Income-related inequality in perceived oral health among adult Finns before and after a major dental subsidization reform

<p><b>Objectives</b> In Finland, a dental subsidization reform, implemented in 2001–2002, abolished age restrictions on subsidized dental care. The aim of this study was to investigate income-related inequality in the perceived oral health and its determinants among adult Finns before and after the reform. <b>Materials and methods</b> Three identical cross-sectional nationally representative postal surveys, concerning perceived oral health and the use of dental services among people born before 1971, were conducted in 2001 (<i>n</i> = 2157), in 2004 (<i>n</i> = 1814) and in 2007 (<i>n</i> = 1671). Three measures of perceived oral health were used: toothache or oral discomfort during the past 12 months, current need for dental care and self-reported oral health status. Concentration index was used to analyse the income-related inequalities. Its decomposition was used to study factors related to the inequalities. <b>Results</b> The proportion of respondents reporting need for dental care decreased from 2001 to 2007, while no changes were seen in reports of toothache or self-reported oral health status. Income-related inequalities in reports of toothache and perceived need for care widened, while the inequality in self-reported oral health remained stable. Most of the inequalities were related to income itself, perceived general health and the time since the last visit to dental care. <b>Conclusions</b> It seems that the income-related inequalities in perceived oral health remained or even widened after the reform.</p