Examining caries aetiology in adolescence with structural equation modelling.

Area of Science:

• Oral health research
• Adolescent health
• Public health

Background:

• Socioeconomic status (SES) is a known factor influencing health outcomes, including dental caries.
• Understanding the mediators between SES and caries is crucial for effective prevention.
• Adolescence is a critical period for both the development of oral health behaviors and the onset of caries.

Purpose of the Study:

• To examine the etiology of caries development in adolescents.
• To identify behavioral mediators linking socioeconomic status (SES) and caries incidence.
• To investigate the role of sex in caries-preventive behaviors and caries outcomes.

Main Methods:

• Utilized data from the longitudinal Iowa Fluoride Study, a birth cohort.
• Employed structural equation modeling to test hypothesized direct and indirect effects.
• Calculated direct and indirect standardized path coefficients and their standard errors.

Main Results:

• Adolescent SES significantly impacts caries, mediated by behaviors like dental visits, toothbrushing, and sugar-sweetened beverage intake.
• While SES at birth influences adolescent SES, it does not directly predict adolescent behaviors.
• Female adolescents exhibited worse caries than males, despite reporting better oral hygiene behaviors.

Conclusions:

• The role of SES in caries may be less direct than previously assumed, with adolescent behaviors acting as key mediators.
• Sex differences in oral health behaviors and caries emerge during adolescence.
• Findings can inform targeted caries prevention programs for adolescents, considering sex-specific factors.