Does the ethnicity of teenage children influence oral self perception and prevalence of dental disease?

Oral health in children and adolescents with different socio-cultural and socio-economic backgrounds

OBJECTIVES

To describe the occurrence and severity of dental caries in children and adolescents and to relate these findings to the subject's socio-cultural and socio-economic backgrounds.

MATERIAL AND METHODS

A cross-sectional study in 12 706 children aged 5, 7, 12 and 15 years was conducted in 2006. Data on children's caries experience were collected from public oral health registers and pooled with socio-cultural and socio-economic data obtained from official statistics. The study population represented 76% of all registered inhabitants.

RESULTS

Among 5- and 7-year-old children with non-Danish mothers, the mean caries experience was three to four times higher than among children of Danish mothers, and a doubled rate was seen among the adolescents (p < 0.001). Significant differences in caries experience were found in various ethnic minorities. Multiple regression analysis showed that the level of caries was highest among children in families where mothers were not Danish, with low income, where mothers' educational levels were low, and in with a high number of children (p < 0.001).

CONCLUSIONS

Although almost all children and adolescents attend the prevention-oriented, free public dental service, a social gradient still exists for dental health. In addition, in all age groups, major inequalities in dental health were found when families with Danish and non-Danish backgrounds were compared. The findings indicate a need for social action by policymakers. Furthermore, a change in the oral health preventive strategy is proposed to meet the needs of children in risk of caries, and appropriate oral health-promotion programmes should be organized in collaboration with leaders from different ethnic minorities.

Inequalities in oral health practices and social space: an exploratory qualitative study

This study analyzed the oral health practices and access to dental care of individuals according to their position in social space. The rationale was based on the hypothesis that different positions in social space may imply different habitus, in the sense conferred by Bourdieu. Such dispositions would influence practical behavior, choices and preferences in general and in this context, dental care. Twenty-two semi-structured interviews were carried out with individuals, as part of a multiple case study carried out in two municipalities in the state of Bahia, Brazil. Differences were found between the two study groups both with respect to actions of personal care and in seeking and using dental services. This, in addition to poor material and living conditions, and difficult access to restorative dental work in the public sector, may explain part of the pattern of tooth loss found in the adult Brazilian population. The adoption of effective communicative and educational actions by health professionals should be stimulated. However, the structural dimension of the social determinants requires transformations in the structures that generate the perceptions and practices of agents. The study discusses the implications of these data to public dental policies that are focused on reducing these inequalities.