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


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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Editorial: Child oral health; is there anything more to know? 108-109 Download
Caregiver oral health literacy: relationship with socioeconomic factors, oral health behaviors and perceived child dental status 110-114 £10 single article
Associations between caries levels and BMI measures among five-year-old children. Analysis and cross-sectional multi-variable analysis at an individual child level 115-120 £10 single article
Dental Public Health in Action:Challenges and learning in carrying out an enhanced sample to provide small area data for the dental survey of five-year-old children in England 121-124 Download
Randomized Controlled Trial: The effects of Short Message Service on mothers’ oral health knowledge and practice 125-131 £10 single article
Outcomes of a co-designed, community-led oral health promotion program for Aboriginal children in rural and remote communities in New South Wales, Australia 132-137 £10 single article
Greater child dental health inequality in England compared to Wales and Northern Ireland, despite lower average disease levels 138-142 Download
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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