Tooth Loss in the United Kingdom – Trends in Social Inequalities: An Age-Period-and-Cohort Analysis
Identifieur interne : 005346 ( Ncbi/Merge ); précédent : 005345; suivant : 005347Tooth Loss in the United Kingdom – Trends in Social Inequalities: An Age-Period-and-Cohort Analysis
Auteurs : Eduardo Bernabé [Royaume-Uni] ; Aubrey Sheiham [Royaume-Uni]Source :
- PLoS ONE [ 1932-6203 ] ; 2014.
Abstract
This study assessed trends in social inequalities in tooth loss in the United Kingdom between 1988 and 2009. Data from 20,126 adults who participated in the latest three national Adult Dental Health Surveys in England, Wales and Northern Ireland were used. Social class was determined using the 6-point Registrar General’s Social Class. Three indicators of tooth loss were analysed; the proportion of edentate people among all adults and the number of teeth and the proportion with functional dentition (defined as having 20+ teeth) among dentate adults. Trends were modelled within an age, period and cohort framework using partial least squares regression (PLSR). Confidence intervals for PLSR estimates were obtained using non-parametric bootstrapping. The Slope and Relative Index of Inequality (SII and RII) were used to quantify social inequalities in tooth loss. Between 1988 and 2009, absolute inequalities in total tooth loss narrowed (SII changed from −28.4% to −15.3%) while relative inequalities widened (RII from 6.21 to 20.9) in the whole population. On the other hand, absolute and relative social inequality in tooth loss remained fairly stable over time among dentate adults. There was an absolute difference of 2.5–2.9 in number of teeth and 22–26% in the proportion with functional dentition between the lowest and highest social classes. In relative terms, the highest social class had 10–11% more teeth and 25–28% higher probability of having functional dentition than the lowest social class. The findings show pervasive inequalities in tooth loss by social class among British adults despite marked improvements in tooth retention in recent years and generations. In the whole adult population, absolute inequalities in tooth loss have narrowed while relative inequalities have increased steadily. Among dentate adults, absolute and relative inequalities in number of teeth and proportion of people with functional dentition have remained significant but unchanged over time.
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DOI: 10.1371/journal.pone.0104808
PubMed: 25105665
PubMed Central: 4126783
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Tooth Loss in the United Kingdom – Trends in Social Inequalities: An Age-Period-and-Cohort Analysis</title><author><name sortKey="Bernabe, Eduardo" sort="Bernabe, Eduardo" uniqKey="Bernabe E" first="Eduardo" last="Bernabé">Eduardo Bernabé</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>King’s College London Dental Institute at Guy’s, King’s College and St. Thomas’ Hospitals, Division of Population and Patient Health, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>King’s College London Dental Institute at Guy’s, King’s College and St. Thomas’ Hospitals, Division of Population and Patient Health, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Sheiham, Aubrey" sort="Sheiham, Aubrey" uniqKey="Sheiham A" first="Aubrey" last="Sheiham">Aubrey Sheiham</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Department of Epidemiology and Public Health, University College London, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Epidemiology and Public Health, University College London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region><settlement type="city">Londres</settlement></placeName><orgName type="university">University College de Londres</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">25105665</idno><idno type="pmc">4126783</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4126783</idno><idno type="RBID">PMC:4126783</idno><idno type="doi">10.1371/journal.pone.0104808</idno><date when="2014">2014</date><idno type="wicri:Area/Pmc/Corpus">000432</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">000432</idno><idno type="wicri:Area/Pmc/Curation">000432</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">000432</idno><idno type="wicri:Area/Pmc/Checkpoint">001150</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">001150</idno><idno type="wicri:Area/Ncbi/Merge">005346</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Tooth Loss in the United Kingdom – Trends in Social Inequalities: An Age-Period-and-Cohort Analysis</title><author><name sortKey="Bernabe, Eduardo" sort="Bernabe, Eduardo" uniqKey="Bernabe E" first="Eduardo" last="Bernabé">Eduardo Bernabé</name><affiliation wicri:level="3"><nlm:aff id="aff1"><addr-line>King’s College London Dental Institute at Guy’s, King’s College and St. Thomas’ Hospitals, Division of Population and Patient Health, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>King’s College London Dental Institute at Guy’s, King’s College and St. Thomas’ Hospitals, Division of Population and Patient Health, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region></placeName></affiliation></author><author><name sortKey="Sheiham, Aubrey" sort="Sheiham, Aubrey" uniqKey="Sheiham A" first="Aubrey" last="Sheiham">Aubrey Sheiham</name><affiliation wicri:level="4"><nlm:aff id="aff2"><addr-line>Department of Epidemiology and Public