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dc.contributor.authorBernabé, Eduardo
dc.contributor.authorHumphris, Gerry
dc.contributor.authorFreeman, Ruth
dc.identifier.citationBernabé , E , Humphris , G & Freeman , R 2017 , ' The social gradient in oral health : is there a role for dental anxiety? ' , Community Dentistry and Oral Epidemiology , vol. 45 , no. 4 .
dc.identifier.otherPURE: 249229215
dc.identifier.otherPURE UUID: 47027eeb-0ae7-4395-84d4-f8768a953f30
dc.identifier.otherScopus: 85017097328
dc.identifier.otherWOS: 000406975700009
dc.identifier.otherORCID: /0000-0002-4601-8834/work/64033904
dc.description.abstractObjective : To evaluate the contribution of dental anxiety to social gradients in different oral health outcomes and whether social gradients in oral health persist once dental anxiety is removed from the population examined.  M ethods : Data from 9035 British adults were analysed. Participants’ socioeconomic position (SEP) was measured through education and household income. Dental anxiety was measured with the Modified Dental Anxiety Scale. Poor subjective oral health, oral impacts on quality of life and edentulism among all adults and the number of teeth, DMFS and sextants with pocketing among dentate adults were the oral health outcomes. The contribution of dental anxiety to absolute and relative social inequalities in each oral health outcome (measured with the Slope and Relative Index of Inequality [SII and RII], respectively) was estimated from regression models without and with adjustment for dental anxiety and quantified with the percentage attenuation. Interactions between each SEP indicator and dental anxiety were used to test what would happen if dental anxiety were removed from the whole population. Results : The largest contribution of dental anxiety to explaining oral health inequalities was found for education gradients in perceived outcomes (11-13%), but dental anxiety explained <4% of social gradients in edentulism. Among dentate adults, dental anxiety accounted for <5% and <7% of education and income gradients, respectively. Only four of the 24 interactions tested were statistically significant. Hence, the education- and income-based SII and RII for oral impacts were non-significant among anxiety-free adults but were significant at higher levels of dental anxiety.  Conclusions : Little support was found for the role of dental anxiety in explaining social inequalities in various perceived and clinical oral health measures. Oral health inequalities were found among both non-dentally anxious and anxious participants.
dc.relation.ispartofCommunity Dentistry and Oral Epidemiologyen
dc.rights© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd. This work has been made available online in accordance with the publisher’s policies. This is the author created, accepted version manuscript following peer review and may differ slightly from the final published version. The final published version of this work is available at /
dc.subjectPsychosocial aspects of oral healthen
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.subjectRC0321 Neuroscience. Biological psychiatry. Neuropsychiatryen
dc.subjectRK Dentistryen
dc.subjectSDG 3 - Good Health and Well-beingen
dc.titleThe social gradient in oral health : is there a role for dental anxiety?en
dc.typeJournal articleen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. WHO Collaborating Centre for International Child & Adolescent Health Policyen
dc.contributor.institutionUniversity of St Andrews. Health Psychologyen
dc.contributor.institutionUniversity of St Andrews. St Andrews Sustainability Instituteen
dc.contributor.institutionUniversity of St Andrews. Population and Behavioural Science Divisionen
dc.description.statusPeer revieweden

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