Social inequalities in tooth loss: A multinational comparison

Community Dent Oral Epidemiol. 2017 Jun;45(3):266-274. doi: 10.1111/cdoe.12285. Epub 2017 Feb 10.


Objectives: To conduct cross-national comparison of education-based inequalities in tooth loss across Australia, Canada, Chile, New Zealand and the United States.

Methods: We used nationally representative data from Australia's National Survey of Adult Oral Health; Canadian Health Measures Survey; Chile's First National Health Survey Ministry of Health; US National Health and Nutrition Examination Survey; and the New Zealand Oral Health Survey. We examined the prevalence of edentulism, the proportion of individuals having <21 teeth and the mean number of teeth present. We used education as a measure of socioeconomic position and measured absolute and relative inequalities. We used random-effects meta-analysis to summarize inequality estimates.

Results: The USA showed the widest absolute and relative inequality in edentulism prevalence, whereas Chile demonstrated the largest absolute and relative social inequality gradient for the mean number of teeth present. Australia had the narrowest absolute and relative inequality gap for proportion of individuals having <21 teeth. Pooled estimates showed substantial heterogeneity for both absolute and relative inequality measures.

Conclusions: There is a considerable variation in the magnitude of inequalities in tooth loss across the countries included in this analysis.

Keywords: disparities; education; epidemiology; public health; tooth loss.

Publication types

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

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Australia / epidemiology
  • Canada / epidemiology
  • Dental Health Surveys
  • Educational Status*
  • Female
  • Health Status Disparities*
  • Humans
  • Male
  • Middle Aged
  • New Zealand / epidemiology
  • Nutrition Surveys
  • Socioeconomic Factors
  • Tooth Loss / economics
  • Tooth Loss / epidemiology*
  • United States / epidemiology