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Exploring socio-economic gradients in oral health among a national sample of Thai adults

Chaianant, Nichamon; (2019) Exploring socio-economic gradients in oral health among a national sample of Thai adults. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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BACKGROUND: Evidence on socio-economic inequalities and gradients in oral health status exist around the world. Adults who belong to higher socio-economic groups and live in more privileged neighbourhoods experience better oral health compared to their counterparts. A limited number of studies have explored the socio-economic gradients in oral health status among Thai adults and none have assessed the relationship between area-level socio-economic position and oral health. AIMS: To assess the socio-economic gradients in oral health outcomes, including dental caries experience, periodontal disease and tooth loss among a nationally representative sample of Thai adults aged 35-44 and 60-74 years. METHODS: Secondary analysis of data from the 7th Thai National Oral Health Survey was performed. Single level regression models were used to assess individual-level socio-economic gradients, defined by education and income, in six oral health outcomes, namely DMFT, decayed teeth, filled teeth, deep periodontal pockets, nonfunctional dentition and edentulousness (total tooth loss). Multilevel regression models were used to determine the socio-economic gradients, accounting for the variation between provinces and adjusted for both individual- and provincial-level covariates. RESULTS: Regarding individual-level socio-economic position, there were unexpected reverse education and income gradients in DMFT and filled teeth, while there were expected social gradients in decayed teeth, periodontal disease, and tooth loss for both age groups. Regarding provincial-level socio-economic position, provincial poverty was positively associated with only the periodontal disease outcome. In addition, the dentist per population ratio was positively associated with DMFT, filled teeth and periodontal disease. Living in an urban area was more likely to have high DMFT, filled teeth and edentulousness. CONCLUSION: The study added evidence on socio-economic gradients in oral health among Thai adults. However, the gradients varied by different socio-economic measures and oral health outcomes. The results also showed that area-level characteristics were independently associated with oral health outcomes .

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Exploring socio-economic gradients in oral health among a national sample of Thai adults
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author 2019. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10067797
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