title: Effects of a national economic crisis on dental habits and checkup behaviors - a prospective cohort study.
abstract: OBJECTIVE
  The effects of economic recessions on dental health behaviors and care utilization are vastly unexamined. Thus, we aimed to ascertain changes in dental health behaviors and checkup frequency from before to after the start of the 2008 Icelandic economic collapse using a nationally representative, prospective cohort - the Health and Wellbeing in Iceland cohort.
  
  
  METHODS
  Participants in the cohort (n = 4100) were contacted first from October to December of 2007 and again from November to December of 2009. The questionnaires assessed respondent's demographics, dental behaviors (brushing, flossing), and dental checkup frequency. We present odds ratios derived from multivariate logistic regression of visiting a dentist annually after the collapse compared with before, as well as odds ratios of daily brushing and flossing habits.
  
  
  RESULTS
  Overall, there was no strong evidence for drastic changes in dental health behaviors as from 2007 to 2009. However, employed men (odds ratio 1.29; 95% confidence interval 1.07-1.54) - as well as unemployed women (1.98; 1.00-3.92) - experienced increased odds of visiting a dentist at least annually. Additionally, men were more likely to brush (1.42; 1.05-1.93) and floss daily (1.20; 1.03-1.42) after the collapse compared with before.
  
  
  CONCLUSIONS
  Overall, it seems as if the collapse did not have drastic negative effects on dental health behaviors of the population in Iceland. Our findings suggest that men may have opted for healthier dental health behaviors following the national economic collapse in 2008.
authors.affiliation: Centre of Public Health Sciences, University of Iceland, Reykjavik, Iceland; The Health Management Academy, Alexandria, VA, USA.
authors.forename: Christopher Bruce
authors.initials: CB
authors.lastname: McClure
authors.forename: Sigurður Rúnar
authors.initials: SR
authors.lastname: Saemundsson
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D003729:Dental Care / Q000191:economics / Q000706:statistics & numerical data*; D003742:Dental Devices, Home Care / Q000706:statistics & numerical data; D057172:Economic Recession / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008297:Male; D017533:Marital Status; D008875:Middle Aged; D009910:Oral Hygiene / Q000191:economics / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012737:Sex Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D014099:Toothbrushing / Q000706:statistics & numerical data; D055815:Young Adult
keywords: dental health; dental services research; economics; health services research; public health