Oral health inequalities in Italian schoolchildren - a cross-sectional evaluation

Objective: To evaluate which of the following indicators of socio-economic status (SES) has the strongest association with dental caries
status in a 6-years-old population: the educational level of each parent (individual-level); the mean price of housing/m2 in the area where
the family resides; or the mean per capita income in the area where the family lives (area-level). Material and Methods: Dental caries
was recorded in 2,040 schoolchildren (42.5% boys, 57.5% girls) using decayed/missed/filled surface index (d3 level) in primary dentition.
Parents filled in a standardised questionnaire regarding nationality, level of education, frequency of dental check-up and perception of
child’s oral health and child’s oral hygiene habits. Results: At the individual-level of SES, mothers’ educational level was associated with
their children’s caries severity (χ2
(9)=147.51 p<0.01): as educational level rose the proportion of children with high numbers of carious
lesions fell. The two income indicators (area-level SES) were not associated. A multinomial logistic regression model was run for caries
risk factors. Caries severity was used as dependent variable and the model was stratified by mothers’ educational level. Mothers’ perception
of child’s oral health was the only covariate that was always associated in every caries severity strata and for each level of mothers’
education. Conclusions: The present study shows that mothers’ educational level is a useful individual SES indicator for caries in Italian
children living in a low-income population.