Journal List > J Korean Acad Oral Health > v.40(2) > 1057682

Choi and Kim: Effects of socioeconomic level on dental scaling experience in the community: a multilevel analysis

Abstract

Objectives

The purpose of this study was to investigate the associations between a community-level factor and dental scaling experience and to confirm the associations with individual factors in Korea.

Methods

In total, 203,088 individuals from 243 communities participated in the 2013 Community Health Survey. A dichotomized response of experiences with dental scaling was used as the outcome and the regional deprivation index was used as the explanatory community-level factor. In addition, various individual factors were included as covariates. In the bivariate analysis, the chi-square test was used. Multilevel multivariate logistic regression was also performed where in four models were applied. The bivariate analysis showed that all factors at the individual and community level showed significant associations with an individual's experience with dental scaling.

Results

The factors that were significantly associated with the dental scaling experience were being male, being 40-49 years old, having a higher income level, being economically active, having a higher education level, being a non-smoker, being a drinker, having good periodontal health, using oral hygiene products, tooth-brushing after lunch, and residing in less deprived regions (P<0.01). As with the results of multilevel logistic regression analysis, the regional deprivation index was significantly associated with scaling experience after adjusting for individual factors with an adjusted odds ratio of 0.98 (95% CI: 0.97-0.99), demonstrating an association between a lack of experience with scaling and lower socioeconomic status in the community.

Conclusions

This study indicated that the scaling experience was affected not only by individual factors, but also by factors at the community level. Future studies are required to examine the detailed relationships between oral health and other community factors such as medical and social capital.

References

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Table 1.
The variables of this study
Classification The contents of variables
Dependent variables Scaling experience (last year)
Level Variables
Individual level Demographic factor: gender, age
Socioeconomic factors: income, economic activity, education
Health related factor: smoking, drinking
Oral health related factor: periodontal health, using of oral hygiene product, tooth brush after lunch
Community level Regional deprivation index
Table 2.
Scaling experience according to individual-level and community-level factors
Variable N (%) Scaling experience % Non-Scaling experience % P
Gender
Female 110,927 (54.6) 29.5 70.5 <0.001
Male 92,161 (45.4) 30.5 69.5
Age * 50.47±16.37
19-29 23,313 (11.5) 32.4 67.6 <0.001
30-39 33,014 (16.3) 35.3 64.7
40-49 41,057 (20.2) 35.7 64.3
50-59 42,860 (21.1) 35.0 65.0
60-69 31,917 (15.7) 26.3 73.7
≥70 30,927 (15.7) 11.4 88.6
Income
≤100 44,319 (21.8) 15.8 84.2 <0.001
≤250 55,098 (27.1) 26.9 73.1
≤400 49,264 (24.3) 33.9 66.1
>400 54,407 (26.8) 40.9 59.1
Economic activity
No 70,911 (34.9) 25.9 74.1 <0.001
Yes 132,177 (65.1) 32.1 67.9
Education level
≤Primary school 46,134 (22.7) 13.6 86.4 <0.001
Middle school 23,410 (11.5) 26.1 73.9
High school 61,015 (30.0) 32.3 67.7
≥College 72,529 (35.7) 39.6 60.4
Smoking
No 161,572 (79.6) 30.2 69.8 <0.001
Yes 41,516 (20.4) 28.9 71.1
Drinking
No 63,852 (31.4) 23.9 76.1 <0.001
Yes 139,236 (68.6) 32.7 67.3
Periodontal health
Poor 60,211 (29.6) 26.2 73.8 <0.001
Good 142,877 (70.4) 31.5 68.5
Using of oral hygiene product
No 152,584 (75.1) 23.1 76.9 <0.001
Yes 50,504 (24.9) 50.5 49.5
Tooth brush after lunch
No 85,402 (42.1) 22.2 77.8 <0.001
Yes 117,686 (57.9) 35.5 64.5
Community SES (range of RDI) * 0.485±3.849
Lowest (2.79-9.89) 50,336 (24.8) 25.8 74.2 <0.001
Lower (―0.16-2.78) 50,967 (25.1) 29.4 70.6
Higher (―2.93-―0.15) 50,249 (24.7) 28.7 71.3
Highest (―10.37-―2.92) 51,536 (25.4) 35.7 64.3

*Mean±SD. P-values by the chi-square test; SES (socio-economic status); RDI (regional deprivation index).

Table 3.
Multilevel logistic regression analysis for having scaling experience during last year
Fixed effects Model 1 Model 2 OR (95%CI) Model 3 OR (95%CI) Model 4 OR (95%CI)
Individual level
Gender
Female 1 1
Male 1.08 (1.06-1.05) 1.08 (1.06-1.05)
Age
19-29 1 1
30-39 1.06 (1.02-1.11) 1.06 (1.02-1.11)
40-49 1.20 (1.15-1.25) 1.20 (1.15-1.25)
50-59 1.57 (1.51-1.64) 1.57 (1.51-1.64)
60-69 1.57 (1.49-1.66) 1.57 (1.49-1.66)
≥70 0.82 (0.76-0.88) 0.82 (0.76-0.88)
Household income
≤100 1 1
≤250 1.21 (1.16-1.26) 1.21 (1.16-1.26)
≤400 1.36 (1.31-1.42) 1.36 (1.31-1.42)
>400 1.59 (1.31-1.42) 1.59 (1.31-1.42)
Economic activity
No 1 1
Yes 1.11 (1.01-1.14) 1.11 (1.01-1.14)
Education level
≤Primary school 1 1
Middle school 1.45 (1.38-1.52) 1.45 (1.38-1.52)
High school 1.67 (1.60-1.75) 1.67 (1.60-1.75)
≥Colleage 1.99 (1.88-2.01) 1.99 (1.90-2.01)
Smoking
No 1 1
Yes 0.91 (0.88-0.93) 0.91 (0.88-0.93)
Drinking
No 1 1
Yes 1.09 (1.06-1.12) 1.09 (1.06-1.12)
Periodontal health
Poor 1 1
Good 1.17 (1.14-1.21) 1.18 (1.15-2.21)
Using of oral hygiene product
No 1 1
Yes 2.44 (2.38-2.51) 2.45 (2.40-2.52)
Tooth brush after lunch
No 1 1
Yes 1.41 (1.38-1.45) 1.41 (1.38-1.45)
Community level
RDI 0.96 (0.95-0.97) 0.98 (0.97-0.99)

Random effects
Community level variance Tau 0.218*** 0.189*** 0.085*** 0.078***
ICC 0.062 0.056 0.025 0.023
Deviance (-2LL) 574,648.0 574,608.8 571,091.8 571,071
Number of parameters 1 2 19 20
Likelihood ratio test Model 1 vs. 2 Model 1 vs. 3 Model 3 vs. 4
Δ-2LL (Δdf) 39.2 (1)*** 3556.2 (18)*** 20.8 (1)***

***P<.001.

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