title: Social stratification, oral hygiene, and trajectories of dental caries among old Americans.
abstract: OBJECTIVE
  This study analyzed how oral hygiene (i.e., brushing, rinsing, and flossing) influences the trajectories of dental caries (i.e., numbers of decayed, missing, and filled teeth) among older Americans within the context of social stratification.
  
  
  METHODS
  Data came from Piedmont Dental Study that involved a sample of 810 older Americans who were dentate in 1988 with up to four repeated observations through 1994. Hierarchical linear models were used for data analysis.
  
  
  RESULTS
  Brushing, flossing, and rinsing were associated with the trajectories of dental caries in distinct ways. In addition, oral hygiene was correlated with race, education, household income, and use of dental care. The effects of brushing and flossing on decayed and missing teeth remained robust, even when socio-demographic and health attributes were controlled. Conversely, socioeconomic disparities in dental caries persisted, when oral hygiene was adjusted.
  
  
  CONCLUSIONS
  Both social stratification and oral hygiene need to be considered in promoting oral health.
authors.affiliation: University of Michigan, Ann Arbor, USA jliang@umich.edu.
authors.forename: Jersey
authors.initials: J
authors.lastname: Liang
authors.affiliation: Duke University, Durham, NC, USA.
authors.forename: Bei
authors.initials: B
authors.lastname: Wu
authors.affiliation: Duke University, Durham, NC, USA.
authors.forename: Brenda
authors.initials: B
authors.lastname: Plassman
authors.affiliation: University of Michigan, Ann Arbor, USA.
authors.forename: Joan M
authors.initials: JM
authors.lastname: Bennett
authors.affiliation: University of North Carolina, Chapel Hill, USA.
authors.forename: Jim
authors.initials: J
authors.lastname: Beck
mesh_terms: D000368:Aged; D003731:Dental Caries / Q000453:epidemiology*; D003742:Dental Devices, Home Care / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D009910:Oral Hygiene / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014099:Toothbrushing / Q000706:statistics & numerical data
keywords: Piedmont Dental Study; dental caries; hierarchical linear models; oral hygiene; social stratification