Non-Cochrane · aetiology · PM30367654

Socioeconomic status, oral health and dental disease in Australia, Canada, New Zealand and the United States.

Mejia Gloria C, Elani Hawazin W, Harper Sam, et al. · BMC oral health · 2018 · PubMed · doi:10.1186/s12903-018-0630-3

Oral HealthDental cariesAMSTAR 2: not applicable
Full textEvery question was extracted from the full text, figures and supplements by two independent LLM extractors, disagreements adjudicated. Rows cite where in the review the value comes from.
Questions
66
current version
GRADE rated
0
No studies
0
Included studies
6
linked below
No studies 0 · 0%Ungraded 66 · 100%Very low 0 · 0%Low 0 · 0%Moderate 0 · 0%High 0 · 0%

Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.

Review question

ElementPlanned (methods)Found (results)
PopulationAdults aged 25 years and older from four high-income countries with fee-for-service adult dental care (Australia, Canada, New Zealand, United States) with nationally representative oral examination survey data within a 5-year timeframe14,960 adults aged 25 years and older (Australia n=5,073; Canada n=3,278; New Zealand n=2,041; USA n=4,568)
InterventionLower socioeconomic position, measured by education and by incomeLowest education (primary) and lowest income (low tertile)
ComparisonHigher socioeconomic position (highest education category; highest income tertile) as referenceHighest education (university/tertiary) and highest income (high tertile)
OutcomesUntreated tooth decay (prevalence, % DT>0); mean number of decayed teeth (mean DT); fair/poor self-rated oral health (SROH)All three outcomes meta-analysed for both education and income: prevalence of untreated decay (% DT>0), mean DT, and fair/poor SROH (6 pooled random-effects estimates)
Study designsNationally representative cross-sectional survey examination dataFour cross-sectional national surveys (NSAOH, CHMS, NZOHS, NHANES)
TimingCross-sectional; surveys conducted between 2003 and 2009Surveys 2003 to 2009 (no overlapping time period across all four surveys)

Search date: Not applicable (secondary analysis of existing national survey datasets; no bibliographic literature search). Databases: Four nationally representative survey datasets analysed: National Survey of Adult Oral Health (NSAOH; Australia, 2004 to 2006); Canadian Health Measures Survey (CHMS; Canada, 2007 to 2009); New Zealand Oral Health Survey (NZOHS; New Zealand, 2009); National Health and Nutrition Examination Survey…

