Effect of the 2008 economic crisis on oral health in Spain: analysis of serial cross-sectional, population-based health surveys

Silvia Méndez Eirey; Jesús San-Roman-Montero; Angel Gil de Miguel; Rosa Rojo; Antonio F López Sánchez

doi:10.1136/bmjopen-2022-061947

Effect of the 2008 economic crisis on oral health in Spain: analysis of serial cross-sectional, population-based health surveys

BMJ Open. 2022 Dec 14;12(12):e061947. doi: 10.1136/bmjopen-2022-061947.

Authors

Silvia Méndez Eirey¹, Jesús San-Roman-Montero², Angel Gil de Miguel², Rosa Rojo³, Antonio F López Sánchez⁴

Affiliations

¹ Doctoral Program in Health Sciences, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain.
² Department of Medicine Specialties and Public Health, Faculty of Health Sciences, Rey Juan Carlos University, Madrid, Spain.
³ Faculty of Dentistry, Universidad Alfonso X el Sabio, Villanueva de la Canada, Spain rrojolop@uax.es.
⁴ Department of Nursing and Estomatology, Rey Juan Carlos University, Madrid, Spain.

Abstract

Objectives: To evaluate the impact of the economic crisis on the oral health of individuals in Spain based on variables including sex, unemployment, social class and educational level.

Design: This was an analysis of serial cross-sectional, population-based health surveys conducted before the crisis (2003 and 2006) and during the crisis (2011, 2014 and 2017).

Setting: National Health Surveys of Spain and the European Health Survey in Spain.ParticipantsA total of 189 543 participants were recruited.

Outcome measures: The independent variables were sex, employment, social class and educational level. The dependent variables were related to oral health. Descriptive statistics, χ² tests and the Cochran-Mantel-Haenszel test were performed.

Results: The results showed that there were differences (p<0.001) in all oral health indicators before and after the crisis. Compared with the precrisis period, men had a higher probability of tooth extractions (OR 1.41, 95% CI 1.37 to 1.45), dental fillings (OR 1.30, 95% CI 1.27 to 1.34), prostheses (OR 1.04, 95% CI 1.01 to 1.07) and missing teeth (OR 1.35, 95% CI 1.31 to 1.39). Unemployed individuals were more likely to have dental caries (OR 1.08, 95% CI 1.00 to 1.16) and missing teeth (OR 1.36, 95% CI 1.27 to 1.46). Working class individuals had a higher probability of tooth extractions (OR 1.63, 95% CI 1.59 to 1.67), bleeding gums (OR 1.04, 95% CI 1.01 to 1.07), prostheses (OR 1.05, 95% CI 1.02 to 1.07) and missing teeth (OR 1.36, 95% CI 1.33 to 1.39). Participants with a basic or intermediate level of education had a higher probability of dental mobility (OR 1.13, 95% CI 1.07 to 1.19), prostheses (OR 1.11, 95% CI 1.08 to 1.14) and missing teeth (OR 1.42, 95% CI 1.38 to 1.46).

Conclusions: The economic crisis affected the oral health of the Spanish population, with a more significant deterioration among men, working class individuals and unemployed individuals.

Keywords: EPIDEMIOLOGY; HEALTH ECONOMICS; ORAL MEDICINE; PUBLIC HEALTH.

MeSH terms

Cross-Sectional Studies
Dental Caries* / epidemiology
Economic Recession*
Health Surveys
Humans
Male
Oral Health
Spain / epidemiology
Tooth Loss*