Neighbourhood characteristics and children's oral health: a multilevel population-based cohort study

Agatha W van Meijeren-van Lunteren, Joost Oude Groeniger, Eppo B Wolvius, Lea Kragt

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BACKGROUND: To understand determinants of oral health inequalities, multilevel modelling is a useful manner to study contextual factors in relation to individual oral health. Several studies outside Europe have been performed so far, however, contextual variables used are diverse and results conflicting. Therefore, this study investigated whether neighbourhood level differences in oral health exist, and whether any of the neighbourhood characteristics used were associated with oral health.

METHODS: This study is embedded in The Generation R Study, a prospective cohort study conducted in The Netherlands. In total, 5 960 6-year-old children, representing 158 neighbourhoods in the area of Rotterdam, were included. Data on individual and neighbourhood characteristics were derived from questionnaires, and via open data resources. Caries was assessed via intraoral photographs, and defined as decayed, missing and filled teeth (dmft).

RESULTS: Differences between neighbourhoods explained 13.3% of the risk of getting severe caries, and 2% of the chance of visiting the dentist yearly. After adjustments for neighbourhood and individual characteristics, neighbourhood deprivation was significantly associated with severe dental caries (OR: 1.48, 95% CI: 1.02-2.15), and suggestive of a low odds of visiting the dentist yearly (OR: 0.81, 95% CI: 0.56-1.18).

CONCLUSIONS: Childhood caries and use of dental services differs between neighbourhoods and living in a deprived neighbourhood is associated with increased dental caries and decreased yearly use of dental services. This highlights the importance of neighbourhoods for understanding differences in children's oral health, and for targeted policies and interventions to improve the oral health of children living in deprived neighbourhoods.

Original languageEnglish
Pages (from-to)742-748
Number of pages7
JournalEuropean Journal of Public Health
Issue number4
Early online date24 Feb 2021
Publication statusPublished - Aug 2021

Bibliographical note

This work was supported by financial support from the Erasmus
Medical Centre, Erasmus University Rotterdam, The Netherlands
Organization for Health Research and Development, The
Netherlands Organization for Scientific Research, the Ministry of
Health Welfare and Sport, the Ministry of Youth and Families,
and the European Research Council. The dental caries assessment
of the study was financially supported by an unrestricted grant of
GABA international, Therwil, Switzerland.

© The Author(s) 2021. Published by Oxford University Press on behalf of the European Public Health Association.


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