Area deprivation and oral health in Scottish adults: a multilevel study.
OBJECTIVE
To explore the association between area deprivation and adult oral health.


METHODS
Multilevel regression analysis of data taken from the 1998 Adult Dental Health Survey in the UK comprising 632 participants living in 346 households located in 31 postcode sectors in Scotland. Three oral health outcomes were investigated: number of sound (including restored) teeth; has one or more unsound teeth; has periodontal pocketing 4 mm or more in one or more teeth.


RESULTS
In the most deprived areas, individuals had a mean of 4.6 fewer sound teeth than those in the least deprived areas. The difference in normalised number of sound teeth between least and most deprived areas was -0.707 (95% CI -1.164, -0.250), P = 0.024. After adjusting for age, sex, qualification status, head of household social class and household income, the estimated difference was -0.238 (-0.591 to 0.115) (P = 0.164). Area deprivation was not associated with having one or more unsound teeth or periodontal pocketing 4 mm or more in one or more teeth.


CONCLUSIONS
There is a univariate association of area deprivation with the number of sound teeth. This association is largely explained by household and individual level socioeconomic variables. A small area deprivation effect cannot be excluded in these data. The findings challenge current understanding of the relationship between area deprivation and oral health. Further multilevel research exploring the relationship between area deprivation and oral health is required using a larger sample and a prospective longitudinal design.
Bower
Elizabeth
E
Department of Oral Health Services Research and Dental Public Health, King's College London Dental Institute, London, UK. elizabeth.bower@kcl.ac.uk
Gulliford
Martin
M
Steele
Jimmy
J
Newton
Tim
T
D000293:Adolescent; D000328:Adult; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D009909:Oral Health; D010514:Periodontal Pocket / Q000453:epidemiology*; D011203:Poverty / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012606:Scotland / Q000453:epidemiology; D012959:Socioeconomic Factors