Disparities in aspects of oral-health-related quality of life among Chilean adults

Abstract

Objective: Socioeconomic disparities in oral health among adults have been observed in many countries, but it is not clear whether they exist in aspects of Oral Health-Related Quality of Life in Chile. Methods: Data were analyzed from the 1st National Health Survey (NHIS) of Chilean adults, conducted in 2003. It included questions on aspects of oral-health-related quality of life (OHRQoL), including problems (‘always’ or ‘almost always’) with speaking, eating, pain, or daily activities. These were the dependent variables. Covariates included age, sex, education level, rurality, smoking, general quality of life, the number of remaining teeth, the number of untreated decayed teeth, and the reason for the last dental visit. Multivariate modelling was used to describe disparities in aspects of OHRQoL, using education level as the marker for socioeconomic status. Results: The sample comprised 3050 participants (54.7% female), of whom 49.0%, 40.5% and 10.5% had been educated to primary, secondary or tertiary level respectively. In the bivariate analysis, there were significant gradients in all four aspects of OHRQoL across those three categories. Covariates significantly associated with poorer OHRQoL were female gender, rurality, and poor self-reported general quality of life, and these were subsequently controlled for in the multivariate analysis. Adults with primary education (or less) were more likely than their tertiary-educated counterparts to report problems speaking (relative risk = 2.38; CI: 1.41, 4.05), trouble or pain (relative risk = 2.77; CI: 1.56, 4.91), discomfort in eating with others (relative risk = 2.35; CI: 1.34, 4.10), and interference with activities of daily living (relative risk = 2.29; CI: 1.15, 4.55). Those educated only to secondary level had relative risks which were lower than these but still significantly different from the reference category. The number of teeth with untreated caries was positively associated with impaired OHRQoL, and the number of remaining teeth was negatively associated with it. Conclusions: Socio-economic disparities in oral-health-related quality of life are apparent among Chilean adults, and remain after adjusting for dental status.