Dental attitudes: proximal basis for oral health disparities in adults.
OBJECTIVE
Behavioral science postulates that underlying characteristics of populations, rather than sociodemographic groupings, are more proximal causes of oral health disparities through differing oral health behaviors. To our knowledge this is the first report in the literature that examines longitudinal correlates of oral health and dental care using groups of persons holding similar attitudes and beliefs.


METHODS
The subjects were 873 participants in the Florida Dental Care Study, a longitudinal study of oral health among dentate adults. Hierarchical cluster analysis identified four groups with similar dental attitudes that were labeled 'favorable attitudes about dental care', 'frustrated believers in dental care', 'negative attitudes and cost concerns', 'pessimistic about personal and professional oral care'.


RESULTS
The attitudinal groups cut across race, sex, and age with race and educational status the best discriminators among sociodemographic and economic variables. The negative attitude group reported the least preventive care and the largest oral health decrements on clinical examination at baseline and 24 months. The group with favorable attitudes about dental care reported the highest number of preventive and restorative visits and the lowest point-prevalence of toothache pain, temperature sensitivity, and painful gums. The frustrated believers have access to dental care equivalent to the favorable attitude group, but may delay seeking dental care until oral disease becomes more severe, based on their pattern of preventive, restorative, and dental extraction visits. Additional group differences on oral health and dental care are reported.


CONCLUSIONS
This study takes a novel approach to examining oral healthy disparities. Differences in oral health behaviors support the validity of the groups.
Riley
Joseph L
JL
Division of Public Health Services and Research, College of Dentistry University of Florida, Gainesville, FL, USA. jriley@dental.ufl.edu
Gilbert
Gregg H
GH
Heft
Marc W
MW
D000328:Adult; D001294:Attitude to Health; D016009:Chi-Square Distribution; D016000:Cluster Analysis; D003729:Dental Care / Q000523:psychology* / Q000706:statistics & numerical data*; D005260:Female; D005431:Florida; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008960:Models, Psychological; D009909:Oral Health; D009910:Oral Hygiene / Q000523:psychology / Q000706:statistics & numerical data; D025341:Principal Component Analysis; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires