Tooth loss over 13 years of follow-up: can regular dental visits reduce racial and socioeconomic inequalities?

Celeste, R. K., Goulart, M. d. A. and Faerstein, E. (2022) Tooth loss over 13 years of follow-up: can regular dental visits reduce racial and socioeconomic inequalities? Journal of Dentistry, 122, 104110. (doi: 10.1016/j.jdent.2022.104110)

Abstract

Objectives: To assess if regular dental visits modify the effects of social and racial indicators on the incidence of tooth loss. Methods: This is a longitudinal analysis using data from the Pro-Saude Study. In 1999-2001, 3253 civil servants responded to self-administered questionnaires, and then in 2012-2013, with 19% attrition. The outcome was any increase in self-reported tooth loss, measured in four ordered categories (none, one or few, many, all or almost all). Main variables included income, education, race/ethnicity and an adapted version of Everyday Discrimination Scale. The dental visit was dichotomized into regular and problem-oriented attenders. Potentially confounding factors were age and sex; effect modification was estimated using the relative excess of risk due to interaction (RERI). Results: An increase in the tooth loss category was reported by 23.1% of the individuals over 13 years of follow-up. Among problem-oriented attenders, 27.3% reported an increase against 20.4% in regular users (p<0.01). Interaction results are inconclusive. Even though not significant, either antagonism or synergism were observed: between lower income and problem-oriented (RERI = -0.22; 95%CI: -0.75: 0.31), being Black+Brown and problem-oriented (RERI = -0.25; 95%CI: -0.64: 0.14), discrimination and problem-oriented (RERI = -0.15; 95%CI: -0.55: 0.25), and between having less than university degree and being problem-oriented (RERI = 0.21; 95%CI: -0.19: 0.62). Conclusions: Regular attenders from advantaged groups seem to benefit more from dental care than disadvantaged groups, increasing unfair inequalities. Inconsistencies in current findings warrant further investigations. Clinical Significance: Regular attenders from advantaged groups seem to benefit more from dental care than disadvantaged groups, increasing inequities, but the effect size of the Relative Excess of Risk due to Interaction were not large and were inconclusive.

• Item Type: Articles
• Additional Information: This paper is based on the Pró-Saúde cohort study; the project was sponsored by the Brazilian National Council for Scientific and Technological Development (CNPq), grant number 300228/99.
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Goulart, Ms Mariel

Creator Roles

Goulart, M. d. A.: Conceptualization, Data curation, Writing – review and editing

• Authors: Celeste, R. K., Goulart, M. d. A., and Faerstein, E.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
• Journal Name: Journal of Dentistry
• Publisher: Elsevier
• ISSN: 0300-5712
• ISSN (Online): 1879-176X
• Published Online: 29 March 2022
• Copyright Holders: Copyright © 2022 Elsevier Ltd.
• First Published: First published in Journal of Dentistry 122: 104110
• Publisher Policy: Reproduced in accordance with the publisher copyright policy