Health, University College London, London, United Kingdom</addr-line></nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Department of Epidemiology and Public Health, University College London, London</wicri:regionArea><placeName><settlement type="city">Londres</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Londres</region><settlement type="city">Londres</settlement></placeName><orgName type="university">University College de Londres</orgName></affiliation></author></analytic><series><title level="j">PLoS ONE</title><idno type="eISSN">1932-6203</idno><imprint><date when="2014">2014</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>This study assessed trends in social inequalities in tooth loss in the United Kingdom between 1988 and 2009. Data from 20,126 adults who participated in the latest three national Adult Dental Health Surveys in England, Wales and Northern Ireland were used. Social class was determined using the 6-point Registrar General’s Social Class. Three indicators of tooth loss were analysed; the proportion of edentate people among all adults and the number of teeth and the proportion with functional dentition (defined as having 20+ teeth) among dentate adults. Trends were modelled within an age, period and cohort framework using partial least squares regression (PLSR). Confidence intervals for PLSR estimates were obtained using non-parametric bootstrapping. The Slope and Relative Index of Inequality (SII and RII) were used to quantify social inequalities in tooth loss. Between 1988 and 2009, absolute inequalities in total tooth loss narrowed (SII changed from −28.4% to −15.3%) while relative inequalities widened (RII from 6.21 to 20.9) in the whole population. On the other hand, absolute and relative social inequality in tooth loss remained fairly stable over time among dentate adults. There was an absolute difference of 2.5–2.9 in number of teeth and 22–26% in the proportion with functional dentition between the lowest and highest social classes. In relative terms, the highest social class had 10–11% more teeth and 25–28% higher probability of having functional dentition than the lowest social class. The findings show pervasive inequalities in tooth loss by social class among British adults despite marked improvements in tooth retention in recent years and generations. In the whole adult population, absolute inequalities in tooth loss have narrowed while relative inequalities have increased steadily. Among dentate adults, absolute and relative inequalities in number of teeth and proportion of people with functional dentition have remained significant but unchanged over time.</p></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Baelum, V" uniqKey="Baelum V">V Baelum</name></author><author><name sortKey="Van Palenstein Helderman, W" uniqKey="Van Palenstein Helderman W">W van Palenstein Helderman</name></author><author><name sortKey="Hugoson, A" uniqKey="Hugoson A">A Hugoson</name></author><author><name sortKey="Yee, R" uniqKey="Yee R">R Yee</name></author><author><name sortKey="Fejerskov, O" uniqKey="Fejerskov O">O Fejerskov</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Fejerskov, O" uniqKey="Fejerskov O">O Fejerskov</name></author><author><name sortKey="Escobar, G" uniqKey="Escobar G">G Escobar</name></author><author><name sortKey="Jossing, M" uniqKey="Jossing M">M 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<front><journal-meta><journal-id journal-id-type="nlm-ta">PLoS One</journal-id><journal-id journal-id-type="iso-abbrev">PLoS ONE</journal-id><journal-id journal-id-type="publisher-id">plos</journal-id><journal-id journal-id-type="pmc">plosone</journal-id><journal-title-group><journal-title>PLoS ONE</journal-title></journal-title-group><issn pub-type="epub">1932-6203</issn><publisher><publisher-name>Public Library of Science</publisher-name><publisher-loc>San Francisco, USA</publisher-loc></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">25105665</article-id><article-id pub-id-type="pmc">4126783</article-id><article-id pub-id-type="publisher-id">PONE-D-14-23785</article-id><article-id pub-id-type="doi">10.1371/journal.pone.0104808</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="Discipline-v2"><subject>Medicine and Health Sciences</subject><subj-group><subject>Epidemiology</subject><subj-group><subject>Social Epidemiology</subject></subj-group></subj-group><subj-group><subject>Health Care</subject><subj-group><subject>Socioeconomic Aspects of Health</subject></subj-group></subj-group><subj-group><subject>Oral Medicine</subject><subj-group><subject>Dentistry</subject><subject>Oral Diseases</subject><subject>Oral Health</subject></subj-group></subj-group><subj-group><subject>Public and Occupational Health</subject></subj-group></subj-group></article-categories><title-group><article-title>Tooth Loss in the United Kingdom – Trends in Social Inequalities: An Age-Period-and-Cohort Analysis</article-title><alt-title alt-title-type="running-head">Trend of Inequalities in Tooth Loss in the UK</alt-title></title-group><contrib-group><contrib contrib-type="author"><name><surname>Bernabé</surname><given-names>Eduardo</given-names></name><xref ref-type="aff" rid="aff1"><sup>1</sup></xref></contrib><contrib contrib-type="author"><name><surname>Sheiham</surname><given-names>Aubrey</given-names></name><xref ref-type="aff" rid="aff2"><sup>2</sup></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib></contrib-group><aff