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      Socio‐economic inequality in oral health in childhood to young adulthood, despite full dental coverage

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          Abstract

          The aim of this cross‐sectional study was to assess differences in caries experience according to socio‐economic status ( SES) in a health‐care system with full coverage of dental costs for children up to the age of 18 yr. In 2011 and 2014, by performing hurdle negative binomial models, we obtained data on 3,022 children and young adults aged 5, 8, 11, 14, 17, 20, and 23 yr, living in four cities in the Netherlands. At all ages between 5 and 23 yr, the percentages of children with caries‐free dentitions were lower and mean caries experience were higher in low‐ SES than in high‐ SES participants. In 5‐yr‐old children with dmft > 0, mean caries experience was 3.6 in those with low SES and 2.3 in those with high SES. In 23‐yr‐old participants, these estimates were 6.8 and 4.4, respectively ( P < 0.05). Low‐ SES children have a greater risk of more caries experience than high‐ SES children. Thus, in a system with full free paediatric dental coverage, socio‐economic inequality in caries experience still exists. Dental health professionals, well‐child care doctors and nurses, general practitioners, and elementary school teachers should collaborate to promote oral health at the community level, with specific targeting of low‐ SES families. We further need policy measures to curtail, at community level, the increasing availability and consumption of highly processed, carbohydrate‐rich foods, with particular attention for low‐ SES families.

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          Socioeconomic differences in children's health: how and why do these relationships change with age?

          The effects of socioeconomic status (SES) on health are well documented in adulthood, but far less is known about its effects in childhood. The authors reviewed the literature and found support for a childhood SES effect, whereby each decrease in SES was associated with an increased health risk. The authors explored how this relationship changed as children underwent normal developmental changes and proposed 3 models to describe the temporal patterns. The authors found that a model's capacity to explain SES-health relationships varied across health outcomes. Childhood injury showed stronger relationships with SES at younger ages, whereas smoking showed stronger relationships with SES in adolescence. Finally, the authors proposed a developmental approach to exploring mechanisms that link SES and child health.
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            Sociobehavioural risk factors in dental caries - international perspectives.

            Diseases probably have their roots in a complex chain of environmental and behavioural events which are shaped by broader socioeconomic determinants. Most studies of sociobehavioural risk factors in dental caries have been carried out in industrialized countries, but such reports from low- and middle-income countries have been published in recent years. World Health Organization international collaborative studies and other international studies of social factors in dental caries using the same methodology provide empirical evidence of social inequality in oral health across countries and across oral health care systems. The paper highlights the challenges to dental public health practice, particularly the importance of risk assessment in estimating the potential for prevention. In future public health programmes, systematic risk factor assessment may therefore be instrumental in the planning and surveillance of oral health promotion and oral disease intervention programmes.
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              Managing Carious Lesions: Consensus Recommendations on Terminology.

              Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current words used in the literature for caries removal techniques, and 2) agreed terms and definitions, explaining how these were decided.Dental cariesis the name of the disease, and thecarious lesionis the consequence and manifestation of the disease-the signs or symptoms of the disease. The termdental caries managementshould be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereascarious lesion managementcontrols the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions' clinical manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm dentine; 2)stepwise removal-including stage 1,selective removal to soft dentine, and stage 2,selective removal to firm dentine6 to 12 mo later; and 3)nonselective removal to hard dentine-formerly known ascomplete caries removal(technique no longer recommended). Adoption of these terms, around managing dental caries and its sequelae, will facilitate improved understanding and communication among researchers and within dental educators and the wider clinical dentistry community.
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                Author and article information

                Contributors
                d.a.verlinden@umcg.nl
                Journal
                Eur J Oral Sci
                Eur. J. Oral Sci
                10.1111/(ISSN)1600-0722
                EOS
                European Journal of Oral Sciences
                John Wiley and Sons Inc. (Hoboken )
                0909-8836
                1600-0722
                21 February 2019
                June 2019
                : 127
                : 3 ( doiID: 10.1111/eos.2019.127.issue-3 )
                : 248-253
                Affiliations
                [ 1 ] Centre of Dentistry and Oral Hygiene University Medical Center Groningen University of Groningen Groningen The Netherlands
                [ 2 ] Department of Child Health the Netherlands Organization for Applied Scientific Research TNO Leiden The Netherlands
                [ 3 ] Department of Health Sciences University Medical Center Groningen University of Groningen Groningen the Netherlands
                Author notes
                [*] [* ] Deborah Ashley Verlinden, Centre of Dentistry and Oral Hygiene, University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV Groningen,the Netherlands

                E‐mail: d.a.verlinden@ 123456umcg.nl

                Author information
                https://orcid.org/0000-0001-6307-3010
                Article
                EOS12609
                10.1111/eos.12609
                6593773
                30791128
                7cc52595-d62b-4a7e-bf65-8988636f29ec
                © 2019 The Authors. Eur J Oral Sci published by John Wiley & Sons Ltd

                This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

                History
                : 30 December 2018
                Page count
                Figures: 1, Tables: 3, Pages: 6, Words: 5625
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                eos12609
                June 2019
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.6.5 mode:remove_FC converted:26.06.2019

                Dentistry
                access to care,caries experience,dental care,public health dentistry,youths
                Dentistry
                access to care, caries experience, dental care, public health dentistry, youths

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