Background There is a lack of evidence on the impact of socioeconomic factors on masticatory efficiency. The present study investigates the relationship between individual and neighbourhood socioeconomic factors (main exposure) and the number of masticatory units (MUs) used as surrogate of the masticatory efficiency (main outcome).
Methods In this cross-sectional study nested in the Paris Prospective Study 3, 4270 adults aged 50–75 and recruited from 13 June 2008 to 31 May 2012 underwent a full-mouth examination. Number of MUs defined as pairs of opposing teeth or dental prostheses allowing mastication, number of missing teeth and gingival inflammation were documented. The individual component of the socioeconomic status was evaluated with an individual multidimensional deprivation score and education level. The neighbourhood component of the socioeconomic status was evaluated with the FDep99 deprivation index. Associations were quantified using marginal models.
Results In multivariate analyses, having less than 5 MUs was associated with (1) the most deprived neighbourhoods (OR=2.27 (95% CI 1.63 to 3.17)), (2) less than 12 years of educational attainment (OR=2.20 (95% CI 1.66 to 2.92)) and (3) the highest individual score of deprivation (OR=3.23 (95% CI 2.24 to 4.65)). Associations with education and individual score of deprivation were consistent across the level of neighbourhood deprivation. Comparable associations were observed with the number of missing teeth. Associations with gingival inflammation were of lower magnitude; the relationship was present for deprivation markers but not for education.
Conclusion Poor masticatory efficiency is associated with low educational attainment and high deprivation scores.
- access to hlth care
- health inequalities
- oral health
- social epidemiology
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J-PE and PB contributed equally.
Contributors JPE and BP directed the project. HR, XJ, FT, AB, PB and BP performed the experiments. AB and MCP performed the analysis. AB, XJ and HR drafted the manuscript and designed the figure and tables. All authors discussed the results and contributed to the final manuscript.
Funding The PPS 3 was supported by grants from the National Research Agency (ANR), the Research Foundation for Hypertension (FRHTA), the Research Institute in Public Health (IRESP) and the Région Ile de France (Domaine d’Intérêt Majeur). This study has received institutional support from INSERM (N° C07-39).
Competing interests None declared.
Patient consent Obtained.
Ethics approval The study was approved by the ethics committee of Cochin Hospital, Paris.
Provenance and peer review Not commissioned; externally peer reviewed.