Inequities in early life on dental pain trajectory: A birth cohort study

Resumo

Objective
This birth cohort study aims to investigate the early life inequalities in the dental pain trajectory in the Pelotas 1982 birth cohort.
Methods
A representative sample of all births was prospectively investigated. Sex, maternal schooling, and family income were assessed at birth, and skin color/race was self-reported at 24y. Dental pain was assessed at 24(n = 720), 31(n = 539), and 40y(n = 463). Group-based trajectory modeling was used to identify groups with similar pain trajectories. Inequalities were assessed using the slope index of inequality (SII) and concentration index (CIX).
Results
607 participants were included. The prevalence of dental pain at 24y was 22.6 %, at 31y was 31.6 %, and at 40y was 23.0 %. Lower family income and maternal schooling at birth were significantly associated with a high dental pain trajectory: For family income, the SII was -17.3 (95 % CI:30.1 to -3.8) and the CIX was -6.2 (95 % CI:11.0 to -1.3), indicating more pronounced inequalities. Maternal schooling also showed significant inequalities, with an SII of -15.2 (95 % CI:29.4 to -0.9) and a CIX of -5.6 (95 % CI:10.4 to -0.7). Significant associations were observed in bivariate analysis for sex (p = 0.040) and race (p = 0.030). Males were more likely to follow the low prevalence trajectory (43.8 %) compared to females (51.2 %). Racial disparities were also significant, with Black individuals showing the highest prevalence. Differences according to maternal schooling and family income tended to persist but appeared to narrow slightly over time.
Conclusion
Socioeconomic, racial, and gender inequalities significantly influence dental pain trajectories over the life course.
Clinical Significance
Individuals born into lower-income families or with mothers of lower educational attainment are at higher risk of dental pain. Recognizing these inequalities allows healthcare providers and policymakers to prioritize at-risk populations, implement early oral health promotion strategies, and reduce lifelong disparities in oral health outcomes.