Tooth decay and deprivation in young children

Key Points

• Ward level analyses demonstrated a strong relationship between deprivation and dmft of 5-year-old children, also a strong inverse relationship between deprivation and contact with services in 3-5-year-old children.

• At ward level dmft of 5-year-old children had a strong inverse relationship with contact with services for 3-5-year-olds.

• Further research is needed across the UK to establish if this relationship is specific to Ellesmere Port, and if this relationship is independent of deprivation.

• Further research is also needed to determine if the relationship between dental caries and contact with dental services is caused by the influence of primary dental care or is a marker for population oral health-related behaviour.

Abstract

Objective To measure the relationship between tooth decay, contact with dental services and deprivation at electoral ward level.

Setting The study was carried out in 1998 in Ellesmere Port in the North West of England.

Subjects and Materials All children younger than six years resident in Ellesmere Port registered with GDS services and those using CDS services were matched against the HA population register to identify unregistered children. Rates for children aged 3-5 years 'in contact' with primary dental care services, whether CDS or GDS, were calculated at ward level. One calibrated examiner examined all 5-year-old children in Ellesmere Port and dmft scores were calculated at ward level. Ward deprivation was measured using the Jarman score. Bivariate linear regressions at ward level were performed in turn between: dmft and Jarman score; rates for 3-5-year-olds in contact with dental services and Jarman score; and dmft and rates for 3-5-year-olds in contact with dental services.

Results A significant linear relationship was observed between dmft and Jarman score (P=0.02, R2 = 0.43). Significant inverse relationships were found between rates for 3-5-year-olds in contact with dental services and Jarman score (P=0.001, R2 = 0.67), and also between dmft and rates for 3-5-year-olds in contact with dental services (P=0.002, R2 = 0.65).

Conclusions A strong inverse relationship was found between dental caries and contact with primary dental care services at electoral ward level. This relationship needs to be explored over a wider geographical area to establish if it is consistent and independent of deprivation.

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