June 2020

Volume 37, Issue 2

Deprivation and child dental attendance in England: exploring the shape and moderators

Authors: Candy Cecilia Salomon-Ibarra Amir Rezaee Alexander John Morris Vahid Ravaghi
doi: 10.1922/CDH_00020Ravaghi06

Abstract

Objective: To describe the shape of the relationship between area deprivation and dental attendance (DA) in children aged 5 years and under in England and the modifying effect of caries prevalence, ethnicity, family profile and dentist-to-population ratio. Basic research design: DA rates were calculated at lower-tier local authority level (LA, n=326) using NHS data for the year to March 2017. LA deprivation was determined by Index of Multiple Deprivation 2015. Caries prevalence was retrieved from the 2016/17 National Dental Epidemiology Programme; ethnicity and family profile from Census 2011 and dentist-to-population ratio from NHS statistics. Fractional polynomial (FP) models explored the shape of the relationship. Multivariable regression models were adjusted for covariates. The effect of moderators was estimated by adjusted marginal effects. Clinical setting: English Lower-tier LAs. Main outcome measure: Shape of the relationship between DA and deprivation and its moderators. Results: Best-fitting second-order FP model (p=0.582) did not provide a better fit for the relationship than the linear model. Therefore, the linear model was selected for final analysis. Deprivation was associated with decreased DA rates (Coefficient=-0.39, 95%CI=-0.53,-0.24; p=<0.001); while White ethnicity (Coefficient=0.35, 95%CI=0.29, 0.41; p=<0.001), single parenthood (Coefficient  =  2.21, 95%CI=0.91,3.51; p=0.001) and caries prevalence (Coefficient  =0.34, 95%CI=0.25,0.44; p=<0.001) with increased rates. These moderated the relationship. Conclusions: We hypothesised that the shape of the relationship between deprivation and DA could be curvilinear with higher rates in the extreme ends of deprivation. However, the analysis showed a linear association, moderated by the effect of ethnicity, single parenthood and disease level. Keywords: socioeconomic factors, dental caries, dentistry, dental health services, dental attendance

£10 single article

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Everyone else is using it, so why isn’t the UK? Silver diamine fluoride for children and young people 143-149 £10 single article
Community-based oral health interventions for people experiencing homelessness: a scoping review 150-160 £10 single article
Deprivation and child dental attendance in England: exploring the shape and moderators 161-166 £10 single article
Letter to the Editor 167-168 £10 single article
Meeting report: The 4th Iranian Congress of Community Oral Health 169-169 £10 single article
IADR Symposium report Special Supplement in the March 2020 Issue of Community Dental Health 170-170 £10 single article

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