Social inequality in oral health and use of dental care in Sweden

Objective: To describe oral health and use of dental care in relation to so cio-economic determinants over time in Sweden. Methods: Cross-sectional stu dy based on interview data on two randomly sampled sequential populations c onsisting of 7610 Swedish adult (25-64 years) residents and 4315 children ( 3-15 years) in their households from the Survey of Living Conditions 1996-9 7, and 7649 adult Swedish residents (25-64 years) from the survey of 1988-8 9. Results: Low educational level, having no cash margin and being born out side of Sweden was associated with higher odds of problems with chewing, we aring a prosthesis and not having been treated by a dentist during the 24 m onths preceding the interview, in a logistic regression analysis of data fr om the 1996-97 survey in the adult study population (adjusted odds ratios 1 .6-2.9). The same socio-economic determinants were associated with caries i n children (adjusted odds ratios 1.2-1.5). The socio-economic differences i n dental treatment and problems with chewing were greater in the age group 45-64 years compared to 25-44-year-olds. The prevalence of problems with ch ewing increased from 7.1% (95% CI 6.5-8.1) in the 1988-89 survey to 9.1% (8 .4-9.8) in the 1996-97 survey. A similar increase, from 2.4% (2.2-2.6) to 4 .4% (3.9-4.9) was observed for individuals not having been in dental treatm ent during the last 24 months. The socio-economic distribution of oral heal th and use of dental care in the adult population was similar in the two su rveys. Conclusion: This study demonstrates that socio-economic differences in oral health and use of dental care are most marked in older (45-64 years ) adults in Sweden, but are significant in young adults and, in terms of or al health, in children as well. A steep increase in user charges during the 1990s has been paralleled by a moderate increase in problems with chewing and the proportion of the population that has no regular dental care, which suggests a link that needs to be evaluated in further studies.