower education, the most recent dental appointment being three years or more ago, attending public dental surgeries, having less than 10 natural teeth in at least one arch, self-reporting need for dental treatment, reporting dry mouth, and difficulty eating due to tooth problems were associated with negative self-rated oral health.

CONCLUSIONS

Self-rated oral health reflects social inequalities in health, and it is associated with low socioeconomic status, less frequent use of dental services and poorer self-reported oral health conditions.

Adult; Diagnostic Self Evaluation; Oral Health; Health Inequalities; Dental Health Surveys; Cross-Sectional Studies

[1] Correspondence
: Carla Antoni Luchi Rua Tilápias, 45 Campeche 88063-163 Florianópolis, SC, Brasil E-mail: carlaantoni1@yahoo.com.br

Variable	n	%	95%CI

Self-rated oral health (N = 1,719)
Positive (very good and good)	1,137	66.8	63.4;70.2
Negative (regular, bad and very bad)	582	33.2	29.8;36.6
Self-rated health (N = 1,720)
Positive (very good and good)	1,373	81.2	78.3;84.1
Negative (regular, bad and very bad)	347	18.8	15.9;21.7
Sex (N = 1,720)
Male	761	44.4	42.2;46.6
Female	959	55.6	53.4;57.7
Self-reported skin color (N = 1,715)
White	1,444	83.9	80.3;87.4
Dark	147	8.9	6.5;11.2
Black	87	5.0	3.3;6.7
Yellow	17	1.0	0.5;1.5
Indigenous	20	1.2	0.6;1.7
Age (years) (N = 1,720)
20 to 29	540	32.7	28.2;37.17
30 to 39	392	22.9	20.3;25.5
40 to 49	438	25.0	21.8;28.1
50 to 59	350	19.4	16.9;21.9
Income in terciles (N = 1,685)
3 ^rd tercile (≥ R$ 1,314.00)	559	34.1	27.8;40.4
2 ^nd tercile (R$ 561,00 to R$ 1,300.00)	562	33.3	29.6;36.9
1 ^st tercile (≤ R$ 560.00)	564	32.6	26.1;39.0
Schooling (years) (N = 1,716)
12 or more	737	43.8	37.0;50.8
9 to 11	568	33.4	28.1;38.0
5 to 8	253	14.0	11.2;16.7
Up to 4	158	8.8	6.4;11.1
Last visit to the dentist (years) (N = 1,705)
Less than one	1,136	66.9	63.0;70.7
1 to 2	381	22.4	19.1;25.7
3 or more	188	10.7	8.6;12.8
Type of service used (N = 1,707)
Private	1,293	76.3	72.4;80.3
Public	331	19.0	14.9;23.0
Other	83	4.7	3.1;6.3
Number of teeth (N = 1,717)
≥ 10 teeth in both dental arches	1,394	82.0	79.1;84.9
< 10 teeth in at least one dental arch	279	15.6	12.9;18.2
No teeth	44	2.4	1.6;3.3
Perceived need for dental treatment (N = 1,715)
No	726	42. 7	38.9;46.4
Yes	989	57.3	53.5;61.0
Use complete dentures (N = 1,698)
No	1,575	92.9	91.1;94.7
Yes	123	7.1	5.2;8.9
Dry mouth (N = 1,716)
Never	888	52.5	47.8;57.1
Sometimes	676	47.5	42.8;52.2
Difficulty eating (N = 1,712)
Never or rarely	1,573	92.1	90.1;93.8
Sometimes	139	7.9	6.1;9.6
Toothache (N = 1,674)
No	1,422	85.2	83.2;86.7
Yes	252	14.8	13.3;16.8

Variable	n	%	95%CI	p

Sex				0.017 ^a
Male	234	30.2	26.3;34.2
Female	348	35.5	31.7;39.3
Self-reported skin color				0.003 ^a
White	461	31.2	27.6;34.7
Dark	68	45.8	37.5;54.1
Black	35	39.7	28.6;50.8
Yellow	8	52.8	27.7;77.9
Indigenous	8	31.9	8.8;55.2
Age (years)				< 0.001 ^a
20 to 29	132	23.7	18.9;28.6
30 to 39	136	35.9	29.4;42.5
40 to 49	163	37.5	31.0;39.9
50 to 59	151	42.8	36.9;48.7
Income in terciles				< 0.001 ^b
3 ^rd tercile (≥ R$ 1,314.00)	115	19.9	15.8;24.1
2 ^nd tercile (R$ 561,00 to R$ 1,300.00)	202	35.7	31.7;39.7
1 ^st tercile (≤ R$ 560.00)	255	44.7	40.4;49.0
Schooling (years)				< 0.001 ^b
12 or more	149	19.5	16.5;22.6
9 to 11	211	36.9	31.9;41.8
5 to 8	133	53.2	46.3;60.1
Up to 4	87	54.9	47.4;62.4
Last visit to the dentist (year )				< 0.001 ^b
Less than one	347	29.8	26.2;33.4
1 to 2	133	34.7	27.1;42.2
3 or more	99	52.5	46.0;59.1
Type of service used				< 0.001 ^a
Private	391	29.9	26.4;33.3
Public	166	48.7	42.2;55.2
Other	23	28.3	18.9;37.8
Number of teeth				< 0.001 ^b
≥ 10 teeth in both dental arches	399	28.2	24.5;31.9
< 10 teeth in at least one dental arch	167	59.1	53.1;65.1
No teeth	16	36.0	22.8;49.1
Perceived need for dental treatment				< 0.001 ^a
No	66	9.0	6.6;11.4
Yes	515	52.1	47.2;55.3
Use complete dentures				< 0.001 ^a
No	519	32.5	28.9;36.0
Yes	63	49.0	39.3;58.9
Dry mouth				< 0.001 ^a
Never	260	28.4	24.7;32.1
Sometimes	322	38.6	34.3;42.9
Difficulty eating				< 0.001
Never or rarely	476	29.6	26.5;32.8
Sometimes	103	73.8	66.3;81.3
Toothache (N = 1,674)				< 0.001
No	447	30.7	27.1;34.3
Yes	119	47.2	39.2;55.1