title: Socioeconomic inequality in oral health behavior in Iranian children and adolescents by the Oaxaca-Blinder decomposition method: the CASPIAN- IV study.
abstract: The present study set to describe the socioeconomic inequality associated with oral hygiene behavior among Iranian pediatric population.
  
  
  
  A representative sample of 13486 school students aged 6-18 years was selected through multistage random cluster sampling method from urban and rural areas of 30 provinces in Iran. Principle Component Analyses (PCA) correlated variables summarized as socioeconomic status (SES). Association of independent variables with tooth brushing was assessed through logistic regression analysis. Decomposition of the gap in tooth brushing between the first and fifth SES quintiles was assessed using the counterfactual decomposition technique. To assess the relation between tooth brushing and each socioeconomic category, Concentration Index (C) and the slope index of inequality (SII) were used, representing the linear regression coefficient.
  
  
  
  The participation rate was 90.6 % (50.7 % boys and 75.6 % urban inhabitants). The mean age of participants was 12.47 ± 3.36 years. The frequency of tooth brushing increased across SES quintiles, prevalence of tooth brushing between the first and fifth quintile, under 20 % difference, increased from 58.22 (95 % CI: 56.24,60.20) to 78.61 (95 % CI: 77.00,80.24). Only 3 % of the difference is explained by the factors considered in the study, and 17 % remained unknown. Residence area, family size, and smoking status made a significant contribution to the gap between the first and last SE groups. Residence area [ -2.01 (95 % CI: -3.46, -0.55)] was along the maximum levels of gaps between SE categories.
  
  
  
  The findings revealed a socio-economic inequality in oral health behavior in Iranian children and adolescents. Also, factors influencing oral health are addressed to develop and implement complementary public health actions.
authors.affiliation: Managerial Epidemiology Research Center, Department of Public Health, School of Nursing and Midwifery, Maragheh University of Medical Sciences, Maragheh, Iran.|Road Traffic Injury Research Center, Department of Statistics & Epidemiology, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Saeid
authors.initials: S
authors.lastname: Safiri
authors.affiliation: Child Department of Pediatrics, Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Kelishadi
authors.affiliation: Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Ramin
authors.initials: R
authors.lastname: Heshmat
authors.affiliation: School of Humanities and Tourism Management, Bangkok University, Bangkok, Thailand.
authors.forename: Ali
authors.initials: A
authors.lastname: Rahimi
authors.affiliation: Development of Research & Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran.
authors.forename: Shirin
authors.initials: S
authors.lastname: Djalalinia
authors.affiliation: Dental School, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Anoosheh
authors.initials: A
authors.lastname: Ghasemian
authors.affiliation: Department of Epidemiology and Biostatistics, Shahid Beheshti University of Medical Science, Tehran, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Sheidaei
authors.affiliation: Department of Pediatrics, Ahvaz Jondishapour University of Medical Sciences, Ahvaz, Iran.
authors.forename: Mohammad Esmaeil
authors.initials: ME
authors.lastname: Motlagh
authors.affiliation: Development of Research & Technology Center, Deputy of Research and Technology, Ministry of Health and Medical Education, Tehran, Iran.
authors.forename: Gelayol
authors.initials: G
authors.lastname: Ardalan
authors.affiliation: Department of Health Education, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
authors.forename: Morteza
authors.initials: M
authors.lastname: Mansourian
authors.affiliation: Department of Medical Emergencies, Qom University of Medical Sciences, Qom, Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Asayesh
authors.affiliation: Department of Epidemiology and Reproductive Health, Reproductive Epidemiology Research Centre, Royan Institute for Reproductive Biomedicine, ACECR, Tehran, Iran.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Sepidarkish
authors.affiliation: Department of Community Medicine, School of Medicine, Alborz University of Medical Science, Karaj, Iran. mqorbani1379@yahoo.com.|Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. mqorbani1379@yahoo.com.
authors.forename: Mostafa
authors.initials: M
authors.lastname: Qorbani
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002648:Child; D002652:Child Behavior; D005191:Family Characteristics; D005260:Female; D015438:Health Behavior; D054624:Health Status Disparities; D006801:Humans; D007492:Iran; D008297:Male; D009909:Oral Health; D012111:Residence Characteristics; D012737:Sex Factors; D012907:Smoking; D012923:Social Class; D012959:Socioeconomic Factors; D014099:Toothbrushing
keywords: Adolescents; Children; Inequality; Iran; Oaxaca-Blinder decomposition; Oral health