Supplementary Material for: Influence of social mobility on untreated dental caries at age 4: Intergenerational and Intragenerational analysis

Introduction: This study aimed to describe the prevalence of untreated dental caries in early childhood based on intergenerational socioeconomic data; and to evaluate the association between intragenerational socioeconomic mobility data and untreated dental caries in children aged 4. Methods: Longitudinal study. Data from three birth cohorts in Pelotas (1982, 1993, and 2015) were used. Data from three generations participating in these cohorts were evaluated. Untreated dental caries in childhood (2015 cohort) was considered the dependent variable. Family income and schooling were independent variables. The social mobility variable was categorized considering income and level of schooling data in the mothers' generation. Poisson regression was performed to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI). Results: 286 pairs of children and mothers/grandmothers were evaluated for the intergenerational sample (1982 and 1993 cohorts), and 3,633 mothers and children for the intragenerational sample (2015 cohort). In the intergenerational analysis, there was a reduction of about 10 percentage points in the prevalence of untreated caries in children from families that experienced upward/downward income mobility compared to children whose generations remained with lower income. In the intragenerational analysis, children belonging to the ascending/descending economic mobility groups had twice the prevalence of untreated dental caries compared to those always with higher salaries ([RP 2.04;95%CI 1.52-2.71] [PR 2.07;95%CI 1.56-2.74), respectively). Conclusion: Findings demonstrate an association between untreated dental caries in children and family socioeconomic status, including their mothers' income/education mobility. Thus, intervening in early childhood socioeconomic conditions is needed to improve children's oral health.

引言：本研究旨在基于代际社会经济数据（intergenerational socioeconomic data），阐明儿童早期未治疗龋齿（untreated dental caries）的患病情况；并评估4岁儿童的代内社会经济流动（intragenerational socioeconomic mobility）数据与未治疗龋齿之间的关联。方法：本研究为纵向研究。数据来源于佩洛塔斯（Pelotas）的三个出生队列（birth cohorts，1982年、1993年及2015年），纳入参与上述队列的三代人群进行分析。以2015年队列的儿童早期未治疗龋齿作为因变量，以家庭收入与受教育程度作为自变量。社会流动变量依据母亲一代的收入与受教育水平数据进行分类。本研究采用泊松回归（Poisson regression）估算患病率比（prevalence ratios, PR）及95%置信区间（95% confidence intervals, 95%CI）。结果：代际样本（1982年与1993年队列）共纳入286对儿童与母亲/祖母，代内样本（2015年队列）共纳入3633对母亲与儿童。代际分析结果显示，相较于世代收入水平始终较低的儿童，经历收入向上/向下流动的家庭的儿童，其未治疗龋齿患病率降低约10个百分点。代内分析结果显示，经济流动处于上升/下降组的儿童，其未治疗龋齿患病率分别为始终高收入组儿童的2倍（[PR=2.04; 95%CI: 1.52-2.71]、[PR=2.07; 95%CI: 1.56-2.74]）。结论：研究结果表明，儿童未治疗龋齿与家庭社会经济地位（包括母亲的收入与受教育程度流动情况）存在关联。因此，需通过干预儿童早期的社会经济状况，以改善儿童的口腔健康水平。