Generalized estimating equation analysis of the influence of socioeconomic factors on permanent tooth caries among school children in Yulin City

Objective To explore the relationship between socioeconomic factors and the incidence of permanent tooth caries in school children.

Methods A baseline cohort of 946 seven-year-old children was recruited from Yulin City. A questionnaire was used to collect demographic, socioeconomic, oral health behavioral, and oral healthcare utilization data. Clinical oral examinations were performed, with follow-up assessments conducted every six months for 1 year. A generalized estimating equation (GEE) was employed to examine the association between socioeconomic factors and the 1-year incidence of permanent tooth caries in 7-year-old children.

Results At the one-year follow-up, 908 children were reassessed, yielding a follow-up rate of 96.0%. The incidence of caries in the first permanent molars increased over time, with the increment in decayed, missing, filled surfaces (△DMFS) rising from 310 to 485. The final GEE model indicated that children with low maternal education (95% CI=1.037–1.234, P=0.007), with fathers engaged in secondary or tertiary occupations (95% CI: 1.017 –1.188, P=0.024; 95% CI: 1.109–1.401, P < 0.001), and with lower per capita monthly household income (95% CI=1.003-1.152, P=0.044) had a higher risk of △DMFS increment in the first permanent molars.

Conclusion Low maternal education, paternal occupation status, and household income are significant risk factors for the incidence of permanent tooth caries in school children.