Social stratification, oral hygiene, and trajectories of dental caries among old americans

Jersey Liang, Bei Wu, Brenda Plassman, Joan M. Bennett, Jim Beck

Research output: Contribution to journalArticlepeer-review


Objective: This study analyzed how oral hygiene (i.e., brushing, rinsing, and flossing) influences the trajectories of dental caries (i.e., numbers of decayed, missing, and filled teeth) among older Americans within the context of social stratification. Method: Data came from Piedmont Dental Study that involved a sample of 810 older Americans who were dentate in 1988 with up to four repeated observations through 1994. Hierarchical linear models were used for data analysis. Results: Brushing, flossing, and rinsing were associated with the trajectories of dental caries in distinct ways. In addition, oral hygiene was correlated with race, education, household income, and use of dental care. The effects of brushing and flossing on decayed and missing teeth remained robust, even when socio-demographic and health attributes were controlled. Conversely, socioeconomic disparities in dental caries persisted, when oral hygiene was adjusted. Discussion: Both social stratification and oral hygiene need to be considered in promoting oral health.

Original languageEnglish (US)
Pages (from-to)900-923
Number of pages24
JournalJournal of Aging and Health
Issue number6
StatePublished - Sep 2014


  • Piedmont Dental Study
  • dental caries
  • hierarchical linear models
  • oral hygiene
  • social stratification

ASJC Scopus subject areas

  • Health(social science)
  • Sociology and Political Science
  • Life-span and Life-course Studies


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