Questions and results

Primary education vs University education

Population: Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States
15 questions
OutcomeEffectEvidenceStatus / GRADE
Mean number of decayed teeth (mean DT)
2007-2009 · Canada
In Canada, primary versus university education differed by 0.69 decayed teeth in mean number of decayed teeth.
AD 0.69 [0.43, 0.94]1 study · 3278 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2009 · New Zealand
In New Zealand, primary versus university education differed by 17.68 percentage points in prevalence of untreated decay.
AD 17.68 [6.62, 28.74]1 study · 2041 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2007-2009 · Canada
In Canada, primary versus university education differed by 22.11 percentage points in prevalence of untreated decay.
AD 22.11 [14.21, 30.02]1 study · 3278 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2004-2006 · Australia
In Australia, primary versus university education differed by 18.40 percentage points in prevalence of untreated decay.
AD 18.40 [13.13, 23.67]1 study · 5073 participantsUngraded
Prevalence of fair/poor self-rated oral health
2003-2009 · Overall random-effects meta-analysis
Across four countries, primary versus university education differed by 20.49 percentage points in prevalence of fair/poor self-rated oral health (random-effects meta-analysis; I2=97.1%).
Source: Fig. 1; I-squared=97.1%, p=0.000 · same question in other reviews
AD 20.49 [4.95, 36.04]4 studies · 14960 participantsUngraded
Prevalence of fair/poor self-rated oral health
2003-2004 · United States
In United States, primary versus university education differed by 40.35 percentage points in prevalence of fair/poor self-rated oral health.
AD 40.35 [35.19, 45.51]1 study · 4568 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2003-2009 · Overall random-effects meta-analysis
Across four countries, primary versus university education differed by 19.67 percentage points in prevalence of untreated decay (random-effects meta-analysis; I2=0.0%).
Source: Fig. 1; I-squared=0.0%, p=0.861 · same question in other reviews
AD 19.67 [16.70, 22.65]4 studies · 14960 participantsUngraded
Mean number of decayed teeth (mean DT)
2004-2006 · Australia
In Australia, primary versus university education differed by 0.61 decayed teeth in mean number of decayed teeth.
AD 0.61 [0.44, 0.78]1 study · 5073 participantsUngraded
Mean number of decayed teeth (mean DT)
2003-2004 · United States
In United States, primary versus university education differed by 0.43 decayed teeth in mean number of decayed teeth.
AD 0.43 [0.31, 0.54]1 study · 4568 participantsUngraded
Prevalence of fair/poor self-rated oral health
2007-2009 · Canada
In Canada, primary versus university education differed by 12.86 percentage points in prevalence of fair/poor self-rated oral health.
AD 12.98 [6.23, 19.73]1 study · 3278 participantsUngraded
Mean number of decayed teeth (mean DT)
2003-2009 · Overall random-effects meta-analysis
Across four countries, primary versus university education differed by 0.58 decayed teeth in mean number of decayed teeth (random-effects meta-analysis; I2=57.5%).
Source: Fig. 1; I-squared=57.5%, p=0.070 · same question in other reviews
AD 0.58 [0.43, 0.74]4 studies · 14960 participantsUngraded
Prevalence of fair/poor self-rated oral health
2009 · New Zealand
In New Zealand, primary versus university education differed by 17.59 percentage points in prevalence of fair/poor self-rated oral health.
AD 17.59 [7.09, 28.09]1 study · 2041 participantsUngraded
Prevalence of fair/poor self-rated oral health
2004-2006 · Australia
In Australia, primary versus university education differed by 10.88 percentage points in prevalence of fair/poor self-rated oral health.
AD 10.88 [8.42, 13.33]1 study · 5073 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2003-2004 · United States
In United States, primary versus university education differed by 20.11 percentage points in prevalence of untreated decay.
AD 20.11 [15.76, 24.47]1 study · 4568 participantsUngraded
Mean number of decayed teeth (mean DT)
2009 · New Zealand
In New Zealand, primary versus university education differed by 0.80 decayed teeth in mean number of decayed teeth.
AD 0.80 [0.41, 1.20]1 study · 2041 participantsUngraded

Secondary education vs University education

Population: Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States
12 questions
OutcomeEffectEvidenceStatus / GRADE
Prevalence of fair/poor self-rated oral health
2003-2004 · United States
In United States, secondary versus university education differed by 27.5 percentage points in prevalence of fair/poor self-rated oral health.
AD 27.5 [22.6, 32.5]1 study · 4568 participantsUngraded
Mean number of decayed teeth (mean DT)
2007-2009 · Canada
In Canada, secondary versus university education differed by 0.7 decayed teeth in mean number of decayed teeth.
AD 0.7 [0.4, 1.1]1 study · 3278 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2003-2004 · United States
In United States, secondary versus university education differed by 10.4 percentage points in prevalence of untreated decay.
AD 10.4 [4.7, 16.2]1 study · 4568 participantsUngraded
Prevalence of fair/poor self-rated oral health
2004-2006 · Australia
In Australia, secondary versus university education differed by 2.7 percentage points in prevalence of fair/poor self-rated oral health.
AD 2.7 [-0.4, 5.7]1 study · 5073 participantsUngraded
Mean number of decayed teeth (mean DT)
2004-2006 · Australia
In Australia, secondary versus university education differed by 0.3 decayed teeth in mean number of decayed teeth.
AD 0.3 [0.2, 0.5]1 study · 5073 participantsUngraded
Prevalence of fair/poor self-rated oral health
2007-2009 · Canada
In Canada, secondary versus university education differed by 13.8 percentage points in prevalence of fair/poor self-rated oral health.
AD 13.8 [7.3, 20.4]1 study · 3278 participantsUngraded
Mean number of decayed teeth (mean DT)
2003-2004 · United States
In United States, secondary versus university education differed by 0.3 decayed teeth in mean number of decayed teeth.
AD 0.3 [0.1, 0.4]1 study · 4568 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2007-2009 · Canada
In Canada, secondary versus university education differed by 15.2 percentage points in prevalence of untreated decay.
AD 15.2 [8.8, 21.6]1 study · 3278 participantsUngraded
Mean number of decayed teeth (mean DT)
2009 · New Zealand
In New Zealand, secondary versus university education differed by 0.4 decayed teeth in mean number of decayed teeth.
AD 0.4 [0.1, 0.6]1 study · 2041 participantsUngraded
Prevalence of fair/poor self-rated oral health
2009 · New Zealand
In New Zealand, secondary versus university education differed by 6.7 percentage points in prevalence of fair/poor self-rated oral health.
AD 6.7 [-1.3, 14.7]1 study · 2041 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2009 · New Zealand
In New Zealand, secondary versus university education differed by 14.1 percentage points in prevalence of untreated decay.
AD 14.1 [5.1, 23.1]1 study · 2041 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2004-2006 · Australia
In Australia, secondary versus university education differed by 14.4 percentage points in prevalence of untreated decay.
AD 14.4 [7.7, 21.0]1 study · 5073 participantsUngraded

