December 2018

Volume 35, Issue 4

A multi-variable analysis of four factors affecting caries levels among five-year-old children; deprivation, ethnicity, exposure to fluoridated water and geographic region

Authors: Weston-Price S Copley V Smith H Davies GM
doi: 10.1922/CDH_4383Weston-Price06

Abstract

Objective: To assess the role of factors posited to affect population caries levels across England. Basic research design: Multivariable regression analysis assessing four potential determinants of caries severity and prevalence: deprivation, exposure to fluoridated water, ethnicity and geographic region Participants: Random sample of 121,875 five-year-old children in England in the 2014/15 academic year. Main outcome measures: Decayed, missing and filled teeth, with decay measured at the dentinal level, (d3mft), presented as prevalence (dmft>0) and extent of decay among children who have any (d3mft if d3mft>0). Independent variables: Parental reported ethnicity from school records, index of multiple deprivation (IMD) scores, region and exposure to water fluoridation calculated utilising home postcodes. Results: The data support wider literature displaying associations between caries and deprivation across a social gradient. The important, new findings are deprivation, some ethnic groups and lack of exposure to water fluoridation are all associated with increased prevalence and severity of caries when considered together and independently. New evidence supports the impact of water fluoridation on health inequalities in that the greatest impact of exposure to fluoridated water was seen in the most deprived children and those from an Asian / Asian British ethnic group. Conclusions: Five-year-old children who were from the most deprived areas, not exposed to fluoridated water, of an Eastern European ethnic group and living in the North West demonstrated the highest prevalence and severity of caries in the survey under scrutiny. This is of public health importance, providing evidence for population groups to target with health improvement activities. Keywords: caries, children, deprivation, ethnicity, water fluoridation,

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Other articles in this issue

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Editorial: Public Health at Christmas 195-196 Download
Dental Public Health in Action: Understanding oral health care needs and oral health-related quality of life in vulnerable adults in Plymouth 197-200 £10 single article
Dental Public Health in Action: A feasibility study to explore the governance processes required for linkage between dental epidermiological, and birth cohort, data in the UK 201-203 £10 single article
Illuminating Mexican migrant adolescents’ dental access and utilization experiences 204-210 £10 single article
Results of a two year dental health education program to reduce dental caries in young Aboriginal children in New South Wales, Australia 211-216 £10 single article
A multi-variable analysis of four factors affecting caries levels among five-year-old children; deprivation, ethnicity, exposure to fluoridated water and geographic region 217-222 Download
The impact of age and deprivation on NHS payment claims for domiciliary dental care in England 223-227 £10 single article
A critical review of protocols for conventional microwave oven use for denture disinfection 228-234 £10 single article
Why might patients in the UK consult a general medical practitioner when experiencing dental problems? A literature review of patients’ perspectives 235-240 £10 single article
The distribution of dental health specialist locations in Sri Lanka 241-246 £10 single article
Decision tree analysis for factors associated with dental caries in school-aged children in Japan 247-251 £10 single article
Dentist’s views on incorporating oral health collaborative practice into primary medical care in Ireland 252-256 £10 single article

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