March 2017

Volume 34, Issue 1

A model for oral health gradients in children: using structural equation modeling

Authors: A. Behbahanirad H. Joulaei J. Jamali M. Vossoughi A. Golkari
doi: 10.1922/CDH_3978Behbahanirad06


Detecting the underlying socioeconomic and behavioral determinants is essential for reducing oral health disparities in children. Objective: To test a conceptual model in children to explore the interaction amongst social, environmental, behavioral factors and oral health outcomes. Methods: This analytic cross-sectional study was performed in 2014-2015 in Shiraz, Iran. The sampling was conducted using a multistage stratified design to represent the whole 6-year-olds in Shiraz County. Participants were 830, 6-year-old first grade primary schoolchildren and their parents. Children were examined to register decayed, missing and filled teeth (dmft) and simplified oral hygiene index (OHI-S). Parents were asked for data on socio-cultural risk factors, oral health behaviors and children’s oral health related quality of life (C-OHRQoL). Data on environmental risk factors were collected from several sources. The proposed model, a development of Peterson’s, was tested using structural equation modeling (SEM). Results: The tested model could empirically demonstrate the wide range of social and behavioral factors affecting C-OHRQoL. Socioeconomic status (SES) affected the OHRQoL of children through several pathways. Tooth brushing frequency, use of oral health services and consuming cariogenic foods were the mediators, through which SES affected dmft and subsequently C-OHRQoL. Conclusions: Using the modified Petersen’s model and SEM, the paths in which different distal and proximal factors affect oral health outcomes in children could be clearly identified. It showed that addressing the underlying social, economic and behavioral determinants is essential for reducing oral health disparities among Iranian children. Key words: quality of life, oral health, children, socioeconomic status, tooth brushing, structural equation modeling, Iran


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The oral health of people with learning disabilities - a user-friendly questionnaire survey 4-7 Download
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Access to urgent dental care: a scoping review 19-26 Download
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Directly observed daily mouth care provided to care home residents in one area of Kent, UK 32-36 Download
Association between sense of coherence and oral health-related quality of life among toddlers 37-40 Download
Tobacco use in late adolescence among rural Sri Lankans 41-45 Download
Dental caries experience among Albanian pre-school children: a national survey 46-49 Download
A model for oral health gradients in children: using structural equation modeling 50-55 Download
Using the simplified case mix tool (sCMT) to identify cost in special care dental services to support commissioning 56-59 Download
Oral health and oral health behaviours of five-year-old children in the Charedi Orthodox Jewish Community in North London, UK 60-64 Download


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