Social Determinants Affecting Oral Health of School Children in Hamadan

Background & objectives: Dental caries is one of the most common chronic diseases and affected by many determinants identified as social inequalities. So, this study explored how social determinants of health had impacts on dental health in school children of Hamadan. Methods: This cross-sectional study was conducted based on data related to the examination of 14858 students in Hamadan in 2016. The fluoride concentration was measured in drinking water samples from 22 urban and 61 rural areas using SPAND colorimetric method and spectrophotometer (DR/5000). For data analysis, frequency tests, chi-square, and regression model were used in SPSS-23. Results: Our results indicated that 11.5% of the rural and 18.2% of the city regions had fluoride level lower than standard level and 4.9% of the rural and 9.1% of the city regions higher than standard concentration. The probability of dental caries was decreased with age (AOR: 0.97, CI: 0.91-0.98) and increased with reducing each mg/l of fluoride concentration in water (AOR: 6.51, CI: 5.68-7.47). The probability of boy's dental caries was more likely than girls (AOR: 1.07, CI: 1.15-1.24). Also dental caries was less likely in healthy students in comparison to students with visual impairment (AOR: 0.45, CI: 0.36-0.56), pediculosis (AOR: 0.21, CI: 0.11-0.40), smoker parents (AOR: 0.40, CI: 0.27-0.58), obesity and overweight (AOR: 0.20, CI: 0.24-0.73). Conclusion: Although, fluoride is an important factor in the prevention of dental caries, other factors also play some roles. A better understanding of the social determinants of health can help decision-makers in policy making and prioritizing of costs.