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Surprising dental health inequalities found between foreign‐ and UK‐born adults

UK researchers have found that large inequalities in caries experience exist between foreign‐ and UK‐born adults, with considerable variation across ethnic groups.

Tue. 19 June 2018

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LONDON, UK: Migration patterns in the UK have changed tremendously in the last two decades owing to ease of global travel, asylum seekers from conflict areas and new accession countries. However, according to King’s College London Dental Institute, the oral health of migrants remains largely uninvestigated in the UK. A recent study at the university explored the interrelationship between ethnicity, migration status and caries experience among adults in East London. Large inequalities in caries experience were found between foreign‐ and UK‐born adults, with considerable variation across ethnic groups.

The researchers analysed data from 1,910 adults, of whom 874 were UK-born and 1,036 foreign-born. The participants, aged between 16 and 65, represented nine ethnic groups and took part in a community‐based health survey in East London. They completed a supervised questionnaire and were clinically examined by trained dentists. Dental caries was assessed according to the number of decayed, missing and filled teeth (DMF index). Ethnicity was self-assigned using an adaptation of the UK census 2001 categories, including 26 ethnic subgroups organised into five main groups (white, Asian, black, mixed and other).

The study found that white migrants had greater DMF scores than did UK‐born adults, whereas every Asian and black migrant group had lower DMF scores than did adults of the same ethnic group born in the UK. Among foreign‐born adults, age at arrival and length of residence were positively associated with DMF scores. The greatest caries experience was found among older migrants with long-term residence in the UK. The synergistic effect between age at arrival and length of residence differed by ethnicity.

Moreover, all native-born Asian and black adults had lower caries experience than did white British adults. The findings challenge two strongly held views in migrant health research. First, the findings demonstrate that the “healthy migrant” experience does not apply to dental health across all ethnic groups. This is particularly true for white others (mainly Eastern Europeans). Geographical and political access means that Europeans do not face a health barrier to migration as do migrants from other world regions, thus increasing the likelihood that worse-off individuals migrate if an opportunity arises. Second, the findings imply that migrants’ dental status reflects that of their area of origin. Global data shows that the prevalence of untreated caries is higher in Eastern Europe and lower in Africa and South Asia compared with the prevalence in the UK.

The study, titled “Ethnicity, migration status and dental caries experience among adults in East London”, was published online in Community Dentistry and Oral Epidemiology on 16 May 2018 ahead of inclusion in an issue.

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