Oral Health inside - Communities and Local Government

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Funding and supportFor the Republic of Ireland, the Department of Health and Children and the Health Boardsfunded the survey as part of a contract for epidemiological services. The Oral Health ServicesResearch Centre in University College Cork won the contract to advise and assist the HealthBoards in the design and conduct of the survey and provide other epidemiological servicesthrough a competitive tender process. The tender was originally advertised in the EU journal in1998 and the contract was awarded in July 1999. The extension of the fieldwork to NorthernIreland resulted from discussions with the Chief Dental Officer and managers of the CommunityDental Service in NI who provided support for the extension of the survey.The protocol for the survey was developed by the project team in the Oral Health ServicesResearch Centre (Appendix 1) following widespread consultation with the Assistant ChiefExecutive Officers of the health boards, Principal Dental Surgeons, Dental Examiners for theSurvey, Irish Dental Council, Council Members of the Irish Dental Association, Dublin DentalHospital, Irish Dental Health Foundation and the National Adult Literacy Agency. The staff ofthe Department of Health and Children and health boards had an important role in theplanning and management of the survey. The fieldwork for the survey was conducted by healthboard dentists and dental nurses (Appendix 2). As part of the process, staff at the Oral HealthServices Research Centre trained 39 dentists and 39 dental nurses in survey methods and in theuse of computers and computer software for the collection of survey data. Hence, developmentof new skills for health board staff was an integral part of the survey. Communication wasongoing between the fieldworkers and the OHSRC headquarters team throughout thefieldwork. The OHSRC provided advisory support for both the epidemiological and technicalaspects of the data collection. A number of primary schools around the country assisted withthe training and calibration of the examining dental teams. The Department of Education andScience provided data for the development of the sampling frame. A ‘User Group’ (Appendix 3)was established to represent the health boards in the planning, implementation and monitoringof the surveys. This group provided the link between the dental service managers and thesurvey headquarters team. Regular meetings ensured clear communication between the two.The Northern Ireland component of the survey was facilitated by members of the CommunityDental Service and the Department of Health, Social Services and Public Safety (Appendix 4).Ethical approval and data protectionThe Ethics Committee of the Cork Teaching Hospitals reviewed the protocols for training andcalibration of the examiners and for the main study. The committee approved the study on the2 nd October 2001. Ethical Approval was also obtained from the Research Ethics Committee ofQueen’s University, Belfast for the Northern part of the study.The Office of the Data Protection Commissioner was consulted regarding the direct entry ofdata to computers. The Data Protection Licenses of the health boards and of University CollegeCork were extended to include the survey data. The study complied with the requirements ofthe Data Protection Act 1988, Data Protection (Access Modification)(Health) Regulations, 1989,(S.I. No.82 of 1989), Data Protection (Access Modification)(Social Work) Regulations, 1989, (S.I.No.83 of 1989), Council Directive on the Protection of Individuals with Regard to Processing ofPersonal Data (Directive 95/46/EC)(W)SampleChildren were selected randomly on the basis of age, gender, and geographical location of theschool attended and whether they attended a school with fluoridated or non-fluoridated watersupply. The groups chosen were children in Junior Infants, Second Class, Sixth Class and JuniorCertificate in RoI and in Primary 1, Primary 4, Year 1 and in Year 4 in NI. The groups will bereferred to as five, eight, twelve and fifteen year olds within this report. These age groups are8 Children’s Oral Health in Ireland 2002
Introductioncomparable with earlier Irish studies and with studies conducted internationally as they includethose age groups recommended for study by the World Health Organisation (WHO). Selectionof children on the basis of age is essential because dental caries is a cumulative condition,hence levels increase with age. The number and type of teeth present in the mouth alsochanges with age. For example, children in Junior Infants / Primary 1 are on average five yearsold, have all their primary (deciduous, milk, or baby teeth), and no second or permanent teeth.Children in 2 nd Class / Primary 4 (8-year-olds) have approximately twelve second or permanentteeth plus twelve primary teeth. By the time children are in 6 th Class / Year 1 (12-year-olds), theteeth