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Do contextual factors have a role in periodontal disease?
Author(s) -
Sun Xiangyu,
Bernabé Eduardo,
Liu Xuenan,
Gallagher Jennifer E.,
Zheng Shuguo
Publication year - 2017
Publication title -
journal of clinical periodontology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.456
H-Index - 151
eISSN - 1600-051X
pISSN - 0303-6979
DOI - 10.1111/jcpe.12630
Subject(s) - socioeconomic status , demography , medicine , ethnic group , gross domestic product , per capita , population , public health , epidemiology , gini coefficient , periodontal disease , environmental health , dentistry , inequality , economic inequality , mathematical analysis , nursing , mathematics , sociology , anthropology , economics , economic growth
Aim To explore the association between contextual factors and periodontal disease. Methods We pooled individual‐level data from 20,204 35–44‐year‐olds and 9,666 65–74‐year‐ olds, who participated in the 3rd National Oral Health Survey in China (2005), with province‐level data from different sources. The association of provincial macroeconomic factors [Gross Domestic Product ( GDP ) per capita and Gini coefficient], health resources (public health expenditure, dentist‐to‐population ratio and dental‐therapist‐to‐population ratio), demographic composition (proportion of rural population and minority ethnic groups) and tobacco industry (tobacco crops, cigarette production and proportion of smokers) with the numbers of teeth with periodontal pocket depth ( PPD ) ≥ 4 mm and loss of attachment ( LOA ) ≥ 4 mm were assessed in multilevel models, controlling for individual‐level demographic, socioeconomic and behavioural factors. Results Only the proportion of smokers at province level was associated with the number of teeth with PPD ≥ 4 mm and only among senior adults. However, public health expenditure, dentist‐to‐population ratio and the proportion of minority ethnic groups were associated with the number of teeth with LOA ≥ 4 mm in both age groups. GDP per capita was also associated with the number of teeth with LOA ≥ 4 mm only among 35–44‐year‐olds. Conclusion Contextual factors may contribute to periodontal disease and help explain geographical inequalities among Chinese adults.