Determinants of Oral health
There are multiple factors affecting our oral health. Some of them are a direct result of our individual choices (e.g. lifestyle and behaviours) whereas others come from the society we live in (e.g. socioeconomic and environmental conditions) and may be beyond our individual control.
Poor oral health has been associated with several factors including socioeconomic disadvantage, non-fluoridated water supply, poor maternal oral health and low level of maternal education. These factors are explored in greater depth below.
Disadvantaged people in low socioeconomic positions have a higher number of caries than those who are less deprived. Did you know that dental caries is a very sensitive measure of inequalities and is used to tell us about the socioeconomic development of countries?
Socioeconomic differences in the occurrence of decay amongst children are less marked in communities living in fluoridated areas. Also, children who have always lived in a fluoridated community are less likely to experience caries than those in non-fluoridated communities. Since fluoridated water acts irrespective of gender, age or socioeconomic position it is considered to be a key intervention to reduce inequalities in oral health.
Maternal oral health is another factor related to the occurrence of children’s tooth decay. For instance, if the mother or the first caregiver has good oral hygiene and no decayed teeth her children are less likely to get the bacteria (Mutans streptococci) implicated in dental caries (Birse 2004).
Also, the higher the mum’s educational level, the more likely that her child will be caries-free. Possible explanations are that highly educated people have more favourable dental health behaviours such as lower sweet consumption, more frequent brushing and a routine dental visiting pattern.
Most of this information comes from:
Birse, S., (2004). Dental Health is a key child health issue. Nursing New Zealand, 10(2):20-2.
Thomson M, Ayers K, and Broughton J (2003) Child Oral Health Inequalities in New Zealand. National Health Committee.
Inequalities in the Auckland Region
Regional Significant Caries Index
In order to bring attention to those individuals with the highest caries scores in each population, the World Health Organization (WHO) developed the significant caries index (SiC). The global WHO goal is that by the year 2015, 12-year-olds in all populations have a SiC index of less than three.
For five-years-olds in each territorial authority in the Auckland region the first graph shows that, overall, they are yet to reach that WHO goal (shown by the red line in the graphs). For year eight students (generally aged 11 to 13), the second graph indicates similarly that only children in Rodney and North Shore have achieved the target. However, these results may have been affected by the ethnic make up of those areas as the third graph shows that European and Asian populations have better SiC index scores than Maori, Pacific and Other groups.
This information comes from the report: Auckland Regional Public Health Services (2006). Improving Health and Wellbeing: A Public Health Perspective for Local Authorities in the Auckland Region.
Significant caries index for five-year-olds by territorial authority (2005)
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Significant caries index for year eight students by territorial authority (2005)
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Significant caries index in the Auckland region by ethnicity (2005)
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