The online version of this article (https://doi.org/10.1186/s12903-017-0444-8) contains supplementary material, which is available to authorized users.
Although oral health has improved remarkably in recent decades, not all populations have benefited equally. Ethnic identity, and in particular visible minority status, has been identified as an important risk factor for poor oral health. Canadian research on ethnic disparities in oral health is extremely limited. The aim of this study was to examine ethnic disparities in oral health outcomes and to assess the extent to which ethnic disparities could be accounted for by demographic, socioeconomic and caries-related behavioral factors, among a population-based sample of grade 1 and 2 schoolchildren (age range: 5-8 years) in Alberta, Canada.
A dental survey (administered during 2013-14) included a mouth examination and parent questionnaire. Oral health outcomes included: 1) percentage of children with dental caries; 2) number of decayed, extracted/missing (due to caries) and filled teeth; 3) percentage of children with two or more teeth with untreated caries; and 4) percentage of children with parental-ratings of fair or poor oral health. We used multivariable regression analysis to examine ethnic disparities in oral health, adjusting for demographic, socioeconomic and caries-related behavioral variables.
We observed significant ethnic disparities in children’s oral health. Most visible minority groups, particularly Filipino and Arab, as well as Indigenous children, were more likely to have worse oral health than White populations. In particular, Filipino children had an almost 5-fold higher odds of having severe untreated dental problems (2 or more teeth with untreated caries) than White children. Adjustment for demographic, socioeconomic, and caries-related behavior variables attenuated but did not eliminate ethnic disparities in oral health, with the exception of Latin American children whose outcomes did not differ significantly from White populations after adjustment.
Significant ethnic disparities in oral health exist in Alberta, Canada, even when adjusting for demographic, socioeconomic and caries-related behavioral factors, with Filipino, Arab, and Indigenous children being the most affected.
Additional file 1: Appendix A. Question about participants’ ethnic identity in parent questionnaire: Shows the exact question that was asked in the parent questionnaire about the child’s ethnic identity (DOCX 12 kb)12903_2017_444_MOESM1_ESM.docx
Additional file 2: Figure S1. Flow chart of participant exclusions. Shows the flow chart of participant exclusions, from the initial sample with data available from both the open mouth exam and the parent questionnaire, to the final analytic sample which takes into account missing data and exclusions for other reasons (e.g., ethnic identity grouping that fell below our cut-off of n=100). * Main sources of missing covariate data were: sugar-sweetened beverage consumption (n=317), at least one routine dental visit in the past year (n=184), dwelling ownership (n=146), household educational attainment (n=127), and sex (n=134); other covariates in this study had 10 or fewer missing cases. These numbers total more than 792 due to children with missing data on multiple covariates. (DOCX 27 kb)12903_2017_444_MOESM2_ESM.docx
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- Ethnic disparities in children’s oral health: findings from a population-based survey of grade 1 and 2 schoolchildren in Alberta, Canada
Deborah A. McNeil
Melissa L. Potestio
- BioMed Central
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