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Adult tooth loss for residents of US coal mining and A ppalachian counties
Author(s) -
Hendryx Michael,
Ducatman Alan M.,
Zullig Keith J.,
Ahern Melissa M.,
Crout Richard
Publication year - 2012
Publication title -
community dentistry and oral epidemiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.061
H-Index - 101
eISSN - 1600-0528
pISSN - 0301-5661
DOI - 10.1111/j.1600-0528.2012.00691.x
Subject(s) - medicine , odds , coal mining , tooth loss , odds ratio , edentulism , residence , covariate , demography , logistic regression , dentistry , environmental health , coal , statistics , geography , oral health , mathematics , archaeology , sociology
Objectives The authors compared rates of tooth loss between adult residents of A ppalachian coal‐mining areas and other areas of the nation before and after control for covariate risks. Methods The authors conducted a cross‐sectional secondary data analysis that merged 2006 national B ehavioral R isk F actor S urveillance S ystem data ( BRFSS ) ( N = 242 184) with county coal‐mining data and other county characteristics. The hypothesis tested was that adult tooth loss would be greater in A ppalachian mining areas after control for other risks. Primary independent variables included main effects for coal‐mining present (yes/no) residence in A ppalachia (yes/no), and their interaction. Data were weighted using the BRFSS final weights and analyzed using SUDAAN P roc M ultilog to account for the multilevel complex sampling structure. The odds of two measures of tooth loss were examined controlling for age, race\ethnicity, drinking, smoking, income, education, supply of dentists, receipt of dental care, fluoridation rate, and other variables. Results After covariate adjustment, the interaction variable for the residents of A ppalachian coal‐mining counties showed a significantly elevated odds for any tooth loss [odds ratio ( OR ) = 1.19, 95% CI = 1.02, 1.38], and greater tooth loss measured by a 4‐level edentulism scale ( OR = 1.20, 95% CI = 1.05, 1.36). The main effect for Appalachia was also significant for both measures, but the main effect for coal mining was not. Conclusions Greater risk of tooth loss among adult residents of A ppalachian coal‐mining areas is present and is not explained by differences in reported receipt of dental care, fluoridation rates, supply of dentists or other behavioral or socioeconomic risks. Possible contributing factors include mining‐specific disparities related to access, behavior or environmental exposures.