Enhancing dental attendance rates for children from deprived areas in the UK

The influence of educational level and oral hygiene behaviours on DMFT index and CPITN index in an adult Italian population: an epidemiological study

OBJECTIVES

To estimate the influence of educational level and oral hygiene behaviours on the prevalence and severity of dental caries and periodontal disease in an adult Italian population attending the Oral Hygiene department of a public Dental Clinic.

METHODS

Dental caries was diagnosed according to the World Health Organization criteria. The DMFT index (decayed, missing, filled tooth) was used to record the dental caries' experience. The periodontal status was assessed using the community periodontal index of treatment needs (CPITN). Questionnaires on educational level and oral hygiene behaviours were also collected.

RESULTS

A total of 350 patients were enrolled. The mean DMFT value reported was 4.37 ± 3.06, and higher values were observed for male patients (P < 0.05). Increased CPITN scores and DMFT values were significantly correlated with lower level of education (P < 0.05). Subjects of high educational status showed significantly better oral hygiene habits (P < 0.05).

CONCLUSIONS

The oral health status, in terms of periodontal disease and dental caries, appears correlated with patients' educational level.

Evaluating “Starting Well,” the Scottish National Demonstration Project for Child Health: Outcomes at Six Months

This paper presents early findings from the evaluation of Starting Well, an intensive home visiting program aimed at improving the health of pre-school children in disadvantaged areas of Glasgow, Scotland. Using a quasi-experimental design, detailed survey, observation and interview data were collected on a cohort of 213 intervention and 146 comparison families over the first six months of the child's life. After controlling for relevant background characteristics, multivariate regression analysis revealed higher child dental registration rates and lower rates of maternal depressive symptoms in the intervention cohort. Findings are interpreted as positive evidence of early program impact. Implications, limitations and future plans for analysis are discussed. EDITORS' STRATEGIC IMPLICATIONS: Starting Well draws on elements of an Australian parent education program and an American home visitation model. The authors demonstrate how the program implementation, research questions, and measurement are designed to fit their Glasgow population and the Scottish public health system. Their quasi-experimental data suggest that this primary prevention program is a promising strategy for improving maternal and child health outcomes.

The role of team dentistry in improving access to dental care in the UK

The role of professionals complementary to dentistry (PCDs) in improving access to NHS primary dental care is discussed. The pattern of under-supply of dentists in poor socio-economic areas is highlighted and identified, in drawing a parallel to the workings of primary medical teams, as a possible area where PCDs could be used.

Capitation registration and social deprivation in England. An inverse 'dental' care law?

OBJECTIVE

To examine associations between NHS child dental registration data and area deprivation scores of English Health Authorities (N= 100) in 1996/97 and 1997/98.

METHOD

The Department of the Environment index of local conditions and the Jarman Underpriviledge Area Score from the 1991 census were used to measure deprivation. Prior to September 1997, children got free dental treatment under a capitation scheme with an NHS dentist. If they did not attend within 24 months their registration lapsed on the last day of December of the second registration year and they were deleted from the capitation list. After September 1997 the registration period was reduced to 15 months.

OUTCOME

Curve-linear regression of the Health Authority (HA) percentage of children registered, lapses in capitation registrations and deprivation scores.

RESULTS

In England 68% of children were registered in December 1996. The percentage registered in each Health Authority was associated with deprivation (DoE, r2=0.33, Jarman, r2=0.27 p<0.01). In January 1997, 17.8% (1,345,142) of children registered lapsed (HA range 12.8% to 30.3%) and this was also significantly associated with deprivation (DoE r2=0.66, Jarman, r2=0.51 p<0.01). Similar results were found in 1997/98.

CONCLUSIONS

Registration and lapse rates were significantly associated with social deprivation confirming that there is an inverse 'dental' care law for children in England. NHS capitation may widen dental health inequalities.