Search

Objective: To validate a model framework comparing resources required for activities in the Community Dental Service. The framework consisted of five levels of care of increasing complexity for six groups of patients. The patient groups were: children with behavioural problems, mentally disabled patients, anxious adults, paedodontic patients, medically compromised and physically disabled patients., Design: Delphi study using two sequential questionnaires. Participants were asked to rate the difficulty of 29 different treatments on a scale from 1 to 100., Participants: Six clinical directors and eleven senior dental officers working in the Community Dental Service in the North West of England., Results: Seventeen of the 29 treatments were rated at the level of care predicted by the model. Nine were rated lower and three higher. Within the patient groups the order of increasing complexity, predicted by the model, was verified with only one exception., Conclusions: The research confirmed that it is possible to measure CDS activity in a rational way. Consensus was reached on a suitable framework which was simpler than the original model in having only four levels of care. The use of the modified model is now being tested in the Community Dental Service.

Objective: To investigate the relationship between household income defined by Super Profiles, a socio-economic indicator, and dental health and dental health behaviours., Basic Research Design: Analytical survey involving a clinical examination and a questionnaire to parents., Setting: Primary schools in Salford, UK., Participants: Two thousand five hundred and seventy eight 5-year-old children were examined; 1938 (75%) returned questionnaires., Main Outcome Measures: Mean caries experience and ages at first visit to dentist and when toothbrushing commenced., Results: Children in the highest income group had a mean dmft of 1.83 compared with 2.56 in the middle group and 3.43 in the lowest income group. The proportions who had visited a dentist by their second birthday were 71%, 64% and 62% respectively. The corresponding proportions having their teeth brushed by their first birthday were 69%, 58% and 57%., Conclusions: The study showed a relationship between Super Profiles, and the dental health and dental health behaviours of 5-year-old children.

At the time of the 1989-90 survey of 5-year-old children, co-ordinated by the British Association for the Study of Community Dentistry, a questionnaire about dental health behaviour was sent home to 2,390 parents in Salford and 2,098 in Trafford. The response rates were 78 per cent and 81 per cent respectively. The questionnaire was repeated for the 5-year-old survey in 1993-94 with the aim of finding out if there had been any changes: 2,794 parents were contacted in Salford and 2,343 in Trafford. The response rates were 75 per cent and 73 per cent. The percentage of children who were having their teeth brushed before they were aged one and who had visited a dentist by their second birthday rose in both districts. Campaigns at regional and district levels are thought to have influenced these improvements. The percentage of children who had experienced toothache and the proportion who had received a general anaesthetic for tooth extraction were similar in both years.

Questionnaires were posted to the parents of 293 5-year-old children who had been dentally examined at school in Stretford, Manchester, UK. Replies were received from 195 addresses and consisted of 182 mothers and 149 fathers. The mothers who replied were divided into three groups; 99 who reported that they attended the dentist for regular check-ups, 38 who went for occasional check-ups and 45 who only went when having trouble. The mean numbers of decayed teeth of their children were 0.92, 1.50 and 2.00 respectively (p < 0.05) and the mean dmft scores were 1.36, 2.05 and 2.69 (p < 0.05). Fifty children whose mothers reported having 25 teeth or less had a mean of 2.12 decayed teeth compared with 1.06 for 125 children whose mothers had 26 teeth or more (p < 0.01). The mean dmft scores for the two groups were 2.68 and 1.59 respectively (p < 0.05). In contrast, dividing the children into groups based on reported attendance patterns and numbers of natural teeth of their fathers did not show any significant differences in decayed teeth or dmft scores. It is concluded that the dental attendance pattern and dental health of the mother, but not of the father, are important influences on the dental health of 5-year-old children.

Five-year-old children in two district health authorities in the North Western Region of England were examined during 1989-90. Questionnaires were issued to parents to determine whether dental health and related behaviours were associated with socio-economic status. Parents of 1858 children in Salford (response rate = 78 per cent) and 1691 in Trafford (response rate = 81 per cent) returned the questionnaires. Their replies were analysed by dividing the children into a hierarchy according to a classification of residential neighbourhood (ACORN). Significantly fewer in the highest of three Divisions in both districts had suffered from toothache and had undergone a general anaesthetic to have teeth extracted. They were also more likely to have had their teeth brushed with toothpaste by their first birthday and to have visited the dentist by their second. Because ACORN had detected these differences in dental health related behaviour it was possible to identify localities towards which dental health promotion activities can be directed.

A seven week induction course for homecarers of mentally handicapped adults, organised by the Social Services Department in Salford, UK, includes a dental health education session of one and a half hours. The session is divided into three parts; an illustrated discussion, a demonstration of tooth-brushing and a practical component session where carers are divided into pairs and carry out oral hygiene measures for each other. The effectiveness of the session has been assessed using a questionnaire. This was completed by 33 carers who attended the session and 31 carers who had not. Many members of both groups knew about the shape and colour of healthy gums and what plaque was. However significantly fewer of the control group knew that gum disease resulted from a lack of toothbrushing, what to do with bleeding gums and the amount of toothpaste to use on the toothbrush.