Social inequalities in clustering of oral health related behaviors in a national sample of British adults.

OBJECTIVES: 1. To assess clustering of oral health related behaviors among a sample of British adults. 2. To determine the variation in clustering of oral health related behaviors by socioeconomic position. METHOD: We used secondary analysis of the Adult Dental Health Survey 2009 data. Health behaviors referred to smoking, tooth brushing frequency, dental visits and sugar consumption. Clustering was assessed by pairwise correlations, counts of clustering of health compromising behaviors and comparison of observed/expected ratios. Logistic regression was used to assess variation in clustering of oral health related behaviors by socioeconomic position crudely and adjusted for age, gender and self-rated oral health. RESULTS: There were weak correlations between four health behaviors. Very low prevalence of clustering was reported. Higher observed to expected ratio was observed for clustering patterns with lower prevalence. Multivariate logistic regression showed clear, strong and significant educational gradients in associations between different clustering patterns of health compromising behaviors and educational attainment. These educational gradients remained significant after adjusting for age, gender and self-reported oral health. CONCLUSION: Very clear and strong educational gradients were observed throughout patterns of clustering of oral health compromising behaviors, suggesting chances of having detrimental behavioral clustering are lower in more educated groups in population.

Oral health of female prisoners in HMP Holloway: implications for oral health promotion in UK prisons.

OBJECTIVES: This study describes the oral health status and associated risk factors in a sample of female prisoners and compares their oral health to that of the female population from the 2009 Adult Dental Health Survey. METHOD: A random sample of prisoners was selected from HMP Holloway, London. Structured interviews were carried out to collect information on oral health behaviours and oral health related quality of life. Clinical examinations using the Adult Dental Health Survey criteria assessed the oral health needs of prisoners. RESULTS: The mean age of female prisoners (n = 103) was 30.9 ± 9.6 years. The prevalence of oral diseases was high. Seventy-five percent had decayed or unsound teeth. The mean DMFT was 12.3 ± 7.5. Compared to the general female population, prisoners had more decayed and fewer filled teeth. Sixty-six percent had periodontal pockets of 4 mm or more. A large proportion (73%) reported at least one oral impact on daily performances. Prisoners were more likely than the general female population to engage in oral health damaging behaviours such as high sugar intake and smoking. CONCLUSION: This survey has demonstrated the poor state of oral health and identified considerable levels of unmet dental treatment needs in HMP Holloway. Urgent action is required to address this major public health problem.