title: Associations between school deprivation indices and oral health status.
abstract: BACKGROUND
  Despite an overall improvement in oral health status in several countries over the past decades, chronic oral diseases (COD) remain a public health problem, occurring mostly among children in the lower social strata. The use of publicly available indicators at the school level may be an optimal strategy to identify children at high risk of COD in order to organize oral health promotion and intervention in schools.
  
  
  OBJECTIVE
  To investigate whether school deprivation indices were associated with schoolchildren oral health status.
  
  
  METHODS
  This ecological study used a sample of 316 elementary public schools in the province of Quebec, Canada. Data from two sources were linked using school identifiers: (i) Two school deprivation indices (in deciles) from the Ministry of Education, a poverty index based on the low income cut-offs established by Statistics Canada and a socioeconomic environment index defined by the proportions of maternal under-schooling and of unemployed parents and (ii) Oral health outcomes from the Quebec Schoolchildren Oral Health Survey 1998-99 aggregated at the school level. These included proportions of children with dental caries and reporting oral pain. The relation between school deprivation indices and oral health outcomes was assessed with linear regression for dental caries experience and logistic regression for oral pain.
  
  
  RESULTS
  The mean DMF-S (mean number of decayed, missing and filled permanent teeth surfaces) by school was 0.7 (SD = 0.5); the average proportions of children with dental caries and reporting oral pain were 25.0% and 3.0%, respectively. The poverty index was not associated with oral health outcomes. For the socioeconomic environment index, dental caries experience was 6.9% higher when comparing schools in unfavourable socioeconomic environments to the most favourable ones [95% confidence interval (CI): 2.1, 11.7%]. Furthermore, the most deprived schools, as compared to least deprived ones, were almost three times as likely to have children reporting oral pain in the previous week.
  
  
  CONCLUSIONS
  The school socioeconomic environment index was associated with oral health outcomes, and should be studied for its potential usefulness in planning school-based oral health promotion and screening strategies.
authors.affiliation: Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, University of Quebec, Laval, Canada.
authors.forename: Patricia
authors.initials: P
authors.lastname: Da Rosa
authors.forename: Belinda
authors.initials: B
authors.lastname: Nicolau
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Brodeur
authors.forename: Mike
authors.initials: M
authors.lastname: Benigeri
authors.forename: Christophe
authors.initials: C
authors.lastname: Bedos
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Rousseau
mesh_terms: D002648:Child; D002675:Child, Preschool; D003731:Dental Caries / Q000453:epidemiology; D003753:Dental Health Surveys; D004522:Educational Status; D005260:Female; D006293:Health Promotion; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D016017:Odds Ratio; D009909:Oral Health; D011203:Poverty / Q000706:statistics & numerical data; D011792:Quebec / Q000453:epidemiology; D012574:Schools / Q000706:statistics & numerical data; D012959:Socioeconomic Factors