Search

Purpose: To estimate the additive effects of parent's nativity status/language spoken at country of birth, education, and area-level socioeconomic status (SES) on untreated dental caries among children aged 5 to 9 y in Australia., Methods: Cross-sectional population-based data were obtained from the 2014 National Child Oral Health Study (N = 12,140). Indicators of social position used to explore additive effects on dental caries included nativity status, language, university degree, and neighborhood socioeconomic level. Multiple-way interactions were examined, and departure from additivity resulting from 2- and 3-way interactions were estimated as relative excess risk due to interaction (RERI)., Results: Children marginalized across multiple layers of disadvantage had substantially higher frequencies of dental caries compared with children in the most advantaged category. RERI for the 3-way interaction between immigrant status, education, and neighborhood SES was negative (RERI 3 : -0.14; 95% confidence interval [CI]: -1.68, 1.40). When operationalizing language, education, and neighborhood SES, the joint effect of the 3 marginalized positions was additive (RERI 3 : 0.43; 95% CI: -2.08, 2.95)., Conclusion: Children marginalized across multiple intersecting axes of disadvantage bear the greatest burden of dental caries, with frequencies surpassing the cumulative effect of each social position alone. Findings emphasize the need to account for intersecting inequities and their oral health effects among children with immigrant backgrounds., Knowledge Transfer Statement: Our analysis underscores the necessity for policies and public health strategies targeting dental caries-related inequities to comprehensively account for various indicators of social disadvantage, particularly encompassing language proficiency, educational attainment, and neighborhood socioeconomic status. Within the intricate interplay of these factors, we identify a vulnerable subgroup comprising children with the highest prevalence of dental decay. Therefore, prioritizing this specific demographic should be the focal point of policies and public health initiatives aimed at fostering equitable oral health outcomes., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Objectives: The aim of this study was to assess the structural validity of the Oral Health Impact Profile-14 (OHIP-14) instrument in Indigenous and non-Indigenous populations from Australia and Brazil using a network analysis approach., Methods: Cross-sectional data collected using OHIP-14 were obtained for Indigenous and non-Indigenous populations from Australia and Brazil. Networks were estimated using the Gaussian graphical model. Items of the OHIP-14 instrument are represented as nodes and the partial correlations between items as edges. Dimensionality was assessed using exploratory graph analysis. Structural consistency and item stability were computed using a bootstrap sampling method. Standardized node strength across each dimension was also calculated., Results: Four dimensions were identified across all samples, although the item arrangement of most dimensions presented variation. Similarities with the theoretical domains of the instrument were found. Items from the conceptually derived OHIP-14 domains formed separated clusters or blended with other items in a single dimension. Most dimensions across all samples showed an acceptable structural consistency. Item stability revealed some discrepancies among items of dimensions of both Indigenous networks., Conclusion: The psychometric network perspective adopted in this study provides validation of the OHIP-14 structure in Indigenous and non-Indigenous populations. The structural consistency and item stability analyses showed that both Indigenous networks present a higher number of cross-domain items and less defined boundaries between dimensions. These findings indicate that OHIP-14 does not measure attributes in the same extent among different cultures., Knowledge Transfer Statement: This study demonstrates a new analytical framework from which to conceptualize and interpret the construct oral health-related quality of life using the Oral Health Impact Profile (OHIP-14). Network graphs facilitate knowledge translation of findings to professionals with no expertise in psychometric methods. OHIP-14 is a valuable tool to oral health research and clinical practice. Differences in conceptions of health may influence the extent that the instrument measures oral health impacts. Consequently, dimension scores do not always provide appropriate measures and should be avoided in research reports and assessments of treatment outcomes.