Inequality of Oral Health in a Life-Course Perspective

Viewing health and disease in a life-course perspective has gained scientific interest recently (Kuh & Ben-Shlomo, 1997). Panel studies are scarce but other designs come close to being able to follow health and disease through life (Kuh & Ben-Shlomo, 1997). There are three major perspectives in life-course research: One line emphasizes the importance of life-style and deprivation in childhood for adult chronic disease. This research investigates environmental conditions and experiences through prenatal life, infancy, childhood and adolescence that may make individuals more susceptible to developing adult chronic disease. Pearce et al., 2004 studied the effect of birth-weight, early diet, use of comforter and social status on oral health of young adults, but found only effect of social status in the expected direction. Nicolau and co-workers found a relationship between several biological factors and caries among adolescents (Nicolau et al., 2003, 2007). A second line of research assumes biological programming during critical periods of development either during pregnancy or in early life (Barker, 1994). A third line of research suggests an accumulation of risk through the life course. Accumulation of risk is different from programming in that it does not require the notion of a critical period. This approach explicitly places more emphasis on a greater range of biological and social experiences in childhood, adolescence and in early adulthood than either the life style or programming models. There are reasons to believe that adult oral health is affected through a range of life-course mechanisms. The present work leans on the third perspective arguing that oral health is continuously exposed to environmental and behavioral risks that lead to accumulated plaque in the mouth and diseases in the dental tissues (Fejerskov & Kidd, 2008). On a population basis the vast majority of children are born with a good oral health. Exposure to different life-styles and nutrional and hygienic conditions appears as a threat to oral health through life (Holst & al., 2007). The global picture of oral health is patterned by variation in living conditions and variation in life-course patterns of oral health (Petersen et al., 2006). A number of studies have described oral health of populations in repeated cross-sectional studies (Schuller & Holst, 1998, Kelly et al., 2000; Skudutyte-Rysstad &Eriksen 2007, Krustrup et al., 2008). These studies provide valuable information about background related changes in oral health conditions at certain points of time. It has for example been shown