Social inequalities in oral health and in use of oral health care services among adolescents in Uganda.
OBJECTIVE
The aim of this study was to describe clinical and self-perceived indicators of oral health status and the use of oral health care services by social and demographic characteristics.


METHODS
In 2001, a cross-sectional random sample survey was conducted in urban and rural settings in Uganda (Kampala and Lira, respectively), and 1146 secondary school students with a mean age of 15.8 years completed questionnaires in school. Dental caries was recorded by one examiner on a random subsample of 372 students.


RESULTS
Logistic regression analyses revealed that being an urban resident was associated with higher odds for having dental caries (dmft > 0), seeking care because of toothache (delayed treatment demand) and being dissatisfied with one's own oral health status [adjusted odds ratio (OR) = 1.5-2.1]. Being an urban resident was associated with lower odds for oral health care attendance generally and for having missing teeth in particular (adjusted OR = 0.6-0.4). Students who had parents with a higher education and those with weak social ties were, respectively, less and more likely to be dissatisfied with their oral health status. As compared to caries-free participants, the odds for being dissatisfied with oral health and delayed treatment demand increased significantly with an increasing dmft score (adjusted OR = 2.1-3.2).


CONCLUSIONS
Urban students were most likely to have a dmft > 0 and to rate their oral health status negatively. Having received dental care and the prevalence of missing teeth, and delayed treatment demand were, respectively, most and least prevalent among rural students. Dental caries at different diagnostic cut-off points and weak social ties affected self-reported oral health negatively, independently of social and demographic characteristics.
Okullo
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Centre for International Health, University of Bergen, Bergen, Norway.
Astrøm
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Haugejorden
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D000293:Adolescent; D000294:Adolescent Behavior; D001294:Attitude to Health; D003430:Cross-Sectional Studies; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology; D003752:Dental Health Services / Q000706:statistics & numerical data*; D004522:Educational Status; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D020380:Needs Assessment / Q000706:statistics & numerical data; D009909:Oral Health; D010290:Parents / Q000193:education; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D012423:Rural Health / Q000706:statistics & numerical data; D012931:Social Environment; D016388:Tooth Loss / Q000453:epidemiology; D014098:Toothache / Q000453:epidemiology; D014454:Uganda / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data