Inequalities in dental caries of 5-year-old children in Scotland, 1993-2003

Abstract

Background: Previous research suggests there are significant differences between socio-economic groups in prevalence and amount of decayed missing and filled primary teeth (d₃mft). The aim of this study was to describe the variation in obvious tooth decay experience amongst 5-year olds in Scotland and to look at the association between d₃mft and deprivation in Scotland. Methods: Data derived from 1993 to 2003 National Dental Inspection Programme were modelled using Bayesian multilevel zero-inflated Negative Binomial models, adjusting for age, sex and the deprivation. Results: Deprivation is positively and significantly associated with having d₃mft; the odds of a child in DepCat 7 (most deprived) having d₃mft in 1993 were 7.49 (5.03–11.15) that of a child in DepCat 1 (most affluent). Inequalities in the prevalence of d₃mft have reduced and in 2003 the odds of a child in DepCat 7 having d₃mft were 4.60 (3.47–6.14) that of a child in DepCat 1. However, socio-economic inequalities in the amount of d₃mft for those with d₃mft have seen no reduction and have in fact increased between 1993 and 2003, with this increase approaching significance. Conclusion: While socio-economic inequalities in prevalence of children with d₃mft have decreased in recent years, socio-economic inequalities in the amount of d₃mft for those with d₃mft persist. This suggests that improvements are only seen for those children with the potential for low d₃mft. High d₃mft persists among children from more deprived areas. The national target conceals this apparent inconsistency.