Publications

Scottish Health Boards' Dental Epidemiological Programme

Report of the 1996/97 Survey of 12 Year Old Children

Executive Summary

Prepared by:

NB Pitts, JA Davies, HE Fyffe
Dental Health Services Research Unit,
University of Dundee.

The Scottish Health Boards' Dental Epidemiological Programme (SHBDEP) is a joint venture between all fifteen Health Boards (represented through the Chief Administrative Dental Officers/Consultants in Dental Public Health Group) and the Chief Scientist Office's Dental Health Services Research Unit based at the University of Dundee. Standardised surveys are undertaken on randomly selected samples of children across Scotland using the criteria and timetable agreed by the British Association for the Study of Community Dentistry (BASCD). This enables Health Boards to compare their results with other areas of Scotland and with other parts of the UK. These surveys are essential for monitoring progress towards the targets set in the recent Oral Health Strategy for Scotland.

Aim

The aim of this year's survey was to determine, from this large representative sample, current levels of tooth decay (dental caries measured clinically at the dentinal level) in 12 year old children in Scotland. These results are summarised below. Information was also collected on fissure sealants, oral cleanliness, developmental defects of enamel and orthodontic treatment needs along with, for the first time, the views of the children on certain aspects of the appearance of their teeth. Details of these other aspects of the survey can be found in the full Report.

Key Results

Dental caries experience (D3MFT) for Scotland: The overall result, a mean number of decayed, missing and filled teeth (D3MFT) of 1.75 represents an improvement from the level of 2.08 reported in the previous survey of Scotland's 12 year olds in 1992/93. Unfortunately it remains higher than the 1.27 recorded for this age group for dentinal caries experience in Great Britain in 1992. The map opposite (Appendix L of the Report) shows the variation in the distribution of dentinal caries experience across Scotland.

Dental caries experience (D3MFT) for individual Health Boards: The Figure opposite (Figure 1 of the Report) shows the mean number of decayed, missing and filled teeth (D3MFT) for each Health Board and the 95% confidence intervals associated with each mean. The size of the error bars indicates the limited extent to which this Figure can be considered a simple league table of caries experience; overlapping error bars indicate differences which are not statistically significant.

The proportion "with caries experience" and the pattern of attack: More than half (57.6%) of the 12 year olds were found to have suffered caries experience at the dentinal level. Removing those with D3MFT=0 from the calculation, it is found that the mean D3MFT for those with caries experience (D3MFT>0) was 3.04. 75% of the disease experience was in the first permanent molars.

Uneven distribution of decay (D3): The skew in the distribution of decay, seen across all age groups, must be appreciated. Under half (37%) of these 12 year olds had one or more decayed teeth (D3T>0), with half of the decayed surfaces being found in an unfortunate 7% of the children.

Trends over time: The continuing fall in D3MFT for 12 year olds between 1992/93 and 1996/97 might have been predicted from the data on 5 year olds in the 1980s, as the children in the present survey would have been aged 5 years in 1989 and are the first adolescents in the SHBDEP series who can be linked back to the lower caries rates achieved in 5 year olds by the end of the 1980s. There has been only a small drop in the number of decayed teeth (D3T) from 0.87 to 0.81, little change in the number of teeth missing due to caries (MT) from 0.19 to 0.17, but a 23% fall in the number of filled teeth (FT) from 1.01 in 1992/93 to 0.78 in the present survey. The relative amount of restorative care provided ([FT/D3MFT]x100, the "Care Index") has shown a slight worsening from 49.7% to 44.3%, indicating that almost half of the dentinal disease experience in permanent teeth has remained unrestored even though most dentists would recommend fillings for such teeth.

National targets and the future: In 1992/93 only 4 Health Boards had achieved a mean D3MFT of 1.5 or less, the target for the year 2005 specified in the Oral Health Strategy for Scotland. This year seven Health Boards have reached the target level but a mean D3MFT of 1.75 for Scotland's 12 year olds indicates that improvements are still required. However, evidence from other SHBDEP surveys highlight the possibility that the downward trend will not be maintained without further preventive action. The next survey for this age group, due in 2000/2001, will be important in ascertaining whether further improvements can be made.

More detailed information is available in the full Report. Copies can be obtained from the Dental Health Services Research Unit, Dental School, Park Place, Dundee DD1 4HR (price 10 pounds sterling per copy). For local information please contact the Chief Administrative Dental Officer / Consultant in Dental Public Health at the relevant Health Board.

This executive summary is accompanied by two figures:

1 Mean D3MFT Results for Scotland by Health Board 1996/97 (D3=caries into dentine)

2 Mean number of Decayed, Missing and Filled teeth (D3MFT) per child for each Health Board

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