Does optimal access to dental care counteract the oral health-related quality of life social gradient?

Objective: To determine if an oral health-related quality of life (OHRQoL) social gradient existed when Australian Defence Force (ADF) members have universal and optimal access to dental care.

Methods: A nominal roll included 4,089 individuals who were deployed to the Solomon Islands (SI) as part of operation ANODE and a comparison group of 4,092 ADF personnel frequency matched to the deployed group on sex, age group, and service type, from which 500 deployed and 500 comparison individuals were randomly selected. The dependent variables were the OHIP-14 summary measures. Rank was used to determine socioeconomic status. The demographic variables selected were: sex and age.

Results: Response rate was 44%. Of the individual OHIP-14 items, being self-conscious, painful aching and having discomfort when eating were the most common problems. Mean OHIP-14 severity was 2.8. In bivariate analysis, there was not a significant difference in mean OHIP-14 severity (p = 0.52) or frequency of OHIP-14 impacts (p = 0.57) by military rank. There was a significant increasing OHIP-14 extent score from commissioned officer to non-commissioned officer to other ranks (0.07, 0.19, 0.40, p = 0.03).

Conclusion: Even with optimal access to dental care, there was an OHRQoL social gradient between military ranks in the ADF.