Sex differences in Oral Health Inequalities in the Canadian Population

Objectives: This study evaluates the sex differences in the magnitude of oral health inequalities in Canada for the numbers of decayed, missing, and filled teeth. Methods: Data for this study are from the 2007-2009 Canadian Health Measure Survey (CHMS). The sample size consisted of 4951 Canadians aged 6-79 (2409 male and 2542 female). Socioeconomic status was measured as equivalized household income. Oral health outcomes consist of the total number of decayed, missing, and filled teeth. We used the concentration index (CI) and concentration curves to quantify the oral health inequalities; and therefore compare the size of inequalities between males and females. Data analyses were performed using STATA 11.1 and ADePT. Results: The number of decayed and missing teeth decreased with increasing income, while the number of filled teeth increased with increasing income. This pattern was present for both sexes. Men's CIs for decayed teeth, missing, and filled teeth were -0.205, 0.002, and 0.135, respectively. Female's CIs for decayed teeth, missing, and filled teeth were -0.372, -0.135, and 0.115, respectively. Female's CIs for decayed and missing teeth were negative and greater than those of men suggesting greater inequality in females. Despite differences in the magnitude of oral health inequalities between males and females, there was statistically significant deviation from equality for almost all indicators of oral health for both sexes. Conclusion: For both males and females, in general, there was a higher concentration of decayed and missing teeth in the poorer groups and the rich had a greater concentration of filled teeth. There was a sex difference in the pattern of oral health inequalities with greater degree of inequality present among women in terms of the number of decayed and missing teeth. The degree of inequality was greater for decayed teeth in comparison with missing and filled teeth in both sexes.