Cent Eur J Public Health 2008, 16(2):65-70 | DOI: 10.21101/cejph.a3469

The Development of a Directed Population Approach to Tackle Inequalities in Dental Caries Prevalence among Secondary School Children Based on a Small Area Profile

Darius Sagheri1, Petra Hahn2, Elmar Hellwig2
1 Department of Orthodontics, School of Dental Science, University of Cologne, Germany
2 Department of Restorative Dentistry and Periodontology, Albert Ludwigs University of Freiburg, Germany

Background: It has been observed that the prevalence of dental caries among children has declined in the last decade in Germany. However, despite of these improvements there is still a proportion of children suffering from dental decay.

Aims: The aims of this study were to evaluate if a social gradient in the prevalence of dental caries exists and, based on those findings, to develop a strategy to target those children with heightened risk to develop dental caries in order to assist oral health care professionals to refocus the current uniform school-based dental health programme to a caries preventive strategy based on a directed population approach.

Design: A representative, random sample of 12-year olds in Freiburg (Germany) was examined and dental caries was recorded using WHO criteria. Educational attainment of the child's parents was used as an indicator of socio-economic status and classified by use of the CASMIN Educational Classification.

Results: A total of 322 children participated. An examination of dental caries score revealed that its distribution was positively skewed. For this reason this study provides summary analyses based on medians and a non-parametric rank-sum test. The Kruskal-Wallis H-test showed a significant difference between median scores across the different educational levels (p-value=0.015) which was due to lower dental caries levels in children with non-deprived social background.

Conclusions: In order to reduce current social inequalities in child oral health the current uniform school-based dental health programme at secondary school level should be developed to a targeted school-based screening and prevention programme.

Keywords: children, dental caries, educational level, Germany, inequalities, oral health

Received: December 18, 2007; Revised: February 12, 2008; Accepted: February 12, 2008; Published: June 1, 2008  Show citation

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Sagheri D, Hahn P, Hellwig E. The Development of a Directed Population Approach to Tackle Inequalities in Dental Caries Prevalence among Secondary School Children Based on a Small Area Profile. Cent Eur J Public Health. 2008;16(2):65-70. doi: 10.21101/cejph.a3469. PubMed PMID: 18661808.
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