Evaluating a community-based dental registration program for preschool children living in areas of high social deprivation

  • S. Yuan
  • G. Kerr
  • K. Salmon
  • P. Speedy
  • R. FreemanEmail author


Aim: This was to evaluate the effectiveness of a community-based program to promote dental registration and access to dental services for preschool children residing in areas of high social deprivation using monthly registration data provided by the Central Services Agency (CSA). Design: A quasi-experimental non-equivalent two group comparison. Setting: Areas of high social deprivation in the greater Belfast area. Methods: The dental registration program was conducted by community-based nurses (health visitors). The health visitors provided oral health education and distributed registration vouchers to mothers of new babies during home visits. The mothers exchanged the vouchers for motivational materials from the participating dental practices. Preschool child registration data were obtained from the CSA to evaluate the effectiveness of the program. Results: The registration rates were significantly greater 5 months after the program for 0–2-year old children residing in the intervention wards compared with control wards. During the program the rate of change in registration for the 0–2-year-old group residing in the intervention wards was significantly greater compared with those residing in the control wards (t [DF: 21]=4.26: p<0.001). There was a significant increase in registration rate 5 months after the program compared with 6 months before the study started for the 0–2 year old group residing in the intervention wards compared with those residing in the control wards (t[df:21]=3.33:P=0.003). There were no equivalent effects for the 3–5-year old group. Conclusion: The adoption of a community-based approach assisted in promoting dental registration and access to dental services for preschool children residing in areas of high social deprivation.

