Glasgow nursery-based caries experience, before and after a community development-based oral health programme's implementation.
OBJECTIVE
To develop and evaluate NHS-based strategies likely to improve dental health and reduce inequalities in pre-5-year-old's oral health in Greater Glasgow, Scotland, by ecological study of community-based oral health promotion programmes in two of the area's most socio-economically deprived communities.


METHODS
Following an initial health service-based Oral Health Needs Assessment (OHNA) in a severely deprived community, culturally relevant dental health promotion interventions were initiated with multidisciplinary collaborative networks. Ecological studies to monitor dental health involved cross-sectional caries epidemiology of nursery children aged 36-59 months at baseline (1995/96), after two (1997/98) and four years (1999/00), in the G22 (pilot) and G33 post code areas. These areas had similar socio-economic status (SES), i.e. severe social deprivation.


RESULTS
At the outset, mean dmft scores in the pilot area for the age groups 36-47 months and 48-59 months were respectively 3.9 (95% CI 2.8 5.1) and 5.9 (95% CI 5.1-6.8), with the proportions of caries-free children being 38% and 17%, respectively. Reductions in mean dmft of 46% for the 36-47 month-olds and 37% for the 48-59 month-olds occurred in the pilot public health programme area over the four-year period; the proportions of caries-free children increased to 51% and 40%, respectively. During the first two years of the programme, increases in the mean dmft of 36-47 month- and 48-59 month-olds in the G33 (comparator) area were recorded. However, this trend was reversed significantly two years later following the introduction of a similar community development-based caries-prevention programme.


CONCLUSIONS
While not being able to attribute causation, a programme of community development to promote the dental health of pre-school children residing in two socio-economically disadvantaged areas of Glasgow was associated with significant improvements in the dental health of these pre-school populations.
Blair
Y
Y
NHS Greater Glasgow, Dental Public Health Unit, University of Glasgow, Scotland, UK. y.blair@dental.gla.ac.uk
Macpherson
L M D
LM
McCall
D R
DR
McMahon
A D
AD
Stephen
K W
KW
D002675:Child, Preschool; D003153:Community Health Services / Q000379:methods / Q000458:organization & administration*; D004245:DMF Index; D003731:Dental Caries / Q000453:epidemiology* / Q000517:prevention & control; D006293:Health Promotion / Q000379:methods*; D006801:Humans; D009313:National Health Programs; D009909:Oral Health; D016730:Program Development / Q000379:methods; D012606:Scotland / Q000453:epidemiology; D012959:Socioeconomic Factors