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Dentistry and oral medicine
Research
Socioeconomic inequalities in caries experience, care level and dental attendance in primary school children in Belgium: a cross-sectional survey
  1. Martijn J Lambert1,
  2. Jacques S N Vanobbergen1,
  3. Luc C Martens2,
  4. Luc M J De Visschere1
  1. 1 Department of Community Dentistry and Oral Public Health, Dental School, Ghent University, Ghent, Belgium
  2. 2 Department of Paediatric Dentistry and Special Care, Paecomedis Research Cluster, Dental School, Ghent University, Ghent, Belgium
  1. Correspondence to Mr Martijn J Lambert; lambert_martijn{at}hotmail.com

Abstract

Objectives Oral health inequality in children is a widespread and well-documented problem in oral healthcare. However, objective and reliable methods to determine these inequalities in all oral health aspects, including both dental attendance and oral health, are rather scarce.

Aims To explore oral health inequalities and to assess the impact of socioeconomic factors on oral health, oral health behaviour and dental compliance of primary school children.

Methods Data collection was executed in 2014 within a sample of 2216 children in 105 primary schools in Flanders, by means of an oral examination and a validated questionnaire. Intermutual Agency database was consulted to objectively determine individuals’ social state and frequency of utilisation of oral healthcare services. Underprivileged children were compared with more fortunate children for their mean DMFt, DMFs, plaque index, care index (C, restorative index (RI), treatment index (TI), knowledge and attitude. Differences in proportions for dichotomous variables (RI100%, TI100% and being a regular dental attender) were analysed. The present study was approved by the Ethics Committee of the University Hospital Ghent (2010/061). All parents signed an informed consent form prior to data collection. All schools received information about the study protocol and agreed to participate. Children requiring dental treatment or periodic recall were referred to the local dentist.

Results Underprivileged children had higher D1MFT (95% CI 0.87 to 1.36), D3MT (95% CI 0.30 to 0.64), plaque scores (95% CI 0.12 to 0.23) and lower care level (p<0.02). In the low-income group, 78.4% was caries-free, compared with 88.4% for the other children. Half of the low-income children could be considered as regular dental attenders, while 12.6% did not have any dental visit during a 5-year period.

Conclusion Oral health, oral hygiene, oral healthcare level and dental attendance patterns are negatively affected by children’s social class, leading to oral health inequalities in Belgian primary school children.

  • Epidemiology
  • Oral Medicine
  • Community Child Health
  • Public Health

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/bmjopen-2016-015042

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    Footnotes

    • Contributors All authors declare to have had substantial contributions to the conception and design of the work, to have drafted and revised the work for important intellectual content. All authors gave final approval of the version to be published and agreement to be accountable for all aspects of the work. The corresponding author MJL's task was to analyze data and write the present article. JSNV, LMJDV and LCM are the PhD supervisors of MJL. They are all participating in the ‘Glimlachen.be’ project from its very beginning. In that way, they could provide essential information on data collection procedure and other methodological aspects of the present study. Their expertise was indispensable to realize this publication.

    • Funding The research presented in this report is part of the ‘Glimlachen.be’ project (www.glimlachen.be), commissioned and financed by the ‘Insurance Committee for Health Care’ of the ‘Belgian National Institute for Health and Disability Insurance’.

    • Competing interests None declared.

    • Patient consent Detail has been removed from this case description/these case descriptions to ensure anonymity. The editors and reviewers have seen the detailed information available and are satisfied that the information backs up the case the authors are making.

    • Ethics approval Ethics Committee of the University Hospital Ghent (2010/061) reference number B67020108008.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement Patient level data or full data set and statistical code book are available from the corresponding author on request.