Caries research · 2026
Socioeconomic Disparities in Comorbidity of Dental Caries and Metabolic Syndrome in Norwegian Adults: A Cross-Sectional Study Using HUNT4 Survey Data.
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Stangvaltaite-Mouhat Lina, Skudutyte-Rysstad Rasa, Steingrimsdóttir Ólöf Anna, Sen Abhijit
Аннотация
INTRODUCTION: Dental caries is considered the most prevalent noncommunicable disease worldwide, while metabolic syndrome (MetS) is another noncommunicable condition with an increasing global burden. These conditions are caused by common risk factors, such as lifestyle and diet, which are shaped by overarching socioeconomic determinants. The aim of this study was to assess socioeconomic disparities in caries/MetS comorbidity.
METHODS: This cross-sectional study included data from adults participating in the population-based Trøndelag Health Study (HUNT4, 2017-2019). Inclusion criteria were dentate 35 years or older participants in Oral Health Examination having records of socioeconomic determinants. Socioeconomic determinants included self-reported educational level (3 categories) and household income (3 categories). The outcome was a comorbidity of untreated caries (number of teeth with clinically and radiographically detected cavitation in dentine, D3T) and MetS (defined by the Joint Interim Statement). A modified Poisson regression analysis with robust error variances was used to estimate the prevalence ratio (PR) and the corresponding 95% confidence interval (CI). Sensitivity analyses were performed.
RESULTS: Out of 7,347, 3,840 (52%) participants were included (55% women, the mean age of the participants 57.4 years; standard deviation 12.3). Neither dental caries nor MetS were recorded in 1,052 (27%) participants, while 887 (23%) experienced caries/MetS comorbidity. Caries/MetS comorbidity was associated with the educational level in a gradient: basic and middle educational level (vs. higher), PR 1.47 (95% CI: 1.22-1.79) and PR 1.29 (95% CI: 1.15-1.47), respectively. Income gradient was also observed: lower and medium income level (vs. higher) PR 1.46 (95% CI: 1.19-1.80) and PR 1.23 (95% CI: 1.03-1.48), respectively. The sensitivity analyses yielded results of similar strength.
CONCLUSION: A socioeconomic gradient was observed in caries/MetS comorbidity in adult Norwegian population. This finding supports integrated public health interventions targeting both health conditions simultaneously, particularly among populations with lower educational levels aiming to decrease overall burden of these conditions and reduce socioeconomic disparities. Oral health services should be a part of the Universal Health Coverage to reduce financial barriers to access. Further research in other contexts and longitudinal studies as well as public health intervention studies are warranted.
METHODS: This cross-sectional study included data from adults participating in the population-based Trøndelag Health Study (HUNT4, 2017-2019). Inclusion criteria were dentate 35 years or older participants in Oral Health Examination having records of socioeconomic determinants. Socioeconomic determinants included self-reported educational level (3 categories) and household income (3 categories). The outcome was a comorbidity of untreated caries (number of teeth with clinically and radiographically detected cavitation in dentine, D3T) and MetS (defined by the Joint Interim Statement). A modified Poisson regression analysis with robust error variances was used to estimate the prevalence ratio (PR) and the corresponding 95% confidence interval (CI). Sensitivity analyses were performed.
RESULTS: Out of 7,347, 3,840 (52%) participants were included (55% women, the mean age of the participants 57.4 years; standard deviation 12.3). Neither dental caries nor MetS were recorded in 1,052 (27%) participants, while 887 (23%) experienced caries/MetS comorbidity. Caries/MetS comorbidity was associated with the educational level in a gradient: basic and middle educational level (vs. higher), PR 1.47 (95% CI: 1.22-1.79) and PR 1.29 (95% CI: 1.15-1.47), respectively. Income gradient was also observed: lower and medium income level (vs. higher) PR 1.46 (95% CI: 1.19-1.80) and PR 1.23 (95% CI: 1.03-1.48), respectively. The sensitivity analyses yielded results of similar strength.
CONCLUSION: A socioeconomic gradient was observed in caries/MetS comorbidity in adult Norwegian population. This finding supports integrated public health interventions targeting both health conditions simultaneously, particularly among populations with lower educational levels aiming to decrease overall burden of these conditions and reduce socioeconomic disparities. Oral health services should be a part of the Universal Health Coverage to reduce financial barriers to access. Further research in other contexts and longitudinal studies as well as public health intervention studies are warranted.