present in the mouth are mainly permanent ones. For Junior Certificate / Year 4adolescents (15-year-olds), there are usually no primary teeth left and they have their fullcomplement of permanent teeth (except wisdom teeth).The Department of Education and Science provided information on numbers of children indifferent classes in schools in the RoI. This allowed the random selection of schools for inclusionin the survey. The primary sampling unit was the school. A cluster sampling technique was usedwith schools as the clustering unit. Schools were categorised according to health board regionand size (to ensure representation of schools of various sizes) and whether they were located ina fluoridated or non-fluoridated areas. Within each Community Care Area, schools wererandomly selected to ensure a balance for fluoridation status (where appropriate) andproportionally to the size of the school. A list of children in each class in each year (JuniorInfants, 2 nd Class, 6 th Class and Junior Cert.) was obtained from the selected schools.The Department of Education for Northern Ireland provided information on numbers of childrenin different classes in schools in NI. This allowed the random selection of schools for inclusionin the survey. The primary sampling unit was the school. A cluster sampling technique was usedwith schools as the clustering unit. Schools were categorised according to geographical region,size and an income deprivation index assigned to each school (to allow comparison with RoIwithin socioeconomic status). Within each geographical region, schools were randomlyselected proportionally to the size of the school. A list of children in each class in each year(Primary 1 and 4 and Years 1 and 4) was obtained from the selected schools.All children within a class were included in the random selection irrespective of whether theyhad special needs, but teams were told not to include in the selection whole classes that weredesignated as special needs within a school. Schools designated ‘special needs’ by theDepartment of Education and Science were the subject of a separate survey of oral healthconducted in 2003 (report in preparation). The required number of children was selectedrandomly from each year and the consent forms were issued to only those children. In instanceswhere there was a number of different classes within one year e.g. four different 2 nd classes inthe same school, a class was randomly selected and the children were randomly selected withinthis class. If insufficient numbers of children were present in the first class selected, anotherclass was randomly selected until the required number of children to issue consent forms wasobtained.The total target sample size required in the Republic of Ireland was 14,400. The sample sizewas based on the desire to have 120 children per cell in each of the four age groups in 30community care areas (120 X 4 age groups X 30 Community Care Areas = 14,400). The cell sizeof 120 would allow reliable estimates of dmft / DMFT by fluoridation or disadvantage (medicalcard or low income benefit) status. The total sample size had sufficient power to demonstrate adifference in dmft / DMFT level of at least 0.5 in 5, 12 and 15 year olds and at least 0.2 in the 8year olds between children from fluoridated and non fluoridated areas in the ROI at the 5%level of significance. The target sample size of 2,390 in NI was chosen to demonstrate the samedifferences in dmft/DMFT (in each age group) between NI (non fluoridated) children andadolescents and those in fluoridated areas in the RoI according to socioeconomic status.9
Page 1: North South Survey of Children’s
Page 6: A fissure sealant is a plastic resi
Page 11 and 12: IntroductionThe children were asked
Page 13 and 14: ResultsFluoridation status was clas
Page 15 and 16: ResultsAge of the children and adol
Page 17 and 18: Resultsschool based fluoride mouthr
Page 19 and 20: ResultsFigure 6 Mean number of deca
Page 21 and 22: ResultsFigure 7 Percentage of child
Page 23 and 24: ResultsFigure 9 Mean number of prim
Page 25 and 26: ResultsMWHB (mean dmft of 2.9 in 19
Page 27 and 28: ResultsWHO criteria, but not in the
Page 29 and 30: ResultsMean vdmftFigure 12 Mean num
Page 31 and 32: Results% vdmft untreatedFigure 13 U
Page 33 and 34: ResultsOne might expect to find lit
Page 35 and 36: ResultsThere was considerable varia
Page 37: ResultsDEAN’S INDEX OFFLUOROSIS S
Page 40 and 41: Prevalence of traumatic injuryTable
Page 42 and 43: Comparison with the National Childr
Page 44 and 45: Appendix 2Survey Teams, Republic an
Page 46 and 47: Appendix 5a) Principal Trainer and
Page 48 and 49: Appendix 7aMean number of decayed (
Page 50 and 51: Appendix 7cMean number of decayed (
Page 52 and 53: Appendix 7dMean number of decayed (
Page 54 and 55: Appendix 7eMean number of teeth aff
Page 56 and 57: Bibliography1Quality and Fairness,
Page 58:
AcknowledgementsThe study of oral d
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