Education as a Predictor of Chronic Periodontitis: A Systematic Review with Meta-Analysis Population-Based Studies

被引:83
作者
Boillot, Adrien [1 ]
El Halabi, Bechara [1 ]
Batty, George David [4 ]
Range, Helene [1 ]
Czernichow, Sebastien [2 ,3 ]
Bouchard, Philippe [1 ]
机构
[1] Univ Paris 07, Rothschild Hosp, AP HP, Dept Periodontol,Serv Odontol,UFR Odontol, Paris, France
[2] Univ Versailles St Quentin, Ambroise Pare Hosp, Dept Nutr, Boulogne, France
[3] Ctr Res Epidemiol & Populat Hlth, INSERM, U1018, Villejuif, France
[4] UCL, Dept Epidemiol & Publ Hlth, London, England
来源
PLOS ONE | 2011年 / 6卷 / 07期
关键词
ORAL-HEALTH; ATTACHMENT LOSS; RISK INDICATORS; OSLO CITIZENS; TOOTH LOSS; DISEASE; ADULTS; ASSOCIATION; INEQUALITIES; PERSPECTIVE;
D O I
10.1371/journal.pone.0021508
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Background: The impact of socioeconomic inequalities on health is well-documented. Despite the links of periodontal disease with cardiovascular diseases, adverse pregnancy outcomes and diabetes, no meta-analysis of socioeconomic variations in periodontal disease exists. This meta-analytic review was conducted to determine the extent to which education attainment influences risk of periodontitis in adults aged 35+ years in the general population. Methods: The authors searched studies published until November 2010 using EMBASE and MEDLINE databases. References listed were then scrutinised, our own files were checked, and, finally, we contacted experts in the field. The authors included only general population-based studies conducted in adults aged 35 years and more. All articles were blind reviewed by two investigators. In the case of disagreement, a third investigator arbitrated. Using PRISMA statement, two reviewers independently extracted papers of interest. Results: Relative to the higher education group, people with low education attainment experience a greater risk of periodontitis (OR: 1.86 [1.66-2.10]; p<0.00001). The association was partially attenuated after adjustment for covariates (OR: 1.55 [1.30-1.86]; p<0.00001). Sensitivity analyses showed that methods used to assess periodontitis, definition of cases, study country and categorization of education are largely responsible for the heterogeneity between studies. No significant bias of publication was shown using both the Egger (p = 0.16) and rank correlation tests (p = 0.35). Conclusions: In the studies reviewed, low educational attainment was associated with an increased risk of periodontitis. Although this evidence should be cautiously interpreted due to methodological problems in selected studies, efforts to eliminate educational inequalities in periodontitis should focus on early life interventions.
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页数:9
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