Social class modifies the impact of tooth loss on subjective oral health (SOH) in the UK. However, it is not known whether this occurs in other populations nor whether the effect is limited to occupational-based markers of socioeconomic status. Objectives: to determine whether occupational prestige (OP) of employed Australians modifies associations between tooth loss and SOH and to assess the additional effects of income and education. Methods: Cross sectional data were obtained from n=2,018 dentate, employed people aged 18+ years who participated in the 1999 Australian National Dental Telephone Interview Survey. A 14-item Oral Health Impact Profile (OHIP-14 – Slade, 1997) questionnaire was mailed to subjects. Subjects were also asked to count and record the number of remaining teeth. Questions about occupation were used to create ordinal groups of OP (Daniel, 1983). Mean OHIP-14 scores formed the dependent variable in multivariate regression analyses that controlled for age, sex, country of birth and denture wearing. Results: There was a significant interaction (P=0.02) between OP and tooth loss: for the high-OP group, mean OHIP scores increased by 63% as the number of teeth reduced from 25+ to <20 teeth (P<0.01), but tooth loss was not associated with OHIP scores in the lowest OP group (P >0.09). In an expanded multivariate model, the effect of OP was explained by income (P<0.01), but not education (P=0.97), and there was a significant interaction between income and tooth loss (P=0.03). Among people with <20 teeth, greater income was associated with higher OHIP scores, whereas among people with 25+ teeth, greater income was associated with lower OHIP scores. Conclusions: Consistent with the UK results, OP modified the relationships between tooth loss and SOH. In Australia this effect appeared to be due to contrasting effects of income on SOH.
GD Slade*, PF Allen, AE Sanders, JG Steele, NM Nuttall
Presented at the 81st General Session and Exhibition of the IADR, 25-28 June 2003, Goteborg, Sweden