id="aff1"><label>1</label><addr-line>King’s College London Dental Institute at Guy’s, King’s College and St. Thomas’ Hospitals, Division of Population and Patient Health, London, United Kingdom</addr-line></aff><aff id="aff2"><label>2</label><addr-line>Department of Epidemiology and Public Health, University College London, London, United Kingdom</addr-line></aff><contrib-group><contrib contrib-type="editor"><name><surname>Divaris</surname><given-names>Kimon</given-names></name><role>Editor</role><xref ref-type="aff" rid="edit1"></xref></contrib></contrib-group><aff id="edit1"><addr-line>UNC School of Dentistry, University of North Carolina-Chapel Hill, United States of America</addr-line></aff><author-notes><corresp id="cor1">* E-mail: <email>a.sheiham@ucl.ac.uk</email></corresp><fn fn-type="conflict"><p><bold>Competing Interests: </bold>The authors have declared that no competing interests exist.</p></fn><fn fn-type="con"><p>Conceived and designed the experiments: EB AS. Analyzed the data: EB. Contributed to the writing of the manuscript: EB AS.</p></fn></author-notes><pub-date pub-type="collection"><year>2014</year></pub-date><pub-date pub-type="epub"><day>8</day><month>8</month><year>2014</year></pub-date><volume>9</volume><issue>8</issue><elocation-id>e104808</elocation-id><history><date date-type="received"><day>28</day><month>5</month><year>2014</year></date><date date-type="accepted"><day>14</day><month>7</month><year>2014</year></date></history><permissions><copyright-year>2014</copyright-year><copyright-holder>Bernabé, Sheiham</copyright-holder><license><license-p>This is an open-access article distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.</license-p></license></permissions><abstract><p>This study assessed trends in social inequalities in tooth loss in the United Kingdom between 1988 and 2009. Data from 20,126 adults who participated in the latest three national Adult Dental Health Surveys in England, Wales and Northern Ireland were used. Social class was determined using the 6-point Registrar General’s Social Class. Three indicators of tooth loss were analysed; the proportion of edentate people among all adults and the number of teeth and the proportion with functional dentition (defined as having 20+ teeth) among dentate adults. Trends were modelled within an age, period and cohort framework using partial least squares regression (PLSR). Confidence intervals for PLSR estimates were obtained using non-parametric bootstrapping. The Slope and Relative Index of Inequality (SII and RII) were used to quantify social inequalities in tooth loss. Between 1988 and 2009, absolute inequalities in total tooth loss narrowed (SII changed from −28.4% to −15.3%) while relative inequalities widened (RII from 6.21 to 20.9) in the whole population. On the other hand, absolute and relative social inequality in tooth loss remained fairly stable over time among dentate adults. There was an absolute difference of 2.5–2.9 in number of teeth and 22–26% in the proportion with functional dentition between the lowest and highest social classes. In relative terms, the highest social class had 10–11% more teeth and 25–28% higher probability of having functional dentition than the lowest social class. The findings show pervasive inequalities in tooth loss by social class among British adults despite marked improvements in tooth retention in recent years and generations. In the whole adult population, absolute inequalities in tooth loss have narrowed while relative inequalities have increased steadily. Among dentate adults, absolute and relative inequalities in number of teeth and proportion of people with functional dentition have remained significant but unchanged over time.</p></abstract><funding-group><funding-statement>The authors have no support or funding to report.</funding-statement></funding-group><counts><page-count count="8"></page-count></counts><custom-meta-group><custom-meta id="data-availability"><meta-name>Data Availability</meta-name><meta-value>The authors confirm that all data underlying the findings are fully available without restriction. All Adult Dental Health Surveys files are available from the UK Data Archive (accession numbers SN 2834, SN 4226 and SN 6884 for the 1988, 1998 and 2009 survey).</meta-value></custom-meta></custom-meta-group></article-meta><notes><title>Data Availability</title><p>The authors confirm that all data underlying the findings are fully available without restriction. All Adult Dental Health Surveys files are available from the UK Data Archive (accession numbers SN 2834, SN 4226 and SN 6884 for the 1988, 1998 and 2009 survey).</p></notes></front></pmc><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Londres</li></region><settlement><li>Londres</li></settlement><orgName><li>University College de Londres</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Bernabe, Eduardo" sort="Bernabe, Eduardo" uniqKey="Bernabe E" first="Eduardo" last="Bernabé">Eduardo Bernabé</name></region><name sortKey="Sheiham, Aubrey" sort="Sheiham, Aubrey" uniqKey="Sheiham A" first="Aubrey" last="Sheiham">Aubrey Sheiham</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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| HfdSelect -Kh $EXPLOR_AREA/Data/Ncbi/Merge/biblio.hfd \
| NlmPubMed2Wicri -a EdenteV2
| This area was generated with Dilib version V0.6.32. |  |