Decomposing Socio-Economic Inequalities in Edentulism Among Community-Dwelling Older Adults in a Socially Diverse Metropolitan by Using the Erreygers Concentration Index Publisher Pubmed

Summary: Can socio-economic disparities lead to edentulism in older adults? Research suggests that older and poorer individuals in Tehran face significant oral health inequalities. Urgent health interventions needed! #OralHealth #ElderlyCare

Joudi A ; Sargeran K ; Hessari H
Source: BMC Geriatrics Published:2026

Abstract

Objectives: Edentulism, the complete loss of natural teeth, profoundly affects the oral health and quality of life of older adults. Socio-economic disparities are a critical determinant of oral health outcomes. This study assessed and decomposed socio-economic inequalities in edentulism among community-dwelling older adults in Tehran in 2023. Materials and methods: The analytical study was employed data from the Oral Health Utilization Survey. Participants aged ≥ 60 years (N = 478) were selected using a stratified random sampling method. Data were collected using a validated questionnaire including socio-demographic variables, individuals’ oral health-related behaviors and oral health information, and outcome variable of edentulism. The Erreygers-corrected concentration index (ECI) was employed to demonstrate disparity and its gradient qualitatively and quantitatively. A decomposition approach based on logit model was used, and analysis was conducted by STATA 16. Results: The participants’ mean age was 68.9 (SD = 6.4) years. Approximately 48.0% of the participants reported no dental care utilization. The ECI was − 0.23 (95% CI: -0.31 to -0.15), indicating a pro-poor concentration of edentulism. Key contributors included wealth status (72.08%), chewing difficulties (-17.30%), and halitosis (5.02%). Notably, older age, living alone, and lower socio-economic status were associated with higher odds of edentulism. Conclusion: Edentulism among older adults in Tehran is disproportionately concentrated among socio-economically disadvantaged groups. Edentulism was highly contributed to age, living arrangements, socio-economic status, and difficulty while chewing. Targeted public health interventions addressing socio-economic disparities and oral health promotion are essential to improve equity in oral health outcomes for the aging population. © The Author(s) 2026.