Key words

dental attendance preschool children social deprivation 


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  1. Angelillo IF., Anfosso R., Nobile CG., Pavia M. Prevalence of dental caries in school children in Italy. Eur. J. Epidemiol 1998; 14: 351–357.PubMedCrossRefGoogle Scholar
  2. Antunes JL., Narvai PC., Nugent ZJ. Measuring inequalities in the distribution of dental caries. Community Dent Oral Epidemiol 2004; 32: 41–48.PubMedCrossRefGoogle Scholar
  3. Bentley E. Promoting registrations of young children. In (eds) E Bentley et al. Working together to promote oral health. London. FDI World Press. 1995.Google Scholar
  4. Bullock C., Boath E., Lewis M., Gardam K., Croft P. A case-control study of differences between regular and causal adult attenders in general dental practice. Prim Dent Care 2001; 8: 35–40.PubMedCrossRefGoogle Scholar
  5. Carson P. Freeman R. Characteristics of children referred by general dental practitioners for dental general anaesthesia. Prim Dent Care 2000; October: 163–167.Google Scholar
  6. Carson P. Freeman R. Dental caries, age and anxiety: factors influencing sedation choice in the treatment of children attending for emergency dental care. Community Dent Oral Epidemiol 2001; 29: 30–36.PubMedCrossRefGoogle Scholar
  7. Cattell V. Poor people, poor places, and poor health: the mediating role of social networks and social capital. Soc Sci Med 2001; 52: 1501–1516.PubMedCrossRefGoogle Scholar
  8. Central Services Agency. Northern Ireland Family Practitioner Services Statistical Report 2003/2004. Northern Ireland Research of Statistics Agency, Belfast. accessed November 2005.
  9. Chen M: Oral health of disadvantaged populations. In: Cohen LK, Gift HC (Hrsg.): Disease prevention and oral health promotion. Socio-dental sciences in action. Munksgaard, Copenhagen 153–306, 1995.Google Scholar
  10. Department of Health, Social Services and Public Safety. An oral health strategy for Northern Ireland. Belfast, DHSSPSNI, 2004a.Google Scholar
  11. Department of Health, Social Services and Public Safety, Northern Ireland. Priorities for action 2004/2005. Planning priorities and actions for the health and personal social services. Belfast. DHSSPS. 2004b.Google Scholar
  12. Department of Health, Social Services and Public Safety, Northern Ireland. Dental branch report 2004/2005. Belfast. DHSSPS. accessed November 2005.
  13. Department of Health. NHS dental care for patients not registered with an NHS dentist. accessed June 2006.
  14. Eckersley A J and Blinkhorn F A. Dental attendance and dental health behaviour in children from deprived and non-deprived areas of Salford, Northwest England. Int J Paediatr Dent 2001; 11:103–109.PubMedCrossRefGoogle Scholar
  15. Hendricks S. Freeman R. Sheiham A. Why inner city mothers take their preschool children for medical and dental check-ups. Community Dent Health 1990; 7: 33–42.PubMedGoogle Scholar
  16. Hjern A., Grindefjord M., Sundberg H. Rosen M. Social inequality in oral health and use of dental care in Sweden. Community Dent Oral Epidemiol 2001; 29: 167–174.PubMedCrossRefGoogle Scholar
  17. Huygens I. Towards social change partnerships: responding to empowerment of oppressed groups with voluntary depowerment of dominant groups. Paper presented at the Biennial Conference of the Society for Community Research and Action, Columbia, South Carolina. 1997.Google Scholar
  18. Kay E, Locker D. A systematic review of the effectiveness of health promotion aimed at improving oral health. Community Dent Health 1998: 15(3): 132–44.PubMedGoogle Scholar
  19. Kelly M, Steele J, Nuttall N, et al. Adult Dental Health Survey. Oral health in the United Kingdom 1998. London. The Stationery Office, 2000.Google Scholar
  20. Kinirons M, McCabe M. Familial and maternal factors affecting dental health and dental attendance of pre-school children. Community Dent Health 1995; 12:226–229.PubMedGoogle Scholar
  21. Kowash, M.B., Pinfield, A., Smith, J. and Curzon, M.E.J. Effectiveness on oral health of a long-term health education programme for mothers with young children. Br Dent J 2000;188, 201–205.PubMedGoogle Scholar
  22. Maas WR. Access to care-what can the United States learn from other countries? Community Dent Oral Epidemiol 2006; 34: 232–240.PubMedCrossRefGoogle Scholar
  23. Macek MD, Wagner ML, Goodman HS, Manz MC, Marrozzo Dental visits and acess to dental care among Maryland schoolchildren. J Am Dent Asso 2005; 136:524–533.Google Scholar
  24. Marthaler TM., O’Mullane D. Vrbic V. The prevalence of dental caries in Europe 1990–1995. Caries Res 1996; 30: 237–55.PubMedCrossRefGoogle Scholar
  25. Mettes D. Insufficient evidence to support or refute the need for 6-monthly dental check-ups. What is the optimal recall frequency between dental checks? Evid Based Dent. 2005;6: 62–63.PubMedCrossRefGoogle Scholar
  26. McKeown A., Speedy P., Freeman R. The evaluation of an oral health promotion resource pack for health visitors. Community Practitioner 2003; 76: 21–24.Google Scholar
  27. Mouradian WE., Berg JH, Somerman MJ. Addressing health disparities through dental-medical collaborations, Part I: The role of cultural competency in health disparities: training of primary care medical practitioners in children’s oral health. J Dent Educ 2003; 67: 860–868.PubMedGoogle Scholar
  28. Mouradian WE., Huebner C., DePaola D. Addressing health disparities through dental-medical collaborations, Part III: Leadership for the public good. J Dent Educ 2004; 68: 505–512.PubMedGoogle Scholar
  29. Nash DA. Developing a pediatric oral health therapist to help address oral health disparities among children. J Dent Educ 2004; 68: 8–20.PubMedGoogle Scholar
  30. Northern Ireland Research and Statistics Agency: accessed April, 2006.
  31. Nyden PW, Wiewel W. Collaborative research: harnessing the tensions between researcher and practitioner. Am Sociol 1992; 24: 43–55.CrossRefGoogle Scholar
  32. Petersen PE, Kwan S. Evaluation of community-based oral health promotion and oral disease prevention-WHO recommendations for improved evidence in public health practice. Community Dent Health 2004; 21 (Supplement):319–329.PubMedCrossRefGoogle Scholar
  33. Quinn G. Freeman R. Health visitor and dentists: working together in dental health education. Health Visitor 1994; 67: 2–4.Google Scholar
  34. Rozier G, Slade GD, Zeldin LP, Wang H. Parents’ satisfaction with preventive dental care for young children provided by nondental primary care providers. Pediatr Dent 2005; 27: 313–322.PubMedGoogle Scholar
  35. Sheiham A, Maizels J, Cushing A, Holmes J. Dental attendance and dental status. Community Dent Oral Epidemiol 1985; 13(6): 304–309.PubMedCrossRefGoogle Scholar
  36. Shute JL., Judge K. Evaluating “Starting Well”, the Scottish national demonstration project for child health: outcomes at six months. J Prim Prev. 2005;26:221–40PubMedCrossRefGoogle Scholar
  37. Silver DH. A comparison of 3-year-olds’ caries experience in 1973, 1981 and 1989 in a Hertfordshire town, related to family behaviour and social class. Brit Dent J 1992; 172: 191–197.PubMedCrossRefGoogle Scholar
  38. Sure Start. accessed June 2006.
  39. Sweeney A., Kinirons M. Recent dental attendance and levels of untreated caries in a sample of 11–12 year old children in Northern Ireland. J Ir Dent Assoc 2000; 46: 55–59.PubMedGoogle Scholar
  40. Watt RG. Analysis of strengths and weaknesses of programme evaluation. In: Evaluation of community-based oral health promotion and oral disease prevention. pp38–39. Oral Health Programme, Geneva. World Health Organization 2004.Google Scholar
  41. Williams S, Fairpo G. Health visitors and dental health education. Health Visitor 1982; 55: 588–589.PubMedGoogle Scholar
  42. Weintraub, J.A., Ramos-Gomez, F., Jue, B., et al. Fluoride Varnish Efficacy in Preventing Early Childhood Caries. J Dent Res 2006; 85: 172–176.PubMedCrossRefGoogle Scholar
  43. Wennhall, I., Martensson, EM., Sjunnesson, I., et al. Caries-preventive effect of an oral health program for preschool children in a low socio-economic, multicultural area in Sweden: results after one year. Acta Odontol Scand 2005; 63: 163–167.PubMedCrossRefGoogle Scholar

Copyright information

© European Archives of Paediatric Dentistry 2007

Authors and Affiliations

  • S. Yuan
    • 1
  • G. Kerr
    • 2
  • K. Salmon
    • 2
  • P. Speedy
    • 2
  • R. Freeman
    • 1
    Email author
  1. 1.Dental Public Health and Behavioural Sciences, School of Medicine and DentistryQueen’s UniversityCanada
  2. 2.Dental DepartmentEastern Health and Social Services BoardBelfastNorthern Ireland

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