Introduction: Previous studies show that dental health is associated with educational and labour market outcomes, but it is unclear whether dental care records in childhood can serve as early markers of financial hardship risk in adulthood. Methods: Data on sociodemographic variables and dental records of all children born in Finland and who lived their childhood in the city of Espoo were obtained from national registers ( n=1867). Debt defaults at the age of 23 years were used as a measure of adulthood financial hardship. Caries recorded in dental check-ups and unnotified absence from dental appointments in childhood were derived from electronic health systems. Logistic regression models were fitted to investigate the extent to which these variables were associated with financial hardship in adulthood before and after adjusting for parental social assistance use. Results: The odds of adulthood debt defaults were higher for people with caries before the age of 13 years (odds ratio 1.37, compared with people without) and for people with significant caries multiple times (odds ratio 2.07). Unnotified absences from dental checks were strongly associated with debt defaults. These associations were substantially reduced after adjusting the models for parental social assistance use. Conclusions: The association between childhood dental care records and adulthood financial hardship mainly reflects the fact that parental socioeconomic status links to dental records. Nevertheless, data from dental care could be used in targeting appropriate measures to prevent financial hardship later in life.

Abstract Objectives The aim was to analyse the costs and duration of orthodontic-surgical treatment with mandibular advancement in the public health care sector in Finland. Materials The study was conducted as a retrospective registry study in a public district hospital on all nonsyndromic patients that were ethnic Finns and treated with full fixed appliances and mandibular advancement surgery in 2016–2020. Results The mean treatment duration of the included 45 patients was 28.1 months, including 18.9 months pre and 9.2 months postoperative orthodontics. The median number of visits was 27, including 17 visits before and 9 visits after surgery. The mean total treatment time was 14.5 h. The mean total direct costs per course of treatment were 7574 € to the municipality and 947 € to the patient. The costs positively correlated with the duration of the treatment (rho = 0.71, P = .000), but were not associated to gender or age of patient. The mean surgery time was 78 minutes, and significantly less with an experienced surgeon (P = .002). It was calculated that the mean minimum treatment costs would be 45% of the present total, achievable with a patient with optimum dental arches at the start of treatment. Limitations The major limitation of the study is the relatively small number of study subjects. Conclusion A 55% share of the costs is influenced by case- and operator-dependent factors. This indicates that the complexity and performance of the orthodontic phases of treatment are important determinants in the cost structure.

LähtökohdatKöyhyys, eriarvoisuus ja suun terveysongelmat kytkeytyvät toisiinsa. Selvitimme vanhempien toimeentulotuen saamisen ja lasten suunterveyden ja suunterveydenhuollon muuttujien välisiä yhteyksiä Espoolaisilla lapsilla.MenetelmätTutkimuksen aineisto sisältää tiedot vuonna 1997 syntyneistä, Espoossa koko lapsuutensa asuneista lapsista, joita on seurattu aikuisikään asti (n = 1 873). Aineistoon on yhdistetty tiedot vanhempien toimeentulotuen saamisesta ja lasten hammashoitokäynneistä Espoon kaupungin suun terveydenhuollossa. Suun terveydenhuollon muuttujia tarkasteltiin vanhempien toimeentulotuen käytön keston mukaan. Tulokset Henkilöillä, joiden vanhemmat olivat saaneet toimeentulotukea yli neljä vuotta, oli 2,7-kertainen riski ilmoittamattomaan poisjääntiin verrattuna henkilöihin, joiden vanhemmat eivät olleet saaneet toimeentulotukea. Pitkään toimeentulotukea saaneiden perheiden lapsilla oli myös 1,4-kertainen riski varhaiseen ja 3,6-kertainen riski toistuvaan kariesvaurioon verrattuna lapsiin, joiden perhe ei ollut saanut toimeentulotukea. Päätelmät Pitkäaikaisesti toimeentulotukea saaneiden perheiden lapsilla on ilmoittamattomia poisjääntejä hammashoidosta ja kariesvaurioita muita lapsia useammin. Niiden perheiden, joissa on taloudellisia vaikeuksia, lasten suunterveyttä tulisi tukea moniammatillisella yhteistyöllä.