Journal
BMC PEDIATRICS
Volume 22, Issue 1, Pages -Publisher
BMC
DOI: 10.1186/s12887-022-03470-4
Keywords
Caries; Health care disparities; Inequalities; Social determinants; Children; Pediatric dentistry
Categories
Funding
- Department of Biomedical, Surgical and Dental Science, University
- Department of Surgery, Microsurgery and Medicine Science-School of Dentistry, University of Sassari, Sassari, Italy
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This study aimed to investigate caries prevalence and severity and health inequalities among Italian preschool children with European and non-European background, as well as to explore the potential existence of a social gradient. The results showed that caries prevalence was significantly higher in children with non-European background compared to European children. Higher household income was associated with lower levels of caries. Factors associated with caries prevalence included immigrant status, parents' occupational and educational level, number of children in the family, living in the North-Western Italian area, and high household income. The social gradient was significantly associated with different caries levels and experience in children with European background.
Background The study was aimed to describe caries prevalence and severity and health inequalities among Italian preschool children with European and non-European background and to explore the potential presence of a social gradient. Methods The ICDAS (International Caries Detection and Assessment System) was recorded at school on 6,825 children (52.8% females). Caries frequency and severity was expressed as a proportion, recording the most severe ICDAS score observed. Socioeconomic status (SES) was estimated by mean a standardized self-submitted questionnaire filled-in by parents. The Slope Index of Inequality (SII) based on regression of the mid-point value of caries experiences score for each SES group was calculated and a social gradient was generated, children were stratified into four social gradient levels based on the number of worst options. Multivariate regression models (Zero-Inflated Negative Binomial logistic and logistic regression) were used to elucidate the associations between all explanatory variables and caries prevalence. Results Overall, 54.4% (95%CI 46.7-58.3%) of the children were caries-free; caries prevalence was statistically significant higher in children with non-European background compared to European children (72.6% vs 41.6% p < 0.01) and to the area of living (p = 0.03). A statistically significant trend was observed for ICDAS 5/6 score and the worst social/behavioral level (Z = 5.24, p < 0.01). Children in the highest household income group had lower levels of caries. In multivariate analysis, Immigrant status, the highest parents' occupational and educational level, only one kid in the family, living in the North-Western Italian area and a high household income, were statistically significant associated (p = 0.01) to caries prevalence. The social gradient was statistically significant associated (p < 0.01) to the different caries levels and experience in children with European background. Conclusions Data show how caries in preschool children is an unsolved public health problem especially in those with a non-European background.
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