The Magnitude of Oral Health Inequalities in the Canadian population

Objectives: This study aimed to: i) Measure the magnitude of income related inequality for some oral health outcomes (numbers of decayed, missing, and filled teeth) in Canada; and ii) Compare the degree of oral health inequality in males and females.

Methods:

Data for this study were from the 2007-2009 Canadian Health Measure Survey (CHMS).  The sample consisted of 4951 Canadians aged 6-79 (2409 male and 2542 female). Oral health indicators in this study were the total number of decayed, missing, and filled teeth. Socioeconomic status was measured as equivalized household income. We used the concentration index (CI) and concentration curves to quantify the health inequalities. Data analyses were performed using STATA 11.1 and ADePT.

Results: The mean numbers of decayed, missing, and filled teeth for the whole population were 0.5, 1.7, and 6.2, respectively. The number of decayed and missing teeth decreased with increasing income, while the number of filled teeth increased with increasing income. In the entire population, the CI’s for decayed teeth, missing, and filled teeth were -0.266, -0.074, and 0.120, respectively. Female’s CIs for decayed (CI= -0.372) and missing teeth (CI= -0.135) were negative and greater than men’s CI’s for decayed (CI= -0.205) and missing teeth (CI= 0.002). There was statistically significant deviation from equality for all indicators of oral health and this was present for both sexes to varying extents. 

Conclusions: There was a higher concentration of decayed and missing teeth in the poorer groups, while the rich had a greater concentration of filled teeth. The degree of inequality is greater for decayed teeth in comparison with missing and filled teeth. There was a sex difference in the pattern of oral health inequalities with greater degree of inequality present among women in terms of the number of decayed and missing teeth.