Post-secondary education vs University education

Population: Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States
12 questions
OutcomeEffectEvidenceStatus / GRADE
Mean number of decayed teeth (mean DT)
2009 · New Zealand
In New Zealand, post-secondary versus university education differed by 0.5 decayed teeth in mean number of decayed teeth.
AD 0.5 [0.2, 0.8]1 study · 2041 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2009 · New Zealand
In New Zealand, post-secondary versus university education differed by 6.8 percentage points in prevalence of untreated decay.
AD 6.8 [-1.3, 14.8]1 study · 2041 participantsUngraded
Mean number of decayed teeth (mean DT)
2007-2009 · Canada
In Canada, post-secondary versus university education differed by 0.2 decayed teeth in mean number of decayed teeth.
AD 0.2 [0.1, 0.3]1 study · 3278 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2007-2009 · Canada
In Canada, post-secondary versus university education differed by 7.8 percentage points in prevalence of untreated decay.
AD 7.8 [3.7, 12.0]1 study · 3278 participantsUngraded
Prevalence of fair/poor self-rated oral health
2007-2009 · Canada
In Canada, post-secondary versus university education differed by 2.4 percentage points in prevalence of fair/poor self-rated oral health.
AD 2.4 [-1.3, 6.1]1 study · 3278 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2003-2004 · United States
In United States, post-secondary versus university education differed by 7.7 percentage points in prevalence of untreated decay.
AD 7.7 [3.6, 11.8]1 study · 4568 participantsUngraded
Prevalence of fair/poor self-rated oral health
2009 · New Zealand
In New Zealand, post-secondary versus university education differed by 4.2 percentage points in prevalence of fair/poor self-rated oral health.
AD 4.2 [-2.9, 11.2]1 study · 2041 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2004-2006 · Australia
In Australia, post-secondary versus university education differed by 9.0 percentage points in prevalence of untreated decay.
AD 9.0 [4.9, 13.1]1 study · 5073 participantsUngraded
Mean number of decayed teeth (mean DT)
2003-2004 · United States
In United States, post-secondary versus university education differed by 0.2 decayed teeth in mean number of decayed teeth.
AD 0.2 [0.1, 0.2]1 study · 4568 participantsUngraded
Mean number of decayed teeth (mean DT)
2004-2006 · Australia
In Australia, post-secondary versus university education differed by 0.3 decayed teeth in mean number of decayed teeth.
AD 0.3 [0.2, 0.4]1 study · 5073 participantsUngraded
Prevalence of fair/poor self-rated oral health
2003-2004 · United States
In United States, post-secondary versus university education differed by 20.8 percentage points in prevalence of fair/poor self-rated oral health.
AD 20.8 [16.3, 25.4]1 study · 4568 participantsUngraded
Prevalence of fair/poor self-rated oral health
2004-2006 · Australia
In Australia, post-secondary versus university education differed by 4.1 percentage points in prevalence of fair/poor self-rated oral health.
AD 4.1 [2.0, 6.3]1 study · 5073 participantsUngraded

