The International and American Associations for Dental Research (IADR/AADR) have published two studies about oral health inequalities in older people and low income individuals. The articles are published in the Journal of Dental Research, the official publication of the IADR/AADR.
The study by Barnebe and Mercenes explores the relationship between state income inequality and individual tooth loss among 386,629 adults in the United States who participated in the 2008 Behavioral and Risk Factor Surveillance System. Multilevel models were used to test the association between income inequality and self-reported tooth loss after sequential adjustment for state- (median household income) and individual level confounders (sex, age, race, education and household income) as well as state- (percent receiving fluoridated water and dentist to population ratio) and individual-level mediators (marital status and last dental visit). Income inequality, as measured by the Gini coefficient, was significantly associated with tooth loss even after adjustment for state- and individual-level confounders and potential mediators. A 5 percent change in state Gini coefficient was associated with almost 20 percent higher odds of reporting greater tooth loss. This study provides support for the relationship between state income inequality and individual tooth loss in the United States.
The purpose of the study by Listl was to describe income-related inequalities in dental service utilization by the elderly populations residing in different European countries. Listl and his team used data from the Survey of Health, Ageing, and Retirement in Europe (SHARE Wave 2), which contains information on utilization of dental services by 33,358 individuals aged 50+ from 14 different countries, and assessed income-related inequalities in dental attendance, preventive and/or operative dental treatment. The team’s findings indicate disproportionate concentration of access to treatment among the rich elderly populations in all countries included in the study. In terms of absolute inequality, the team similarly observed significantly higher access to treatment by individuals located in the highest income group compared with peers located in the lowest income group within all countries except Italy and Czechia.
“Inequalities in oral health and access to care are a growing global concern,” said IADR President E. Dianne Rekow. “These JDR articles address this growing concern and its impact on elderly populations and low-income individuals.”
A perspective article was written by Georgios Tsakos. In it, he calls for an urgent need to address inequalities in oral health — rather than only dental services — and to put more emphasis on the social determinants of health.