NDIP 2003
Detailed Inspection Results
How has the dental health of Scottish five year
olds fared over time?
Trends over time in the percentage of children who showed
no signs of having decay or treatment of decay in any of their teeth are
shown in Figure 5. The latest data from the current inspection appear to
add to the overall picture of a bottoming out of the decline in the prevalence
of decay seen in the nineteen-eighties, a phenomenon which is being increasingly
observed in other areas of Europe[11].
In England, (where overall decay levels are lower than Scotland) the dental
health of five year olds appears to be deteriorating, following a long plateau[12].
The similar trend being observed in the Scottish results at
a higher level than in England may reflect the general poorer health status
of Scotland compared to England and the greater burden of ill-health carried
by Scotland in relation to other developed nations.
Figure 5. Trends in time in the percentage of 5-year-old
children with no obvious decay experience
Figure 6 illustrates the changes in the number of obviously
decayed and filled teeth for Scottish five year old children from 1983 to
2002. A large drop occurred between the 1983 Office of Population Censuses
and Surveys (OPCS) Child Dental Health Survey[13]
and the first SHBDEP survey of five year olds in 1987/88. The figure appears
to have subsequently settled at around 2 decayed and filled teeth.
Figure 6. Trends over time in the number of decayed
and filled teeth.
| The importance of monitoring children's dental
health and being able to make comparisons over a long period of time
is illustrated by Figure 6 above. By viewing the results as a series,
rather than making year on year comparisons, it can be seen that minimal
improvement in the number of decayed and filled teeth has occurred
since the mid 1980's. This year's NDIP inspection figure of 2.11 differs
only a little from the SHBDEP survey figure of 2.22 in 1987 |
How do the results of the 2003 NDIP Inspection
compare with the last SHBDEP survey in 1999?
When the data collected for the last SHBDEP survey in 1999[14]
is compared with the current NDIP Inspection, the number of decayed, missing
and filled teeth has increased significantly. This rise is largely due to
an increase in the number of missing teeth. The proportion of the five year
old population with extractions has not changed, but the number of missing
teeth for those children who have had extractions has increased by 20%.
Although the number of decayed teeth has not changed overall,
both the proportion of teeth with severe decay and the proportion of the
Primary I population with severe decay has increased. This may be explained
in part by the modest rise in the average age of the child participants
this year.
| |
1999
|
2003
|
| number of decayed, missing, and filled teeth |
2.55
|
2.76
|
| number of missing teeth |
0.5
|
0.65
|
| number of teeth with severe decay |
0.18
|
0.34
|
| number of missing teeth |
3.64
|
4.41
|
| (for children with extractions) |
|
|
| % of children with decayed teeth |
49.7
|
47.5
|
| % of children with missing teeth |
13.8
|
14.7
|
| % of children with severe decay |
9.2
|
15.4
|
|
Table 3. Comparison of decay figures in 1999 (SHBDEP) and 2003 (NDIP)
How clean were
the children's teeth?
Overall, 68% were considered to have clean teeth. Poor oral
hygiene leads to thicker plaque deposits and this is associated with obvious
decay[15]. Boys showed higher levels
of plaque than girls, particularly on the measure of "substantial"
plaque, where 60% of the children with substantial plaque (4.3% of the children
in total) were boys.
Was the level
of obvious decay spread evenly throughout the population of five year olds
in Scotland?
| Proportion of children |
with
|
share of disease
|
| Established decay |
|
|
| 1% of population |
had
|
8% of teeth with established decay
|
| 11% of population |
had
|
50% of teeth with established decay
|
| 48% of population |
had
|
100% of teeth with established decay
|
| Severe decay |
|
|
| 1% of population |
had
|
22% of severe decay
|
| 4% of population |
had
|
50% of severe decay
|
| 15% of population |
had
|
100% of severe decay
|
|
Table 4. Skewed distribution of decay
These results clearly demonstrate how unevenly decay and severe
decay are spread among Primary I children. For example, half of the teeth
with severe decay were seen in just 4% of the children inspected.
Is there a link between social deprivation and
poor dental health among Scottish five year olds ?
An approximate measure of social deprivation often used in
Scotland is DEPCAT[16]. This is a
scale of deprivation based on information gathered in the national census
every ten years and describes the social composition of residents in a particular
postcode sector. DEPCAT scores for each postcode area in Scotland are calculated
from the percentage of unemployed males, over-crowded households, households
without cars and people from social classes IV and V. The scale runs from
DEPCAT 1 (most prosperous) to DEPCAT 7 (least prosperous). The index has
been shown to be linked closely with measures of death, illness and health
service use and a clear association between DEPCAT measured social deprivation
and children's dental decay has been established[17].
Of the total 10,080 children examined in this NDIP Inspection,
98% were subsequently able to be linked to their respective DEPCAT scores.
Figure 7. Percentage of 5-year-olds with no obvious
decay experience by DEPCAT
Figure 7 graphically illustrates the yawning gap in dental
health between five year olds from the most deprived areas (DEPCAT group
7) and their more fortunate contemporaries from DEPCAT groups 1 and 2. The
children from DEPCAT 1 have reached the National Target of 60% with no obvious
decay experience in the year 2010 and have in fact met this within the original
timeframe (the year 2000). Additionally, those from DEPCAT 2 are within
two percent of meeting the target. Children from DEPCAT group 7 fall well
short with only 21% with no obvious decay. These results have varied little
since the measure was first used in relation to children's dental health
in Scotland in the mid 1990s.
As well as bearing the overall brunt of dental decay, children
from more socially deprived areas suffer more from severe decay. Nearly
three times as many children in DEPCAT groups 6 and 7 need extractions or
root treatment compared to children in DEPCAT groups 1 and 2. In most cases
this means the child will be given a general anaesthetic with the attendant
risks which this entails.
Continue to the third part of
the detailed results or back to Contents List