Low income vs High income

Population: Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States
15 questions
OutcomeEffectEvidenceStatus / GRADE
Prevalence of untreated decay (% DT > 0)
2004-2006 · Australia
In Australia, low versus high income differed by 11.90 percentage points in prevalence of untreated decay.
AD 11.90 [6.82, 16.98]1 study · 5073 participantsUngraded
Mean number of decayed teeth (mean DT)
2003-2009 · Overall random-effects meta-analysis
Across four countries, low versus high income differed by 0.44 decayed teeth in mean number of decayed teeth (random-effects meta-analysis; I2=76.4%).
Source: Fig. 2; I-squared=76.4%, p=0.005 · same question in other reviews
AD 0.44 [0.23, 0.65]4 studies · 14960 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2003-2009 · Overall random-effects meta-analysis
Across four countries, low versus high income differed by 12.04 percentage points in prevalence of untreated decay (random-effects meta-analysis; I2=29.3%).
Source: Fig. 2; I-squared=29.3%, p=0.237 · same question in other reviews
AD 12.04 [8.35, 15.73]4 studies · 14960 participantsUngraded
Prevalence of fair/poor self-rated oral health
2003-2009 · Overall random-effects meta-analysis
Across four countries, low versus high income differed by 15.77 percentage points in prevalence of fair/poor self-rated oral health (random-effects meta-analysis; I2=13.4%).
Source: Fig. 2; I-squared=13.4%, p=0.326 · same question in other reviews
AD 15.77 [12.77, 18.77]4 studies · 14960 participantsUngraded
Prevalence of fair/poor self-rated oral health
2003-2004 · United States
In United States, low versus high income differed by 20.49 percentage points in prevalence of fair/poor self-rated oral health.
AD 20.49 [13.04, 27.93]1 study · 4568 participantsUngraded
Prevalence of fair/poor self-rated oral health
2004-2006 · Australia
In Australia, low versus high income differed by 13.93 percentage points in prevalence of fair/poor self-rated oral health.
AD 13.93 [11.06, 16.81]1 study · 5073 participantsUngraded
Mean number of decayed teeth (mean DT)
2004-2006 · Australia
In Australia, low versus high income differed by 0.35 decayed teeth in mean number of decayed teeth.
AD 0.35 [0.24, 0.46]1 study · 5073 participantsUngraded
Prevalence of fair/poor self-rated oral health
2009 · New Zealand
In New Zealand, low versus high income differed by 18.77 percentage points in prevalence of fair/poor self-rated oral health.
AD 18.77 [9.75, 27.79]1 study · 2041 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2007-2009 · Canada
In Canada, low versus high income differed by 16.66 percentage points in prevalence of untreated decay.
AD 16.66 [7.47, 25.86]1 study · 3278 participantsUngraded
Mean number of decayed teeth (mean DT)
2007-2009 · Canada
In Canada, low versus high income differed by 0.63 decayed teeth in mean number of decayed teeth.
AD 0.63 [0.31, 0.95]1 study · 3278 participantsUngraded
Mean number of decayed teeth (mean DT)
2009 · New Zealand
In New Zealand, low versus high income differed by 0.99 decayed teeth in mean number of decayed teeth.
AD 0.99 [0.49, 1.49]1 study · 2041 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2003-2004 · United States
In United States, low versus high income differed by 8.93 percentage points in prevalence of untreated decay.
AD 8.93 [4.79, 13.06]1 study · 4568 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2009 · New Zealand
In New Zealand, low versus high income differed by 17.46 percentage points in prevalence of untreated decay.
AD 17.46 [8.00, 26.92]1 study · 2041 participantsUngraded
Prevalence of fair/poor self-rated oral health
2007-2009 · Canada
In Canada, low versus high income differed by 16.91 percentage points in prevalence of fair/poor self-rated oral health.
AD 16.91 [8.91, 24.91]1 study · 3278 participantsUngraded
Mean number of decayed teeth (mean DT)
2003-2004 · United States
In United States, low versus high income differed by 0.22 decayed teeth in mean number of decayed teeth.
AD 0.22 [0.08, 0.35]1 study · 4568 participantsUngraded

