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Education as a Predictor of Chronic Periodontitis: A Systematic Review with Meta-Analysis Population-Based Studies

Boillot, A; El Halabi, B; Batty, GD; Range, H; Czernichow, S; Bouchard, P; (2011) Education as a Predictor of Chronic Periodontitis: A Systematic Review with Meta-Analysis Population-Based Studies. PLOS ONE , 6 (7) , Article e21508. 10.1371/journal.pone.0021508. Green open access

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Abstract

Background: The impact of socioeconomic inequalities on health is well-documented. Despite the links of periodontal disease with cardiovascular diseases, adverse pregnancy outcomes and diabetes, no meta-analysis of socioeconomic variations in periodontal disease exists. This meta-analytic review was conducted to determine the extent to which education attainment influences risk of periodontitis in adults aged 35+ years in the general population.Methods: The authors searched studies published until November 2010 using EMBASE and MEDLINE databases. References listed were then scrutinised, our own files were checked, and, finally, we contacted experts in the field. The authors included only general population-based studies conducted in adults aged 35 years and more. All articles were blind reviewed by two investigators. In the case of disagreement, a third investigator arbitrated. Using PRISMA statement, two reviewers independently extracted papers of interest.Results: Relative to the higher education group, people with low education attainment experience a greater risk of periodontitis (OR: 1.86 [1.66-2.10]; p<0.00001). The association was partially attenuated after adjustment for covariates (OR: 1.55 [1.30-1.86]; p<0.00001). Sensitivity analyses showed that methods used to assess periodontitis, definition of cases, study country and categorization of education are largely responsible for the heterogeneity between studies. No significant bias of publication was shown using both the Egger (p = 0.16) and rank correlation tests (p = 0.35).Conclusions: In the studies reviewed, low educational attainment was associated with an increased risk of periodontitis. Although this evidence should be cautiously interpreted due to methodological problems in selected studies, efforts to eliminate educational inequalities in periodontitis should focus on early life interventions.

Type: Article
Title: Education as a Predictor of Chronic Periodontitis: A Systematic Review with Meta-Analysis Population-Based Studies
Open access status: An open access version is available from UCL Discovery
DOI: 10.1371/journal.pone.0021508
Publisher version: http://dx.doi.org/10.1371/journal.pone.0021508
Language: English
Additional information: © 2011 Boillot et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. The authors have no support or funding to report.
Keywords: 35-TO 44-YEAR-OLD IRANIANS, ORAL-HEALTH, ATTACHMENT LOSS, RISK INDICATORS, OLDER-ADULTS, BRAZILIAN ADULTS, OSLO CITIZENS, THAI ADULTS, TOOTH LOSS, DISEASE
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Pop Health Sciences > Institute of Epidemiology and Health > Epidemiology and Public Health
URI: https://discovery.ucl.ac.uk/id/eprint/1319956
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