Food insecurity describes circumstances of compromised food quality or quantity. Like oral health, food insecurity is closely associated with income deprivation.
Objectives: This study assessed the relationship between food insecurity and oral health using data from the Canadian Community Health Survey (CCHS), 2003-2004.
Methods: The CCHS is a nationwide health survey of persons aged 12 years and older. Secondary data analysis of the CCHS subset included 134,000 individuals who completed both food insecurity and oral health questions. Food insecure household individuals gave “often” or “sometimes” responses to any of the three food insecurity flag questions asking about household experiences in the previous 12 months: (1)“Worried there would not be enough to eat;” (2)“Did not have enough to eat” and (3)“Did not eat desired quality of food.” Oral health questions included tooth extractions due to caries or periodontal disease, toothache and oral/facial pain prevalence, self-reported oral health status, frequency of dental visits, toothbrushing frequency and dental insurance coverage. The data subset also included total personal and household income variables.
Results: Food insecure household individuals made fewer visits to the dentist and were more likely to report cost as a barrier to dental visits than food secure household individuals (p<0.001). Fewer food insecure household individuals were covered by dental insurance (p=0.001). Food insecure household individuals had lower self-perceived oral health ratings than food secure individuals (p<0.001) but comparable toothbrushing frequency. Multiple logistic regression analysis controlling for income showed that food insecure individuals were more than two times more likely to report “bleeding gums”(OR=2.26, 95% CI:2.02-2.52), toothaches (OR=2.58, 95% CI: 2.31-2.87) and mouth or tooth pain (OR=2.14, 95% CI:1.88-2.44) than food secure individuals.
Conclusion: Food insecure household individuals are a dentally vulnerable group.