Dental and Medical Problems

Dent Med Probl
Index Copernicus (ICV 2021) – 132.50
MEiN – 70 pts
CiteScore (2021) – 2.0
JCI (2021) – 0.5
Average rejection rate (2022) – 79.69%
ISSN 1644-387X (print)
ISSN 2300-9020 (online)
Periodicity – quarterly

Download original text (EN)

Dental and Medical Problems

2022, vol. 59, nr 4, October-December, p. 539–545

doi: 10.17219/dmp/138908

Publication type: original article

Language: English

License: Creative Commons Attribution 3.0 Unported (CC BY 3.0)

Download citation:

  • BIBTEX (JabRef, Mendeley)
  • RIS (Papers, Reference Manager, RefWorks, Zotero)

Cite as:

Peršić Bukmir R, Paljević E, Pezelj-Ribarić S, Brekalo Pršo I. Association of the self-reported socioeconomic and health status with untreated dental caries and the oral hygiene level in adult patients. Dent Med Probl. 2022;59(4):539–545. doi:10.17219/dmp/138908

Association of the self-reported socioeconomic and health status with untreated dental caries and the oral hygiene level in adult patients

Romana Peršić Bukmir1,A,B,C,D, Ema Paljević1,B,D,F, Sonja Pezelj-Ribarić2,3,A,E,F, Ivana Brekalo Pršo1,3,A,E,F

1 Department of Endodontics and Restorative Dentistry, Faculty of Dental Medicine, University of Rijeka, Croatia

2 Department of Oral Medicine and Periodontology, Faculty of Dental Medicine, University of Rijeka, Croatia

3 Department of Dental Medicine, Faculty of Dental Medicine and Health, J.J. Strossmayer University of Osijek, Croatia


Background. Dental caries is a multifactorial disease and its management requires a thorough analysis of its etiological factors.
Objectives. The present study used a multivariate approach to investigate the associations of socioeconomic and health-related determinants with untreated tooth decay and level of oral hygiene in adult individuals.
Material and methods. A cross-sectional study involved 597 adult patients. Health and socioeconomic status were assessed using a self-administered structured questionnaire. The presence of decayed teeth was recorded clinically using the World Health Organization diagnostic thresholds. Oral hygiene level was estimated using the plaque index. Multiple linear regression analysis was used to explore the associations of socioeconomic and health-related variables with the number of decayed teeth and level of oral hygiene.
Results. Socioeconomic and health-related variables explained 34.1% of the observed variation in the number of decayed teeth (p < 0.001) and 19.2% of the observed variation in the plaque index (p < 0.001). Analysis revealed several significant associations for both decayed teeth and plaque index scores. Males had 2.3 more untreated decayed teeth than women and an increased plaque index score of 0.3 units (unique contributions of 6.6 and 4.2%, respectively). An increase in self-assessed household economic status decreased the average number of decayed teeth by 1.3 and the plaque level score by 0.13 (unique contributions of 3.13% and 1.46%, respectively). Smokers presented with 1.78 more decayed teeth than non-smokers (unique contribution of 2.1%) and an increase in the plaque index by 0.48 units (unique contribution of 8.5%).
Conclusions. Untreated dental caries and dental plaque severity share the same socioeconomic and health-related determinants.

Key words

smoking, dental caries, oral hygiene, dental plaque index, socioeconomic factors

References (29)

