Trend of Inequalities in Oral Health -related Behaviors among Thai Adolescents

Objectives: This study aimed to examine the trend of inequalities in oral health-related behaviors among Thai adolescents during the health care system has been in transition. Methods: Data of 10,305 10,409 and 10,248 Thai adolescents aged 11-19 years from the nationally representative Health and Welfare Survey 2003 2006 and 2009 were used, respectively. Descriptive analyses were performed to reveal the features of oral health-related behaviors comprising frequency of eating snacks, drinking sweetened beverages, smoking, alcohol drinking and dental care utilization. In addition to the use of concentration index (CI) to quantify the extent of socioeconomic-related inequalities in these behaviors. Bivariate- and multivariate logistic regression was employed to determine the underlying determinants and their associations with inequalities in these behaviors. Results: Reports of eating snacks and drinking sweetened beverages often (i.e. more than 5 days per week) of those adolescents of higher socioeconomic-status were more common than their lower socioeconomic-status counterparts. Likewise, dental care utilization was more common among those of high socioeconomic-status. By contrast, smoking and alcohol consumption revealed reverse gradients as these behaviors were more concentrated among those of lower socioeconomic-status than their peers counterparts. The aforementioned findings were corroborated by CI values that revealed pro-rich inequality in dietary behaviors, and dental care utilization meanwhile the CI indicated pro-poor inequality in smoking and alcohol consumption.Certain demographic-, socioeconomic-, and geographic characteristics were particularly associated with differences in such inequalities. Conclusion: This study demonstrates socioeconomic-related inequality in oral health-related behaviors among Thai adolescents is discernable along the entire spectrum of socioeconomic status. The study also indicates population subgroups that should receive consideration for improving oral health risk behaviors which may be enable for integrated approaches in general health promotion strategies.