On oral health in young individuals with foreign and Swedish backgrounds

Sammanfattning: In Sweden, children and adolescents with two foreign-born parents constitute 17% of all children in the Swedish population.AIMS: The aims of this thesiswere to collect knowledge of the prevalence of gingivitis, caries and caries associated variables, in the 3-, 5-, 10- and 15-year age groups with two foreign born parents compared with their counterparts with Swedish-born parents in a ten-year perspective (Study I). To investigate the prevalence of caries and caries-associated variables in 15-year-olds in relation to foreign backgrounds and to examine differences in the prevalence of caries in adolescents with foreign backgrounds according to their length of residence in Sweden (StudyII).MATERIAL AND METHODS: In 1993 and 2003, cross-sectional studies with random samples of individuals in the age groups of 3, 5, 10 and 15 years were performed in Jönköping, Sweden. The oral health status of all individuals was examined clinically and radiographically. The children or their parents also answered a questionnaire about their attitudes to, and knowledge of, teeth and oral health care habits. The final study sample comprised 739 children and adolescents, 154 with two foreign-born parents (F cohort) and 585 with two Swedish-born parents (S cohort) (Study I). In Study II, all 15-year-olds(n=143) at one school in the city of Jönköping were asked to participate in the study. The final sample comprised 117 individuals, 51 with foreign-born parents and 66 with Swedish-born parents. All the individuals were interviewed using a structured questionnaire with visualisation e.g. food packages, sweets and snacks. Information about DFS was collected from case records at the Public Dental Service.RESULTS: In both 1993 and 2003, more 3- and 5-yearolds in the S cohort were caries free compared with the F cohort. In 1993, dfs was higher among 3- and 5-year-olds in the F cohort (p<0.01) compared with the S cohort. In 2003, dfs/DFS was statistically significantly higher in all age groups among children and adolescents in the F cohort compared with the S cohort. In 2003, the odds ratio of being exposed to dental caries among 10- and 15-year-olds in the F cohort, adjusted for gender and age, was more than six times higher (OR=6.3, 95% CI:2.51-15.61; p<0.001) compared with the S cohort (Study I). Fifteen-year-olds born in Sweden with foreign-born parents, or who had arrived before one year of age, had a caries prevalence similar to that of adolescents with Swedish-born parents, whereas children who had immigrated to Sweden after seven years of age had a caries prevalence that was two to three times higher (p <0.06) (Study II). Both in 1993 and 2003, the mean of the percentage of tooth sites with plaque and gingivitis was numerically higher in all age groups in individuals with foreign backgrounds compared with Swedish background, except between the 15-year-olds (Study I).CONCLUSIONS: The decrease in caries prevalence, in a ten-year perspective, was less among children and adolescents with foreign-born parents compared with children and adolescents with Swedish-born parents. In 2003, there was statistically significantly more caries in all age groups among children and adolescents with foreign-born parents compared with children and adolescents with Swedish-born parents. Children who immigrated to Sweden at age seven or later had a two to three times higher caries prevalence compared with their Swedish counterparts. The odds ratio for being exposed to dental caries was almost six times higher for 10- and 15-year olds with foreign-born parents compared with their Swedish counterparts. The intake of carbohydrate-rich food was higher among 15-year olds with foreign backgrounds compared to those with Swedish background. There is an obvious need to improve the promotion of oral health care programmes among children and adolescents with foreign-born parents.