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      Inequalities in Caries Experience Among Mongolian Children

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          Abstract

          Although inequalities in dental caries have been well-reported, there is only one Mongolian study on the association between socioeconomic status (SES) and caries experience, which was published ten years ago. This study aimed to determine the dental health status of Mongolian children living in urban and suburban areas of Ulaanbaatar city and examine its association with income and parental educational attainment. An oral examination was conducted by dentists and caries were measured as deft/DMFT indices. A questionnaire including demographic characteristics and socioeconomic status was completed by their parents or caregiver. Parental educational attainment and household income were used as the measures of SES. The relative index of inequality (RII) and slope index of inequality (SII) were employed to examine the association between SES on deft and DMFT after adjusting for covariates. Dental caries prevalence (those with deft/DMFT > 0) was 89.3% among the total number of participants. The mean deft/DMFT values for age groups 1–6, 7–12, and 13–18 were 5.83 (SD = 4.37, deft), 5.77 (SD = 3.31, deft/DMFT), and 3.59 (SD = 2.69, DMFT), respectively. Rather than residence area and parental educational attainment, significant caries experience inequality was observed in relation to income (RII 0.65 95%, CI 0.52 to 0.82, SII −2.30, 95% CI −4.16 to −0.45). A prevention strategy for lower socioeconomic groups and building integrated oral health surveillance to monitor epidemiological trends for further evaluation of its progress is necessary.

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          Most cited references32

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          Global burden of oral diseases: emerging concepts, management and interplay with systemic health

          This study presents the global burden of major oral diseases with an exegetical commentary on their current profiles, the critical issues in oral healthcare and future perspectives.
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            Oral Conditions and Health-Related Quality of Life: A Systematic Review.

            The objective of this study was to verify whether oral conditions (tooth loss, periodontal disease, dental caries) are negatively associated with health-related quality of life (HRQoL) in adults. A search was carried out on PubMed, EMBASE, Web of Science, Scopus, SciELO, and LILACS databases until the end of July 2016 with no date restrictions. Quantitative observational studies written in English were included and data extraction was performed independently by 2 reviewers. HRQoL was investigated as the outcome, and tooth loss, periodontal diseases, and dental caries were exposures. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used and the quality of the selected studies was assessed by using the Joanna Briggs Institute Meta-Analysis of Statistics assessment and review instrument (JBI-MAStARI). Twenty-one studies were included. The sample sizes ranged from 88 to 15,501 subjects; 20 studies were cross-sectional designs, while 1 was a case-control study. Case definitions of the exposures were different across the studies, mainly for tooth loss, which was defined according to 11 different criteria. Fifteen studies were of "high" and 6 of "medium" quality. Eight HRQoL instruments were identified, and the most frequent was the EuroQol ( n = 8). Ten of 16 studies reported a negative impact of tooth loss on HRQoL. Four of 7 studies reported that periodontal disease impairs HRQoL, and 1 study showed that periodontal disease is positively associated with HRQoL. All studies that assessed dental caries reported a negative association between this condition and HRQoL. Despite the different definitions and measures of tooth loss and dental caries, the majority of the available evidence reported a negative impact of these conditions on HRQoL. Mixed and inconclusive findings were observed for the association between periodontal disease and HRQoL. Longitudinal prospective studies are suggested to improve the strength of the findings.
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              Using relative and absolute measures for monitoring health inequalities: experiences from cross-national analyses on maternal and child health

              Background As reducing socio-economic inequalities in health is an important public health objective, monitoring of these inequalities is an important public health task. The specific inequality measure used can influence the conclusions drawn, and there is no consensus on which measure is most meaningful. The key issue raising most debate is whether to use relative or absolute inequality measures. Our paper aims to inform this debate and develop recommendations for monitoring health inequalities on the basis of empirical analyses for a broad range of developing countries. Methods Wealth-group specific data on under-5 mortality, immunisation coverage, antenatal and delivery care for 43 countries were obtained from the Demographic and Health Surveys. These data were used to describe the association between the overall level of these outcomes on the one hand, and relative and absolute poor-rich inequalities in these outcomes on the other. Results We demonstrate that the values that the absolute and relative inequality measures can take are bound by mathematical ceilings. Yet, even where these ceilings do not play a role, the magnitude of inequality is correlated with the overall level of the outcome. The observed tendencies are, however, not necessities. There are countries with low mortality levels and low relative inequalities. Also absolute inequalities showed variation at most overall levels. Conclusion Our study shows that both absolute and relative inequality measures can be meaningful for monitoring inequalities, provided that the overall level of the outcome is taken into account. Suggestions are given on how to do this. In addition, our paper presents data that can be used for benchmarking of inequalities in the field of maternal and child health in low and middle-income countries.
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                Author and article information

                Journal
                Int J Environ Res Public Health
                Int J Environ Res Public Health
                ijerph
                International Journal of Environmental Research and Public Health
                MDPI
                1661-7827
                1660-4601
                14 October 2019
                October 2019
                : 16
                : 20
                : 3892
                Affiliations
                [1 ]Department of International and Community Oral Health, School of Dentistry, Tohoku University, Sendai 980-0872, Japan; tselmuunchnzo@ 123456gmail.com (T.C.); j-aida@ 123456umin.ac.jp (J.A.); upul.cooray.15@ 123456ucl.ac.uk (U.C.); osaka@ 123456m.tohoku.ac.jp (K.O.)
                [2 ]Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia; tsengelsaikhan@ 123456mnums.edu.mn (T.N.); soyolmaa@ 123456mnums.edu.mn (S.M.)
                [3 ]School of Medicine, Department of Public Health, International University of Health and Welfare, 4-3 , Kozunomori, Narita-shi, Chiba ken 286-8686, Japan
                Author notes
                Author information
                https://orcid.org/0000-0001-9951-6346
                https://orcid.org/0000-0002-8405-9872
                https://orcid.org/0000-0001-6885-9514
                Article
                ijerph-16-03892
                10.3390/ijerph16203892
                6843787
                31615100
                77075943-045b-4649-8f2a-e0ce159c8127
                © 2019 by the authors.

                Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

                History
                : 24 August 2019
                : 10 October 2019
                Categories
                Article

                Public health
                oral health inequality,caries prevalence,socioeconomic status,mongolia
                Public health
                oral health inequality, caries prevalence, socioeconomic status, mongolia

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