Oral Health Status and Socio-economic Circumstances along the Life Course

The ubiquitous relationship of unfavourable socio-economic circumstances and oral health has been widely demonstrated. Although the effects of poor social and biological circumstances in early life are known to have lasting influences on general health, no such evidence exists for chronic oral diseases. Objective: To assess the relationship between oral health status and socio-economic conditions at different periods of adolescents’ life. Methods: A two-phase cross sectional study was carried out in Brazil. In Phase I, 652 adolescents aged 13 years were clinically examined and interviewed. In the second phase, 311 families were randomly selected for an interview. Ethical approval and consent were obtained. Information was collected on several indicators of socio-economic circumstances, family related variables, school grade, and oral health behaviour, at two different life stages, birth and at 13 years of age. The outcome variable was a composite measure of oral health status at 13 years old. It was constructed by counting the worst scores of DMFT, gingival bleeding, calculus and dental plaque. The data analysis used logistic regression and a stepwise procedure. Results: The response rates for phases 1 and 2 were 85% and 94%. Kappa values for clinical measures were above 80%. Boys, those in lower grade at school for their age, and those who experienced high levels of material deprivation at birth and at 13 years were more likely to have high levels of oral disease; odds ratios were 4.12 (1.86-9.16), 2.41 (1.01-5.76) and 4.61 (1.30-16.3) respectively. Conclusion: Brazilian adolescents experiencing adverse socio-economic circumstances in early life and at 13 years had high levels of oral diseases.