Abstract
Dental caries is almost ubiquitous, but caries-associated tooth loss is experienced by relatively few younger adults. Caries-associated tooth loss reflects poor oral health and lack of access to dental care.
Objectives: To identify those who lose teeth earliest and to investigate differences in the rate of tooth loss between different socio-economic groups.
Methods: The Dunedin Multidisciplinary Study has followed the health and development of 1037 babies born in 1972/73. Dental examinations have been conducted at regular intervals according to the WHO Oral Health Surveys methodology. Childhood SES, occupation, educational attainment, and personal income are among the broad range of data collected.
Results: Two Study members had lost permanent teeth due to caries by age 18, 1 in 10 had by age 26, 1 in 5 by age 32, and 1 in 4 by age 38. The mean number of teeth lost was 0.0 (sd 0.1) at age 18, 0.3 (sd 1.6) at 26, 0.7 (sd 2.3) at 32, and 1.2 (sd 3.5) at age 38. Marked differences in caries-associated tooth loss existed by SES during childhood, educational attainment, occupation, and income. Among those with no educational qualifications by age 26, mean tooth loss from age 18 to 32 was 0.13 teeth per year (95%CI: 0.09, 0.17); for those who left school at year 11, the rate was 0.10 teeth per year (0.07, 0.14); for those who had completed secondary school, the rate was 0.05 teeth per year (95%CI: 0.04, 0.06); for those with tertiary qualifications, the rate was 0.01 teeth per year (95%CI: 0.00, 0.01). Similar divergence in tooth loss occurred by household SES during childhood, and personal occupation and income at age 26.
Conclusion: Social class inequalities in tooth loss diverge with increasing age.