A pilot study to explore the feasibility of building a cohort to investigate factors associated with dental caries in children

Sadique, Silda (2015) A pilot study to explore the feasibility of building a cohort to investigate factors associated with dental caries in children. MSc(R) thesis, University of Glasgow.

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Abstract

Dental caries is the most common chronic disease of childhood, worldwide and in Scotland. There has been a continuous steady improvement in the dental health of young children in Scotland since 2003. However, a clear gradient across all levels of deprivation remains, with those at the lower end of the socioeconomic spectrum suffering the greatest burden of caries. Childsmile is the national oral health improvement programme for young children in Scotland that involves a range of active interventions commencing from infancy. One of the key challenges Childsmile faces is in tackling oral health inequalities.

This study aimed to explore the feasibility of conducting a cohort study among preschool children, following them up one year later, to examine factors associated with dental caries and their role in explaining socioeconomic inequalities in caries.

A dental examination was carried out according to the British Association for the Study of Community Dentistry criteria, saliva and plaque samples collected and heights and weights measured according to the Royal College of Paediatrics and Child Health guidelines in nursery/school settings. Parents completed questionnaires on their child’s habitual diet, early feeding habits, oral hygiene practices, use of dental services; and on their own attitudes and beliefs around oral health and socioeconomic position (SEP). Binary logistic regression was used to produce odds ratios and 95% Confidence Intervals for caries experience according to putative risk factors and socioeconomic position (SEP); and to estimate the relative index of inequality (RII) for caries experience by SEP and attenuation by the aforementioned factors.

Consent was obtained for 219 children (35%) and complete data (clinical and questionnaire) was available for 165 children (75%) in Sweep 1. One hundred and seventy five children (80%) were examined a year later in Sweep 2, of which 144 (66%) had complete data in Sweep 1. Mean [SD] age of the children at baseline was 4.8 [0.4] years and 47% were girls. The prevalence of caries experience was 35.8% at baseline and 47.7% at follow-up and showed a strong social gradient with both area- and individual-based measures of SEP. The level of S.mutans in saliva and six other variables relating to current diet, early feeding habits, oral hygiene practices, use of dental services and SEP were found to be independently associated with caries experience at follow-up. All measures of SEP demonstrated high RIIs for caries experience. Despite some attenuation in the RII after adjustment for relevant risk factors, the socioeconomic gradient in caries persisted, suggesting that perhaps other more distal factors may be important in causing inequalities.

It was feasible to recruit a large number of preschool children and their parents from the most deprived areas of Glasgow via nursery schools and collect clinical and questionnaire data that were of sufficient quality over time across educational establishments. There is a strong socioeconomic gradient in the prevalence of caries, partially attenuated when adjusted for some important risk factors. Explaining the socioeconomic gradient is key to addressing oral health inequalities. The findings from this pilot study will be used to design a larger birth cohort study to robustly investigate modifiable risk factors of caries, identify ‘causes of the causes’, and design and test potential interventions to improve oral health of children overall and tackle and reduce oral health inequalities in the future.

Item Type: Thesis (MSc(R))
Qualification Level: Masters
Keywords: cohort, dental, caries, preschool, young, children, inequalities, socioeconomic, deprivation, childsmile, risk, Scotland, riskfactors, diet, hygiene, parental, beliefs, fatalism.
Subjects: H Social Sciences > HT Communities. Classes. Races
R Medicine > RK Dentistry
Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing > Dental School
Supervisor's Name: Sherriff, Dr. Andrea and Macpherson, Professor Lorna
Date of Award: 2015
Depositing User: Ms Silda Sadique
Unique ID: glathesis:2015-6491
Copyright: Copyright of this thesis is held by the author.
Date Deposited: 22 Jun 2015 15:39
Last Modified: 02 May 2018 14:03
URI: http://theses.gla.ac.uk/id/eprint/6491

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