Scotland's National Dental Inspections Programme 2003
The National Dental Inspection Programme Basic Inspections
The previous section of this report relates to the detailed inspection data collected as part of the National Dental Inspection Programme of 2003. This section gives more information on the complementary, Basic Inspections for all Primary I children in Scotland which provide information for parents and children on the child's oral health status. In its anonymised, aggregated form the data also provides information for schools (where numbers are sufficient to ensure anonymity), local authorities and the NHS and can inform strategies for health promotion activities and service planning. Over time the new system will provide essential information to parents and act as a tool to inform health improvement strategies at local level throughout Scotland.
Background
It is recognised that preventive care and early treatment intervention can positively influence the oral health status of children and adults. However, the risk of children developing poor dental health is greater for some children than others and this programme identifies three risk categories :
Risk Category A (greatest risk)
Children with acute problems requiring an urgent appointment with the dentist. This would normally relate to children who, by the age of five, have abscesses or advanced tooth decay.
Risk Category B
Children who need dental care and require a routine appointment with a dentist. These would include children who had obvious tooth decay or who were at an increased risk of getting tooth decay.
Risk category C (least risk)
Children who have no obvious oral health problems. Children in this category would be encouraged to attend a dentist to ensure that they can benefit from ongoing preventive advice and treatment.
How can the NDIP Programme be applied to local services?
Helping the NHS
The NHS can receive information at Local Health Care Cooperative (LHCC) level or, in the future, Community Health Partnership level and at Health Board level. This can provide valuable information in highlighting areas requiring health promotion and dental service input and will be a useful monitoring tool over time.
Helping Local Authorities
Local Authorities can receive the anonymised, aggregated data at primary school level (where numbers are sufficient to ensure anonymity) or at "cluster" level. The latter are primary schools grouped according to which secondary school the children are most likely to progress. It is hoped that with strategies in place to improve health in schools, progress will be seen over time at each monitoring level.
How can results from NDIP Basic Inspections be presented at a local level?
The following examples are drawn from the Basic Inspections in 2003 for Lanarkshire Health Board area and show how the statistics might be presented locally.
Figure A1. Percentage of 5-year-olds in each health risk category in Lanarkshire Health Board
It is obvious that considerable variation will exist within a Health Board area. For example, as can be seen in Figure A2, in Lanarkshire as a whole, LHCC Code 4 has a far smaller proportion of children requiring urgent treatment than those in LHCC Code 1.
Figure A2. Percentage of risk categories of 5-year-olds
in each LHCC in Lanarkshire Health Board area
Variations within an area may be marked however and inspection results from smaller areas are useful for targeting where resources might have the greatest impact. Looking at each school within a LHCC (Figure A3) reveals substantial difference at this level and offers the opportunity of greater refinement in the planning process.
Figure A3. Variation in risk categories by school within the LHCC code 5
The National Dental Inspection Programme would not have been possible without the efforts of many people throughout Scotland who worked together to ensure its success. The Programme is indebted to:
The participating schools, the children and their parents
Headteachers Mrs Catriona Wood and Mr John Dempsey and the children from Tulloch and Letham Primary Schools in Perth where the training and calibration exercises were conducted
Dental Health Services Research Unit
Scottish Local Education Authorities
Scottish Health Boards
The Consultants in Dental Public Health and Chief Administrative Dental Officers Group
The Community Dental Officers who conducted the inspections
The Scottish Association of Community Dental Directors
Glossary of terms used in this report
Community Dentists
dentists employed by Health Boardsdeciduous teeth
milk or baby teethdental (or tooth) decay
rotting of tooth due to microbial activity which in childhood can usually be attributed to a high sugar diet and inadequate protective measure such as brushing with fluoride toothpastedental decay experience
having decay or past treatment of decaydentine
sensitive layer of tissue under the hard enamel surface of the tooth which forms the bulk of the tooth and surrounds the pulpepidemiology
the scientific study of disease in order to discover means for its prevention and controlincisor
biting tooth at front of mouthmissing teeth
teeth extracted because of decaymolar
chewing or grinding tooth at rear of mouthocclusal surface
surface of molar tooth which makes contact with opposing tooth in order to chew or grindplaque
sticky film left on tooth when toothbrushing has been absent or inadequatepulp
soft tissue at core of tooth which contains nerves and blood vesselsrestorable or substantial decay
decay that is treatable by fillingsroot treatment
filling and sealing of the root canal which contains the nerves, blood and lymphatic vessels of a toothsubstantial plaque
thick sticky film left on tooth when toothbrushing has been absent or inadequateunrestorable or severe decay
decay that can only be treated by root fillings or extractions
Report analysis and preparation undertaken by the Dental Health Services Research Unit,
University of Dundee and Chief Scientist Office
For further details of this report please contact
DHSRU, Mackenzie Building, Kirsty Semple Way, Dundee DD2 4BF.
t 01382 420050 f 01382 420051 e D.Ingham@cpse.dundee.ac.uk
Local information can be obtained from the appropriate Consultant in Dental Public Health
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