title: Socioeconomic position and subjective oral health: findings for the adult population in England, Wales and Northern Ireland.
abstract: BACKGROUND
  The objective of this study was to assess socioeconomic inequalities in subjective measures of oral health in a national sample of adults in England, Wales and Northern Ireland.
  
  
  METHODS
  We analysed data from the 2009 Adult Dental Health Survey for 8,765 adults aged 21 years and over. We examined inequalities in three oral health measures: self-rated oral health, Oral Health Impact Profile (OHIP-14), and Oral Impacts on Daily Performance (OIDP). Educational attainment, occupational social class and household income were included as socioeconomic position (SEP) indicators. Multivariable logistic regression models were fitted and from the regression coefficients, predictive margins and conditional marginal effects were estimated to compare predicted probabilities of the outcome across different SEP levels. We also assessed the effect of missing data on our results by re-estimating the regression models after imputing missing data.
  
  
  RESULTS
  There were significant differences in predicted probabilities of the outcomes by SEP level among dentate, but not among edentate, participants. For example, persons with no qualifications showed a higher predicted probability of reporting bad oral health (9.1 percentage points higher, 95% CI: 6.54, 11.68) compared to those with a degree or equivalent. Similarly, predicted probabilities of bad oral health and oral impacts were significantly higher for participants in lower income quintiles compared to those in the highest income level (p < 0.001). Marginal effects for all outcomes were weaker for occupational social class compared to education or income. Educational and income-related inequalities were larger among young people and non-significant among 65+ year-olds. Using imputed data confirmed the aforementioned results.
  
  
  CONCLUSIONS
  There were clear socio-economic inequalities in subjective oral health among adults in England, Wales and Northern Ireland with stronger gradients for those at younger ages.
authors.affiliation: Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB London, UK. c.guarnizo-herreno.11@ucl.ac.uk.
authors.forename: Carol C
authors.initials: CC
authors.lastname: Guarnizo-Herreño
authors.forename: Richard G
authors.initials: RG
authors.lastname: Watt
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Fuller
authors.forename: Jimmy G
authors.initials: JG
authors.lastname: Steele
authors.forename: Jing
authors.initials: J
authors.lastname: Shen
authors.forename: Stephen
authors.initials: S
authors.lastname: Morris
authors.forename: John
authors.initials: J
authors.lastname: Wildman
authors.forename: Georgios
authors.initials: G
authors.lastname: Tsakos
mesh_terms: D000328:Adult; D000368:Aged; D003753:Dental Health Surveys; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009909:Oral Health / Q000706:statistics & numerical data*; D012923:Social Class; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology
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