Socioeconomic, behavioral, and psychological factors related to oral health in Myanmar: A cross‐sectional study

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Abstract

Objectives

This study aims to evaluate the effects of socioeconomic, behavioral, and psychological factors on oral health status and oral health‐related quality of life in Myanmar adults.

Methods

Data were from a convenience sample of Myanmar adults who are from a township health center in Yangon city. Face‐to‐face interviews using a paper‐based questionnaire in the Myanmar language and clinical oral examinations were performed at the health center. Mann–Whitney U test and linear regressions were used to assess the association of socio‐demographic, behavioral, and psychological variables with oral health outcomes.

Results

In socio‐demographic variables, significant associations were observed in individual income with periodontal pocket and OHIP‐14, and history of COVID‐19 infection with OHIP‐14. However, there were no associations between behavioral factors and oral health outcomes. After adjustment for sex, age, educational level, and individual income, the depression subscale was statistically significant with the number of present teeth, decayed teeth, decayed, missing, and filled teeth, and OHIP‐14. The anxiety subscale remained significant with periodontal pocket, but no stress subscale was associated with oral health outcomes.

Conclusion

The experiences of oral health status were high, and the oral health‐related quality of life was unfavorable in Myanmar adults. A large proportion of them suffers from psychological distress. Additionally, individuals with lower income and who experienced a history of COVID‐19 infection were susceptible to poor oral health‐related quality of life. Psychological distress indicates a higher risk for oral health problems in Myanmar adults.

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Most cited references 25

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Measuring socioeconomic position in health research.

John Lynch, John Lynch, Bruna Galobardes (2007)

In this article we review different measures of socioeconomic position (SEP) and their uses in health-related research. Socioeconomic circumstances influence health. Generally, poorer socioeconomic circumstances lead to poorer health. This has generated a search for generic mechanisms that could explain such a general association. However, we propose that there is a greater variation in the association between SEP and health than is generally acknowledged when specific health outcomes are investigated. We propose that studying these variations provide a better understanding of the aetiological mechanisms relating specific diseases with specific exposures. AREAS TO DEVELOP RESEARCH: Using different indicators of SEP in health research can better capture these variations and is important when evaluating the full contribution of confounding by socioeconomic conditions. We propose that using an array of SEP indicators within a life course framework also offers considerable opportunity to explore causal pathways in disease aetiology.

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Integrating the common risk factor approach into a social determinants framework.

Richard G. Watt, Aubrey Sheiham (2012)

The common risk factor approach (CRFA) has been highly influential in integrating oral health into general health improvement strategies. However, dental policy makers and oral health promoters have interpreted the CRFA too narrowly. They have focussed too heavily on the common behavioural risks, rather than on the broader shared social determinants of chronic diseases. A behavioural preventive approach alone will have minimal impact in tackling oral health inequalities and indeed may widen inequalities across the population. Based on recent WHO policy recommendations, this study presents the case for updating the CRFA in accordance with the social determinants agenda. The theoretical basis for a social determinants framework for oral health inequalities is presented, and implications for oral health improvement strategies are highlighted. Future action to address oral health inequalities in middle- and high-income countries requires a radical policy reorientation towards tackling the structural and environmental determinants of chronic diseases. In more equal and fairer societies, all sections of the social hierarchy experience better health and social well-being. © 2012 John Wiley & Sons A/S.

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Social gradients in oral and general health.

A. Sheiham, W Sabbah, Georgios Tsakos … (2007)

There are social gradients in general health and oral health. However, there have been few studies addressing whether similarities exist in the gradients in oral and general health in the same individuals. We set out to test, using data from NHANES III, whether there are social gradients in oral health, and whether they resemble the gradients in general health. Income, indicated by poverty-income ratio, and education gradients were examined in periodontal diseases, ischemic heart disease, and perceived oral/general health. Our analysis demonstrated consistent income and education gradients in all outcomes assessed. In the adjusted regression models, the probabilities of having poorer clinical and perceived health were attenuated, but remained significantly higher at each lower level of income and education for most outcomes. The results showed similar income and education gradients in oral and general health, implying commonalities of the social determinants of both oral and general health.