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Abstract #157676

Monik C. Jimenez, SM, Epidemiology, Harvard School of Public Health, 677 Huntington Ave., Boston, MA 02115, 7147166096, mjimenez@hsph.harvard.edu, Thomas Dietrich, MD, DMD, MPH, Health Policy and Health Services Research, Boston University Goldman School of Dental Medicine, 560 Harrison Ave., 3rd floor, Deptid 58813, Boston, MA 02118, and Kaumudi J. Joshipura, BDS, ScD, School of Dentistry, University of Puerto Rico, Medical Sciences Campus, 1st Floor, Main Bldg, Office A141 E, San Juan, PR 00935.

Objectives: To identify associations between socio-economic indicators and tooth loss conditional on caries and periodontal disease. Methods: Analyses were conducted on 14,871 dentate adults, using National Health and Nutrition Examination Survey-III data. Multivariate linear regression was used to explore the relationship between tooth loss and socio-economic factors, using residuals of number of missing teeth conditional on age, decay filled surfaces, and severe periodontal disease. Results: Using a residually adjusted outcome allowed for direct interpretation of the amount of variation in number of missing teeth explained by the socio-economic variables conditional on age, decay and severe periodontal disease. In multivariate models Mexican American ethnicity was associated with significantly fewer missing teeth compared to Whites (Β=-1.43, 95%CI:-1.78,-1.07). At least 8 years of education was associated with increased number of missing teeth compared to >12 years (Β=0.54, 95%CI: 0.04,1.05). Dental care utilization was strongly associated with number of missing teeth, adjusting for age and dental disease only. In multivariate analyses, only visiting a dentist “whenever needed” was significantly associated with greater number of missing teeth compared to visiting “once a year” (Β=0.35, 95%CI: 0.13,0.57). Conclusions: Socio-economic factors are associated with tooth loss conditional dental disease. Social factors irrespective of disease severity play an important role in the decision to extract. Traditional socio-economic indicators may not be as strong of predictors of tooth loss in racial/ethnic sub-populations as for Whites. Possibly cultural differences in extraction, utilization of dental services, or differential care may be more important predictors of tooth loss for Blacks and Mexican-Americans.

Learning Objectives:

• Identify important contributors to tooth loss.
• Articulate variation in the relationship between socio-economic factors and tooth loss in ethnically diverse populations. 3.Discuss the application of residual analysis in oral health research.

Keywords: Oral Health Outcomes, Ethnicity

Presenting author's disclosure statement:

Any relevant financial relationships? No
Any institutionally-contracted trials related to this submission?

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.