Socio-economic inequalities and oral health in Canada and the United States

J Dent Res. 2012 Sep;91(9):865-70. doi: 10.1177/0022034512455062. Epub 2012 Jul 26.


This paper describes and compares the magnitude of socio-economic inequalities in oral health among adults in Canada and the US over the past 35 years. We analyzed data from nationally representative examination surveys in Canada and the US: Nutrition Canada National Survey (1970-1972, N = 11,546), Canadian Health Measures Survey (2007-2009, N = 3,508), The First National Health and Nutrition Examination Survey (1971-1974, N = 13,131), and National Health and Nutrition Examination Survey (2007-2008, N = 5,707). Oral health outcomes examined were prevalence of edentulism, proportion of individuals having at least 1 untreated decayed tooth, and proportion of individuals having at least 1 filled tooth. Sociodemographic indicators included in our analysis were place of birth, education, and income. Data were age-adjusted, and survey weights were used to account for the complex survey design in making population inferences. Our findings demonstrate that oral health outcomes have improved for adults in both countries. In the 1970s, Canada had a higher prevalence of edentulism and dental decay and lower prevalence of filled teeth. This was also combined with a more pronounced social inequality gradient among place of birth, education, and income groups. Over time, both countries demonstrated a decline in absolute socio-economic inequalities in oral health.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Canada / epidemiology
  • DMF Index
  • Dental Caries / epidemiology
  • Dental Restoration, Permanent / statistics & numerical data
  • Female
  • Health Status Disparities*
  • Health Surveys
  • Humans
  • Logistic Models
  • Male
  • Mouth, Edentulous / epidemiology
  • Nutrition Surveys
  • Oral Health*
  • Prevalence
  • Residence Characteristics
  • Socioeconomic Factors*
  • United States / epidemiology
  • Young Adult