How much does household food insecurity explain income inequalities in untreated dental caries?

Background: The pathway by which socioeconomic disadvantages are manifested in the occurrence of dental caries remains unclear.

Aim: To explore how much the association between untreated dental caries and income inequalities is related to household food insecurity (HFI).

Design: A population-based study was conducted with a sample of 466 12-year-old students. Dental caries was evaluated by an examiner who had undergone calibration exercises. HFI was assessed using the Food Insecurity Scale validated for Brazilian Portuguese. Poisson regression models were created to determine associations between dental caries and both household income and HFI. The proportion of the income effect on dental caries explained by HFI was determined by the variation in percentages between the crude prevalence ratio (PR ) for dental caries and this measure adjusted by HFI (PR ).

Results: The prevalence of dental caries was higher among children from families with a per capita household income lower than US$ 71 (PR: 1.69; 95%CI: 1.15-2.49) or from US$ 71 to US$ 142 (PR: 1.50; 95%CI: 1.04-2.17). Moreover, 14% of the association between a low income and dental caries was explained by HFI.

Conclusions: Differences in the prevalence of dental caries in schoolchildren related to socioeconomic inequalities could partially be attributed to HFI in low-income families.