  1. Sugars and dental caries. Published 2017. Accessed February 6, 2020.
  2. Sharma S, Mishra SK, Mittal N. Influence of tobacco dependence on caries development in young male adults: A cross-sectional study. J Conserv Dent. 2018;21(6):597–601. doi:10.4103/JCD.JCD_218_18
  3. Vidaković R, Špalj S, Šlaj M, Šlaj M, Katić V. Correlation between the DAI and ICON indices used for assessment of orthodontic treatment need in Croatian schoolchildren. Zdr Varst. 2018;57(4):218–226. doi:10.2478/sjph-2018-0027
  4. Špalj S, Plančak D, Jurić H, Pavelić B, Bošnjak A. Reasons for extraction of permanent teeth in urban and rural populations of Croatia. Coll Antropol. 2004;28(2):833–839. PMID:15666618.
  5. Baelum V, Heidmann J, Nyvad B. Dental caries paradigms in diagnosis and diagnostic research. Eur J Oral Sci. 2006;114(4):263–277. doi:10.1111/j.1600-0722.2006.00383.x
  6. Adler NE, Ostrove JM. Socioeconomic status and health: What we know and what we don’t. Ann N Y Acad Sci. 1999;896:3–15. doi:10.1111/j.1749-6632.1999.tb08101.x
  7. Costa SM, Martins CC, Bonfim Mde L, et al. A systematic review of socioeconomic indicators and dental caries in adults. Int J Environ Res Public Health. 2012;9(10):3540–3574. doi:10.3390/ijerph9103540
  8. Schwendicke F, Dörfer CE, Schlattmann P, Foster Page L, Thomson WM, Paris S. Socioeconomic inequality and caries: A systematic review and meta-analysis. J Dent Res. 2015;94(1):10–18. doi:10.1177/0022034514557546
  9. Benedetti G, Campus G, Strohmenger L, Lingström P. Tobacco and dental caries: A systematic review. Acta Odontol Scand. 2013;71(3–4):363–371. doi:10.3109/00016357.2012.734409
  10. Bernabé E, Delgado-Angulo EK, Vehkalahti MM, Aromaa A, Suominen AL. Daily smoking and 4-year caries increment in Finnish adults. Community Dent Oral Epidemiol. 2014;42(5):428–344. doi:10.1111/cdoe.12101
  11. Singh A, Rouxel P, Watt RG, Tsakos G. Social inequalities in clustering of oral health related behaviors in a national sample of British adults. Prev Med. 2013;57(2):102–106. doi:10.1016/j.ypmed.2013.04.018
  12. Yoshino K, Suzuki S, Ishizuka Y, Takayanagi A, Sugihara N, Kamijyo H. Relationship between amount of overtime work and untreated decayed teeth in male financial workers in Japan. J Occup Health. 2017;59(3):280–285. doi:10.1539/joh.16-0247-OA
  13. Marsh PD, Nyvad B. The oral microflora and biofilms on teeth. In: Fejerskov O, Kidd EAM, eds. Dental Caries: The Disease and its Clinical Management. Hoboken, NJ: Wiley-Blackwell; 2003:29–48.
  14. Oyedele TA, Folayan MO, Chukwumah NM, Onyejaka NK. Social predictors of oral hygiene status in school children from suburban Nigeria. Braz Oral Res. 2019;33:e022. doi:10.1590/1807-3107bor-2019.vol33.0022
  15. Lambert M, De Reu G, De Visschere L, Declerck D, Bottenberg P, Vanobbergen J. Social gradient in caries experience of Belgian adults 2010. Community Dent Health. 2018;35(3):160–166. doi:10.1922/CDH_4254Lambert07
  16. Segura-Egea JJ, Martín-González J, Castellanos-Cosano L. Endodontic medicine: Connections between apical periodontitis and systemic diseases. Int Endod J. 2015;48(10):933–951. doi:10.1111/iej.12507
  17. Ranfl M, Zaletel-Kragelj L. Assessment of the association between dentate status and self-rated general health. Zdr Varst. 2017;56(2):131–139. doi:10.1515/sjph-2017-0017
  18. Persic Bukmir R, Vidas J, Mance D, Pezelj-Ribaric S, Spalj S, Brekalo Prso I. Socio-economic and health status as a predictor of apical periodontitis in adult patients in Croatia. Oral Dis. 2019;25(1):300–308. doi:10.1111/odi.12981
  19. Machtei EE, Christersson LA, Grossi SG, Dunford R, Zambon JJ, Genco RJ. Clinical criteria for the definition of “established periodontitis”. J Periodontol. 1992;63(3):206–214. doi:10.1902/jop.1992.63.3.206
  20. Silness J, Löe H. Periodontal disease in pregnancy. II. Correlation between oral hygiene and periodontal condition. Acta Odontol Scand. 1964;22:121–315. doi:10.3109/00016356408993968
  21. World Health Organization. Oral Health Survey: Basic Methods. 4th ed. Geneva, Switzerland: World Health Organization; 1997. ISBN: 92 4 154493 7.
  22. Aleksejuniene J, Eriksen HM, Holst D. Variation in caries and treatment experience in 35–44-year-old Lithuanians. Community Dent Oral Epidemiol. 2000;28(5):356–364. doi:10.1034/j.1600-0528.2000.028005356.x
  23. Onyejaka NK, Folayan MO, Folaranmi N. Barriers and facilitators of dental service utilization by children aged 8 to 11 years in Enugu state, Nigeria. BMC Health Serv Res. 2016;16:93. doi:10.1186/s12913-016-1341-6
  24. Mamai-Homata E, Koletsi-Kounari H, Margaritis V. Gender differences in oral health status and behavior of Greek dental students: A meta-analysis of 1981, 2000, and 2010 data. J Int Soc Prev Community Dent. 2016;6(1):60–68. doi:10.4103/2231-0762.175411
  25. Thomson WM, Poulton R, Milne BJ, Caspi A, Broughton JR, Ayers KM. Socioeconomic inequalities in oral health in childhood and adulthood in a birth cohort. Community Dent Oral Epidemiol. 2004;32(5):345–353. doi:10.1111/j.1600-0528.2004.00173.x
  26. Beck JD, Kohout F, Hunt RJ. Identification of high caries risk adults: Attitudes, social factors and diseases. Int Dent J. 1988;38(4):231–238. PMID:3063667.
  27. Edman K, Öhrn K, Nordström B, Holmlund A. Prevalence of dental caries and influencing factors, time trends over a 30-year period in an adult population. Epidemiological studies between 1983 and 2013 in the county of Dalarna, Sweden. Acta Odontol Scand. 2016;74(5):385–392. doi:10.3109/00016357.2016.1163733
  28. Peršić Bukmir R, Jurčević Grgić M, Brumini G, Spalj S, Pezelj-Ribaric S, Brekalo Pršo I. Influence of tobacco smoking on dental periapical condition in a sample of Croatian adults. Wien Klin Wochenschr. 2016;128(7–8):260–265. doi:10.1007/s00508-015-0910-8
  29. Sousa VD, Rojjanasrirat W. Translation, adaptation and validation of instruments or scales for use in cross-cultural health care research: A clear and user-friendly guideline. J Eval Clin Pract. 2011;17(2):268–274. doi:10.1111/j.1365-2753.2010.01434.x