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1. Introduction
Socioeconomic inequalities in health refer to the different health-related opportunities and resources that people of different social classes have, so that the most disadvantaged groups are in worse health than their better-positioned counterparts. These differences have their origin in the inequalities of the economic and social policies that exist in society [1]. In this sense, studies carried out in several countries around the world, both developed and developing, show the existence of socioeconomic inequalities in various aspects of health. It is observed that the socioeconomically disadvantaged population is generally the one with the lowest levels of health [2,3,4].
Dental caries continues to be one of the main oral health problems worldwide in school-aged children, and are concentrated in the most disadvantaged social groups [5]. Pitts et al. [6] mention that there are marked differences in caries-related health inequalities in developing and developed countries. Also, it is evident that there is a gradient in caries levels between the least developed and the most developed countries. According to epidemiological studies, in Nicaragua, the prevalence of dental caries in primary dentition is 77.7%, with an average dmft (decayed, missing and filled teeth) index of 3.54 ± 3.13 for children 6 to 9 years of age [7]. In permanent dentition the prevalence is 37.9%, with a mean DMFT (Decayed, Missing and Filled teeth) index of 0.98 ± 1.74 [8]. At the same time, it is observed that little more than 50% of caries lesions in the permanent dentition present treatment needs [9]. Likewise, there are differences between the different social groups, suggesting certain socioeconomic inequalities in oral health in the country. This disease represents a substantial burden both for health systems and for households, due to the costs required for their treatment; the more severe the lesion, the greater the technology and the resources required, so families often incur direct out-of-pocket expenses to obtain the needed services to maintain adequate oral health [10]. According to the World Health Organization, there is limited availability or inaccessibility of oral health services, which makes their utilisation rates particularly low among some vulnerable groups of the population. Moreover, it is estimated that in high-income countries, traditional curative dental care consumes between 5% and 10% of public health expenditure [11].
At the...