Medium income vs High income

Population: Adults aged 25 years and older in Australia, Canada, New Zealand, and the United States
12 questions
OutcomeEffectEvidenceStatus / GRADE
Prevalence of untreated decay (% DT > 0)
2007-2009 · Canada
In Canada, medium versus high income differed by 8.0 percentage points in prevalence of untreated decay.
AD 8.0 [3.0, 12.9]1 study · 3278 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2004-2006 · Australia
In Australia, medium versus high income differed by 6.8 percentage points in prevalence of untreated decay.
AD 6.8 [2.1, 11.4]1 study · 5073 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2009 · New Zealand
In New Zealand, medium versus high income differed by 14.3 percentage points in prevalence of untreated decay.
AD 14.3 [5.4, 23.3]1 study · 2041 participantsUngraded
Prevalence of fair/poor self-rated oral health
2003-2004 · United States
In United States, medium versus high income differed by 10.0 percentage points in prevalence of fair/poor self-rated oral health.
AD 10.0 [3.8, 16.2]1 study · 4568 participantsUngraded
Prevalence of fair/poor self-rated oral health
2007-2009 · Canada
In Canada, medium versus high income differed by 8.3 percentage points in prevalence of fair/poor self-rated oral health.
AD 8.3 [4.1, 12.5]1 study · 3278 participantsUngraded
Mean number of decayed teeth (mean DT)
2003-2004 · United States
In United States, medium versus high income differed by 0.1 decayed teeth in mean number of decayed teeth.
AD 0.1 [-0.1, 0.2]1 study · 4568 participantsUngraded
Prevalence of untreated decay (% DT > 0)
2003-2004 · United States
In United States, medium versus high income differed by 3.4 percentage points in prevalence of untreated decay.
AD 3.4 [-2.2, 9.0]1 study · 4568 participantsUngraded
Prevalence of fair/poor self-rated oral health
2009 · New Zealand
In New Zealand, medium versus high income differed by 11.9 percentage points in prevalence of fair/poor self-rated oral health.
AD 11.9 [3.7, 20.1]1 study · 2041 participantsUngraded
Mean number of decayed teeth (mean DT)
2004-2006 · Australia
In Australia, medium versus high income differed by 0.2 decayed teeth in mean number of decayed teeth.
AD 0.2 [0.1, 0.3]1 study · 5073 participantsUngraded
Mean number of decayed teeth (mean DT)
2007-2009 · Canada
In Canada, medium versus high income differed by 0.4 decayed teeth in mean number of decayed teeth.
AD 0.4 [0.2, 0.5]1 study · 3278 participantsUngraded
Prevalence of fair/poor self-rated oral health
2004-2006 · Australia
In Australia, medium versus high income differed by 3.1 percentage points in prevalence of fair/poor self-rated oral health.
AD 3.1 [0.9, 5.2]1 study · 5073 participantsUngraded
Mean number of decayed teeth (mean DT)
2009 · New Zealand
In New Zealand, medium versus high income differed by 0.4 decayed teeth in mean number of decayed teeth.
AD 0.4 [0.2, 0.6]1 study · 2041 participantsUngraded

Included primary studies 6

Open as a trial list
StudyAlso included byOutcomes it informs hereTrial PICOResults
CDC/NCHS 2005 (NHANES, USA)
matched by author and year (probable)
this review onlynot statednot extracted yetnot extracted yet
Centers for Disease Control and Prevention 2005
matched by author and year (probable)
this review onlynot statednot extracted yetnot extracted yet
Health Canada 2010 (CHMS, Canada)
matched by author and year (probable)
this review onlynot statednot extracted yetnot extracted yet
NZ Ministry of Health 2010 (NZOHS, New Zealand)
Getting into the spirit. 2009 Spirit of Excellence award winners show creativity, passion for their work.
PMID:20092010
this review onlynot statednot extracted yetnot extracted yet
Slade 2007
matched by author and year (probable)
this review onlynot statednot extracted yetnot extracted yet
Slade 2007 (NSAOH, Australia)
matched by author and year (probable)
this review onlynot statednot extracted yetnot extracted yet