Income inequality in dental visits among Chinese children

Background: Socioeconomic factors are a major barrier for dental visits among Chinese children, despite the need for dental care.

Objective: To test whether dental visits are associated with household income regardless of dental diseases.

Methods: The project was approved by King’s College London ethics committee (HR-15/16-2901). Data was from a longitudinal study conducted in Liaoning Province, China, between 2017 and 2018. The analysis included 772 preschool children who were assessed at baseline and a year later. Data on household income and untreated dental caries at baseline and on dental visits during the follow-up time were used in the analysis. The association between household income at baseline and dental visit during the follow-up time was assessed using logistic regression, adjusting for the number of untreated caries, age and gender.

Results: Mean age of the children at baseline was 50.8 months. At baseline, the mean number of decayed teeth was 3.04, and the prevalence was 58%. Dental visits at follow-up were reported by 20% of the children. After adjusting for the mean number of decayed teeth, there were clear income gradients in dental visits at follow-up. Children from lowest and second lowest income groups had lower odds ratios (OR) for dental visits (OR= 0.27, 95%CI: 0.16, 0.47) and (OR=0.39, 95%CI: 0.22, 0.71), respectively, compared to those in highest income group.

Conclusion: Despite the high level of caries among Chinese children, there were steep income gradients in dental visits after the children were diagnosed with the disease.