Contributions of social context to inequality in dental caries: a multilevel analysis of Japanese 3-year-old children. 2008

J Aida, and Y Ando, and M Oosaka, and K Niimi, and M Morita
Department of Preventive Dentistry, Division of Oral Health Science, Hokkaido University Graduate School of Dental Medicine, Sapporo, Japan.

BACKGROUND Community context as well as individual health behavior affects oral health status. However, the contribution of social context to dental caries among people in various regions remains unclear when individual health behavior is taken into account. OBJECTIVE To determine the influence of community context on dmft among 3-year-old children. METHODS After all Japanese municipalities (n = 2522) had been stratified into nine regions with three caries levels, 44 municipalities were randomly selected. Community health service workers were asked to collect information on sociodemographic characteristics, oral health-related behavior, and dental condition for 3-year-old children during community dental health check-ups. Community-related variables, including socioeconomic status, social support, and social cohesion, were obtained from census data. Multilevel analysis was used to determine the effects of social context and individual behavior on dental caries. RESULTS A total of 3301 parents (79.9%) of 3-year-old children from 39 municipalities participated in our survey, and complete information was obtained from 3086 of them. Results of the analysis showed that 90.8% (P < 0.001) of variance in dmft occurred at the individual level and that 9.2% (P < 0.001) of the variance occurred at the community level. Individual-level variables explained only 6.6% of the individual level variance in dmft. Community-level variables explained 47.2% of the community level variance. CONCLUSIONS There are statistically significant effects of social context on dmft in municipalities in Japan.

UI MeSH Term Description Entries
D007564 Japan A country in eastern Asia, island chain between the North Pacific Ocean and the Sea of Japan, east of the Korean Peninsula. The capital is Tokyo. Bonin Islands
D011795 Surveys and Questionnaires Collections of data obtained from voluntary subjects. The information usually takes the form of answers to questions, or suggestions. Community Survey,Nonrespondent,Questionnaire,Questionnaires,Respondent,Survey,Survey Method,Survey Methods,Surveys,Baseline Survey,Community Surveys,Methodology, Survey,Nonrespondents,Questionnaire Design,Randomized Response Technique,Repeated Rounds of Survey,Respondents,Survey Methodology,Baseline Surveys,Design, Questionnaire,Designs, Questionnaire,Methods, Survey,Questionnaire Designs,Questionnaires and Surveys,Randomized Response Techniques,Response Technique, Randomized,Response Techniques, Randomized,Survey, Baseline,Survey, Community,Surveys, Baseline,Surveys, Community,Techniques, Randomized Response
D011998 Recreation Activity engaged in for pleasure. Recreations
D002675 Child, Preschool A child between the ages of 2 and 5. Children, Preschool,Preschool Child,Preschool Children
D003731 Dental Caries Localized destruction of the tooth surface initiated by decalcification of the enamel followed by enzymatic lysis of organic structures and leading to cavity formation. If left unchecked, the cavity may penetrate the enamel and dentin and reach the pulp. Caries, Dental,Carious Lesions,Dental Cavities,Dental Cavity,Dental Decay,Dental White Spots,Carious Dentin,Decay, Dental,Dental White Spot,White Spot, Dental,White Spots, Dental,Carious Dentins,Carious Lesion,Cavities, Dental,Cavity, Dental,Dentin, Carious,Dentins, Carious,Lesion, Carious,Lesions, Carious,Spot, Dental White,Spots, Dental White
D003815 Dentists Individuals licensed to practice DENTISTRY. Dentists, Pediatric,Dentists, Prosthetic,Dentists, Restorative,Periodontists,Prosthodontists,Dentist,Dentist, Pediatric,Dentist, Prosthetic,Dentist, Restorative,Pediatric Dentist,Pediatric Dentists,Periodontist,Prosthetic Dentist,Prosthetic Dentists,Prosthodontist,Restorative Dentist,Restorative Dentists
D004245 DMF Index "Decayed, missing and filled teeth," a routinely used statistical concept in dentistry. Decayed, Missing, and Filled Teeth,DMF Indexes,DMF Indexe,DMF Indices,Index, DMF,Indexe, DMF,Indexes, DMF,Indices, DMF
D005247 Feeding Behavior Behavioral responses or sequences associated with eating including modes of feeding, rhythmic patterns of eating, and time intervals. Dietary Habits,Eating Behavior,Faith-based Dietary Restrictions,Feeding Patterns,Feeding-Related Behavior,Food Habits,Diet Habits,Eating Habits,Behavior, Eating,Behavior, Feeding,Behavior, Feeding-Related,Behaviors, Eating,Behaviors, Feeding,Behaviors, Feeding-Related,Diet Habit,Dietary Habit,Dietary Restriction, Faith-based,Dietary Restrictions, Faith-based,Eating Behaviors,Eating Habit,Faith based Dietary Restrictions,Faith-based Dietary Restriction,Feeding Behaviors,Feeding Pattern,Feeding Related Behavior,Feeding-Related Behaviors,Food Habit,Habit, Diet,Habit, Dietary,Habit, Eating,Habit, Food,Habits, Diet,Pattern, Feeding,Patterns, Feeding,Restrictions, Faith-based Dietary
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000704 Analysis of Variance A statistical technique that isolates and assesses the contributions of categorical independent variables to variation in the mean of a continuous dependent variable. ANOVA,Analysis, Variance,Variance Analysis,Analyses, Variance,Variance Analyses

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