Public assistance

Public assistance Background.—Good levels of oral health are important in themselves but also in respect to their influence on general health. However, the levels of oral health are not equally distributed in populations, with inequalities often occurring with respect to socioeconomic position (SEP). Regular dental visits appear to be a determinant of oral health, but socioeconomically disadvantaged persons and older people are less likely to show health benefits related to dental treatment because of difficulties with access or cost. SEP-related inequalities were explored in relation to the use of dental care services in persons age 50 years or older in European countries in 2006 to determine what role public coverage of dental services plays, as well as the extent of inequalities in these situations. Methods.—Data were obtained in a cross-sectional study of 12,364 men and 14,692 women from 11 European countries. A questionnaire was used to determine the use of dental care services. SEP was analyzed through maximum educational level achieved, with additional measures related to age and chewing ability as reported by the subjects themselves. A review of the literature yielded the degree of public dental care coverage. Results.—Nearly 55% of the respondents had visited the dentist in the past year, with a higher percentage among the better educated groups in all of the countries and in both genders. Countries in which dental care was covered to some degree had a higher prevalence of dental visits than countries where dental care was not covered. Ageand country-standardized prevalence of dental visits was also higher in persons who reported normal chewing ability compared to those with reduced chewing ability regardless of gender or level of education. Inequalities in the use of dental care services were found in all countries, with statistically significant interactions between educational level

and public coverage and between educational level and chewing ability. Countries where dental care was not covered had greater inequalities between educational levels than countries with dental care coverage. Additionally, socioeconomic inequalities were significantly greater in persons with decreased chewing ability compared to those with normal chewing ability. Discussion.—Socioeconomic inequalities in dental care were noted in all the countries studied. When there was no public dental care coverage, the inequalities were greater than when some dental care coverage was provided through public funds.

Clinical Significance.—Europeans are subject to inequalities regarding dental care depending on SEP. However, the inequalities are greater in countries offering no public support for dental care compared to countries that offer some public support for this care. Dental systems that rely on public coverage offer considerable benefits and can affect the dental health of a population.

Pal encia L, Espelt A, Cornejo-Ovalle M, et al: Socioeconomic inequalities in the use of dental care services in Europe: what is the role of public coverage? Community Dent Oral Epidemiol 42:97105, 2014 Reprints available from L Pal encia, Ag encia de Salut P ublica de Barcelona, Plac¸a Lesseps 1, 08023 Madrid, Spain; fax: þ34 933686943; e-mail: [email protected]

HIV-AIDS Update Oral disease and HIV/AIDS Background.—Since the first days of the HIV disease epidemic, remarkable discoveries have been made related to variations in the oral health of persons living with this disease or AIDS. Oral candidiasis (OC) was

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Dental Abstracts

identified as a comorbid condition and early sign of immune suppression. Oral Kaposi sarcoma (KS) was recognized as a sign of AIDS related to oral disease. AIDS-associated oral hairy leukoplakia (OHL) and OC