European archives of paediatric dentistry : official journal of the European Academy of Paediatric Dentistry · 2026
Lifestyle behaviours can mediate socio-economic and sex inequalities in children's oral health: findings from Children's Dental Health Survey 2013, England, Wales, and Northern Ireland.
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Zhou K, Najwa Mohd Khairuddin A, Gallagher J E, Ide M, Kang J
Аннотация
BACKGROUND: Oral health inequalities in adults are well documented but understudied in children.
AIM: To investigate oral health inequality amongst children within the United Kingdom (UK) by sex and socio-economic status (SES), and whether such inequality may be mediated by healthy lifestyle.
DESIGN: Secondary analysis of the Children's Dental Health Survey 2013 data for England, Wales, and Northern Ireland, including questionnaire responses on demographics, lifestyle, and clinically examined oral health measures in children aged 5, 8, 12, and 15 years in the UK. Descriptive statistics on the oral health inequalities and mediation analyses were performed, assessing lifestyle factors (regular dental attendance, sugary drink intake, and toothbrushing frequency) that potentially mediate sex and SES inequalities in oral health.
RESULTS: A total of 9,866 children were included in this study. Oral health inequalities were observed by sex and SES amongst all aspects of oral health (dental caries, oral health-related quality of life, self-reported oral health, gingival status, and basic periodontal examination). Compared with males (35.8%), fewer females (24.1%, p < 0.001) had self-reported good dental health. Children from lower SES groups had more dental caries experience, i.e., decayed, missing, and filled teeth (DMFT), than those from middle and higher SES groups (1.0 ± 2.0 in lower vs. 0.8 ± 1.9 in middle vs. 0.4 ± 1.3 in higher, p = 0.027). Furthermore, there was evidence of lifestyle factors mediating the associations between sex, SES, and adolescents' oral health at 12 and 15 years.
CONCLUSION: Inequality was observed for children's oral health by sex and SES; however, regular dental attendance, having less sugary drink intake and optimal toothbrushing mediated these associations in adolescents.
AIM: To investigate oral health inequality amongst children within the United Kingdom (UK) by sex and socio-economic status (SES), and whether such inequality may be mediated by healthy lifestyle.
DESIGN: Secondary analysis of the Children's Dental Health Survey 2013 data for England, Wales, and Northern Ireland, including questionnaire responses on demographics, lifestyle, and clinically examined oral health measures in children aged 5, 8, 12, and 15 years in the UK. Descriptive statistics on the oral health inequalities and mediation analyses were performed, assessing lifestyle factors (regular dental attendance, sugary drink intake, and toothbrushing frequency) that potentially mediate sex and SES inequalities in oral health.
RESULTS: A total of 9,866 children were included in this study. Oral health inequalities were observed by sex and SES amongst all aspects of oral health (dental caries, oral health-related quality of life, self-reported oral health, gingival status, and basic periodontal examination). Compared with males (35.8%), fewer females (24.1%, p < 0.001) had self-reported good dental health. Children from lower SES groups had more dental caries experience, i.e., decayed, missing, and filled teeth (DMFT), than those from middle and higher SES groups (1.0 ± 2.0 in lower vs. 0.8 ± 1.9 in middle vs. 0.4 ± 1.3 in higher, p = 0.027). Furthermore, there was evidence of lifestyle factors mediating the associations between sex, SES, and adolescents' oral health at 12 and 15 years.
CONCLUSION: Inequality was observed for children's oral health by sex and SES; however, regular dental attendance, having less sugary drink intake and optimal toothbrushing mediated these associations in adolescents.