Can Biological Markers Partially Explain the Link Between the Social Environment and Oral Health? / ¿Pueden los marcadores biológicos explicar parcialmente la relación entre el entorno social y la salud oral?

Abstract Understanding how the social world affects humans´ health by "getting under the skin" and penetrating the cells, organs and physiological systems of the body is a key tenet in public health research. Here, we propose the idea that socioeconomic position (SEP) can be biologically embodied, potentially leading to the production of health inequalities in oral health across population groups. Recent studies show that being exposed to chronic stress across the life course could impact our health. Allostatic load (AL) is a composite biological measure of overall physiological wear-and-tear that could allow a better understanding of the potential biological pathways playing a role in the construction of the social gradient in adult health. However, to use biological measures to better understand the mechanisms that construct health inequalities in oral health has not been tested systematically. The purposes of this New Perspective is to discuss the value of using composite biological markers, such as AL, to analyze oral health. This can allow a better understanding of the mechanisms leading to health inequalities in oral health, and add some valuable information for implementing health interventions.

Resumen Comprender cómo el mundo social afecta la salud de los seres humanos "penetrando bajo la piel" e introduciéndose dentro de las células, los órganos y los sistemas fisiológicos del cuerpo, es un principio clave en la investigación en salud pública. Aquí, proponemos la idea que la posición socioeconómica puede incorporarse biológicamente, lo que puede conducir a la producción de inequidades sociales en salud entre diferentes grupos de población. Estudios recientes muestran que estar expuesto al estrés crónico a lo largo de la vida podría afectar nuestra salud. La carga alostática es una medida biológica compuesta del desgaste fisiológico global del cuerpo que podría permitir una mejor comprensión de las posibles vías biológicas que desempeñan un papel en la construcción del gradiente social en la salud del adulto. Sin embargo, el uso de medidas biológicas para comprender mejor los mecanismos que construyen las inequidades sociales en salud oral, no se ha probado sistemáticamente. El propósito de este boletín de New Perspective es analizar el valor del uso de marcadores biológicos compuestos, como la carga alostática, para analizar la salud oral. Esto puede permitir una mejor comprensión de los mecanismos que conducen a las inequidades sociales en salud oral, y así agregar información valiosa para implementar de manera más adecuada las intervenciones en salud.

Differences between middle-aged and older people in association between income level and remaining teeth / 대한구강보건학회지

OBJECTIVES: To understand the relationship between monthly household income and number of remaining teeth as an indicator of oral health, and to find the differences between middle-aged and older people in this respect. METHODS: This study was conducted on data extracted from the Korean National Health & Nutrition Examination Survey, which surveyed all Korean citizens in 2012. From these data, data of 4502 people about 40 years of age who completed the questionnaires and examination survey were selected and analyzed. This study investigated the main factors affecting the remaining teeth, and analyzed the moderating effect of age on the relationship between income level and remaining teeth. RESULTS: The average number of remaining teeth was 25.17 for middle-aged people and 15.95 for older people, which was significantly different. The number of remaining teeth for middle-aged people showed a significant relationship with income level, education level, and smoking habit. The number of remaining teeth in older people was related to the same factors, along with an additional factor of whether or not they underwent oral examinations. From the interaction analysis conducted to find the moderating effect of age on the relationship between the number of remaining teeth and income level, the number of remaining teeth was more affected by income level in older people than in middle-aged people. CONCLUSIONS: Income level was strongly related to oral health, particularly in older people. Therefore, it can be concluded that an oral health promotion policy is necessary for low-income people, particularly those in the older age group.