On dental caries and socioeconomy in Swedish children and adolescents - Clinical and register-based studies

Sammanfattning: The overall aim was to analyze the dental caries experience among Swedish children and adolescents and explore it with respect to demographic and socioeconomic factors. Study I is a longitudinal clinical study of 271 children, followed from three to six years of age (2003-6), with the aim to analyze initial and manifest caries in the primary dentition. Studies II–IV are cross-sectional registry studies of 300,988 children and adolescents, 3–19 years of age (2007-9). Study II investigated caries with reference to age, gender and geographical area. Study III explored the associations of individual multiple socioeconomic factors on the caries experience. Study IV analyzed the variability in caries experience at different area levels with respect to individual demography and socioeconomics. The results showed that young children with an early caries experience had a high risk of disease progression and initial carious lesions constituted a large share of the disease burden (Study I). Among 18- and 19-year-olds, only one-third had no manifest caries experience. The disease burden was highly skewed at all ages. Females had a higher risk of a caries experience than males before their teens, with a reverse pattern during the teenage years (Study II). Multiple socioeconomic factors had a significant association with the caries experience among children and adolescents, especially the youngest children (Study III). Small geographical areas explained more of the variance in caries experience compared with the more aggregated level dental clinics (Study IV). In conclusion, disparities in caries experience among Swedish children and adolescents were found with a skewed distribution, within age groups, between genders, between residential areas and in relation to individual socioeconomic status. The findings may serve as a basis for allocating resources in dentistry with the goal/ambition to achieve greater equity of dental health.