Periodontitis and Social Conditions: The Role of Social Mobility and Employment Status in an Adult Population in Norway – The Tromsø Study

Objectives

Social condition mobility refers to an individual's ability to move up or down the social ladder during their lifetime. The aim of this study was to explore the relationship between social conditions and periodontitis in an adult Norwegian population, specifically the role of social mobility and employment status.

Methods

The study was cross-sectional, based on data collected from a subset (n = 3717) of 21 083 participants in a population health study (The Tromsø Study: Tromsø7) aged 40–99 years. Data were collected through questionnaires and clinical examinations. Periodontitis was assessed by periodontal probing depth and radiographic bone loss, according to the 2017 case definition of periodontitis. Current social conditions were measured by participants' own income, education and employment status. Early life social conditions were measured by perceived financial situation as a child and their parents' education. Social condition mobility for educational and economic status was categorised as stable high, upward mobility, downward mobility and stable low.

Results

The prevalence of Stage III–IV periodontitis was lowest among those with persistently high educational and economic status (12% and 16%, respectively) and among leaders/academics (11%), and highest among those with persistently low educational and economic status (25% and 28%, respectively) and unemployed participants (25%). After adjusting for age, sex, smoking and BMI, educational and economic status were no longer significantly associated with periodontitis. Being unemployed increased the odds of having Stage III–IV periodontitis by 2.2 times (p = 0.012), independently of other risk factors for periodontitis.

Conclusions

While stable high educational and economic status appears protective against severe periodontitis, unemployment emerged as a significant independent risk factor. These findings highlight the importance of addressing unemployment and related social determinants in efforts to reduce the burden of periodontitis. Programmes aimed at improving oral health literacy and access to dental care in these populations, along with a common risk factor approach addressing smoking cessation and other lifestyle factors contributing to periodontitis, could help reduce disparities.