Age, period, and cohort analysis of regular dental care behavior and edentulism: A marginal approach

Kar Yan Li, May C M Wong, Kwok Fai Lam, Eli Schwarz

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background: To analyze the regular dental care behavior and prevalence of edentulism in adult Danes, reported in sequential cross-sectional oral health surveys by the application of a marginal approach to consider the possible clustering effect of birth cohorts.Methods: Data from four sequential cross-sectional surveys of non-institutionalized Danes conducted from 1975-2005 comprising 4330 respondents aged 15+ years in 9 birth cohorts were analyzed. The key study variables were seeking dental care on an annual basis (ADC) and edentulism. For the analysis of ADC, survey year, age, gender, socio-economic status (SES) group, denture-wearing, and school dental care (SDC) during childhood were considered. For the analysis of edentulism, only respondents aged 35+ years were included. Survey year, age, gender, SES group, ADC, and SDC during childhood were considered as the independent factors. To take into account the clustering effect of birth cohorts, marginal logistic regressions with an independent correlation structure in generalized estimating equations (GEE) were carried out, with PROC GENMOD in SAS software.Results: The overall proportion of people seeking ADC increased from 58.8% in 1975 to 86.7% in 2005, while for respondents aged 35 years or older, the overall prevalence of edentulism (35+ years) decreased from 36.4% in 1975 to 5.0% in 2005. Females, respondents in the higher SES group, in more recent survey years, with no denture, and receiving SDC in all grades during childhood were associated with higher probability of seeking ADC regularly (P <0.05). The interaction of SDC and age (P <0.0001) was significant. The probabilities of seeking ADC were even higher among subjects with SDC in all grades and aged 45 years or older. Females, older age group, respondents in earlier survey years, not seeking ADC, lower SES group, and not receiving SDC in all grades were associated with higher probability of being edentulous (P <0.05).Conclusions: With the use of GEE, the potential clustering effect of birth cohorts in sequential cross-sectional oral health survey data could be appropriately considered. The success of Danish dental health policy was demonstrated by a continued increase of regular dental visiting habits and tooth retention in adults because school dental care was provided to Danes in their childhood.

Original languageEnglish (US)
Article number9
JournalBMC Oral Health
Volume11
Issue number1
DOIs
StatePublished - Mar 17 2011
Externally publishedYes

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Dental Care
Cohort Studies
Demography
Cohort Effect
Economics
Parturition
Cluster Analysis
Tooth
Dentures
Oral Health
Health Surveys
Surveys and Questionnaires
Health Policy
Habits
Software
Age Groups
Cross-Sectional Studies
Logistic Models

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Age, period, and cohort analysis of regular dental care behavior and edentulism : A marginal approach. / Li, Kar Yan; Wong, May C M; Lam, Kwok Fai; Schwarz, Eli.

In: BMC Oral Health, Vol. 11, No. 1, 9, 17.03.2011.

Research output: Contribution to journalArticle

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