TITLE:
Effect of socio-demographic status on dental caries in pupils by using a multilevel hurdle model
AUTHORS:
Yunes Jahani, Mohammad R. Eshraghian, Abbas R. Foroushani, Keramat Nourijelyani, Kazem Mohammad, Arash Shahravan, Mahin Alam
KEYWORDS:
Multilevel Hurdle Model; Dental Caries; Socio-Demographic Status; Primary School Pupils; dmft/DMFT Index
JOURNAL NAME:
Health,
Vol.5 No.7,
July
16,
2013
ABSTRACT:
Introduction: Dental caries is the most prevalent chronic
disease among schoolchildren. We aimed to investigate the association between
dental caries index and socio-demographic status in schoolchildren by using a
multilevel hurdle model. Materials and
Methods: A cross-sectional epidemiological study was carried out on 906
primary school pupils in Kerman, Iran in 2012. The subjects were selected
through a stratified cluster random sampling. At first, the whole target area
was stratified according to two geographic areas, the north and south area.
Then each area was stratified according to gender. In the next step, several
schools were considered as clusters, which were selected randomly in each
geographic area and gender strata. All the schoolchildren in these schools were
included in this study as samples. Twelve-year-old pupils were examined for
dental caries. The dependent variable in this study was the dmft/DMFT index.
Eight variables, including socio-demographic information, were collected.
Multilevel negative binomial hurdle model was employed for data analysis. Results: The prevalence of
caries-free pupils was 30.1% and the mean dmft/DMFT was 3.6 ± 2.2. Negative binomial part of the adjusted model showed that the dmft/DMFT adjusted rate for
females was 1.36 (95% CI: 1.10-1.79) times higher than males. Also, the
dmft/DMFT adjusted rate for overweight pupils was 0.86 (95% CI: 0.74-0.98)
times lower than those with normal weight. Logistic
part of the adjusted model showed that the posibility of caries-free state
in overweight pupils was 1.95 (95% CI: 1.22-3.11) times higher than those
with normal weight. In addition, pupils whose fathers and mothers were workers
and housewives, respectively, and those with a high maternal age were at a
greater risk for caries experience than others (p