Open Access Highly Accessed Research article

Socioeconomic position and subjective oral health: findings for the adult population in England, Wales and Northern Ireland

Carol C Guarnizo-Herreño1*, Richard G Watt1, Elizabeth Fuller2, Jimmy G Steele3, Jing Shen4, Stephen Morris5, John Wildman6 and Georgios Tsakos1

Author Affiliations

1 Department of Epidemiology and Public Health, University College London, 1-19 Torrington Place, WC1E 7HB London, UK

2 National Centre for Social Research NatCen, 35 Northampton Square, EC1V 0AX London, UK

3 School of Dental Sciences, Newcastle University, Framlington Place, Tyne and Wear NE2 4BW Newcastle Upon Tyne, UK

4 Institute of Health and Society, Newcastle University, Baddiley-Clark Building, Tyne and Wear NE2 4AX Newcastle Upon Tyne, UK

5 Department of Applied Health Research, University College London, 1-19 Torrington Place, WC1E 7HB London, UK

6 Business School, Newcastle University, 5 Barrack Rd, Tyne and Wear NE1 4SE Newcastle Upon Tyne, UK

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BMC Public Health 2014, 14:827  doi:10.1186/1471-2458-14-827

Published: 9 August 2014

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.

Keywords:
Oral health; Health inequalities; Adults; Socio-economic factors; Quality of life; Oral health-related quality of life