J Korean Acad Oral Health.  2013 Dec;37(4):208-215.

The relationship between regional socioeconomic position and oral health behavior: A multilevel approach analysis

  • 1Research Institute for Dental Care Policy, Korean Dental Association, Seoul, Korea.
  • 2Department of Preventive Medicine, Chungnam National University, Daejeon, Korea. woung2@gmail.com


OBJECTIVES: This study was conducted to identify discrepancies in oral health behaviors among communities in cities, counties, and districts (si , gun, and gu administrative divisions of South Korea) and to determine their correlations with socioeconomic status, examined in terms of the social deprivation index.
Data for 220,258 individuals, covering 247 communities, were extracted from a 2008 community health survey, and the frequency of brushing the teeth after lunch, flossing and interdental brushing was calculated and analyzed. Considering the characteristics of the data collected at individual and regional levels, a multilevel random-intercept logistic regression model was used for the analysis.
A regional-level discrepancy was found in after-lunch brushing and the use of auxiliary oral hygiene items, with interclass correlations of 0.03 and 0.04, respectively. In particular, the odds ratio of using auxiliary oral hygiene items in the communities with the lowest socioeconomic status was as low as 0.49, compared to the highest level, thus demonstrating a conspicuous intercommunity difference.
The regional-level correlation between socioeconomic status and oral health behaviors indicates the need for the establishment of oral health-related intervention policies based on community characteristics.


Multilevel analysis; Oral health behavior; Socioeconomic position
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