Socio-economic inequalities in tooth loss and chewing difficulty in the Korean elderly

Shin, Bo Mi; Jung, Se Hwan

Abstract

OBJECTIVES
This study aimed to assess socio-economic inequalities in subjects with 20 or more natural teeth and chewing difficulty in the Korean elderly, and to assess the association of health behavior factors, psychological factors, and oral health status on social gradients of subjects with tooth loss and chewing difficulty.
METHODS
Cross-sectional data were from the Fourth Korea National Health & Nutrition Examination Survey. Subjects were 3,598 people over the age of 65 years, who participated in a health interview, dental examination and dietary survey. Income status and educational status were selected as measures of socio-economic position (SEP). Logistic regression models were used to assess socio-economic inequalities of subjects with 20 or more natural teeth and chewing difficulty. To assess the association of related factors, a logistic model that was adjusted for each group of variables was compared to those that were not adjusted for it.
RESULTS
We found that there were socio-economic differences in subjects with 20 or more natural teeth and chewing difficulty in Korean elderly. The social gradient for subjects with 20 or more natural teeth and chewing difficulty persisted, after adjusting for different factors. While adjusting for oral hygiene factors and smoking factors attenuated the association between 20 or more natural teeth and SEP, adjusting for oral health status and psychological factors attenuated the association between chewing difficulty and SEP. Education status was a more apparent measure than income status, in socio-economic inequalities in oral health among the Korean elderly.
CONCLUSIONS
Socio-economic inequalities in oral health among the Korean elderly might be important social problems. More extensive longitudinal research to confirm the pathways that explain oral health inequalities among the elderly is required, to develop effective intervention strategies to reduce socio-economic differences in oral health among the Korean elderly.