Oral Health Improves, but Inequalities Remain for Children in Wales

Objectives: This research explores the manner in which caries levels and related oral health inequalities have changed for 5-year-old children in Wales over the time period 2007-08 to 2014-15.
Methods: Surveys of caries levels were carried out for representative samples of school year 1 children (aged 5-6) for the whole of Wales in 2007-08 (N = 7100), 2012-12 (N = 7715), and 2014-15 (N = 7716). Mean d₃mft and percentage with caries experience (% d₃mft > 0) were found across socioeconomic groups and also for quintiles of deprivation measured using the Welsh Index of Multiple Deprivation (WIMD). Indices of oral health inequality such as the absolute and relative ranges, slope index of inequality, and concentration indices were calculated using these data.
Results: A broad reduction in caries levels has been observed in 5-6 year-old children in Wales over the period investigated (2007-08: mean d₃mft = 1.75; percentage with caries experience = 44.1%; 2011-12: mean d₃mft = 1.50; percentage with caries experience = 40.2%; and, 2014-15: mean d₃mft = 1.24; percentage with caries experience = 34.5%). Some measures of inequality indicate that oral health inequality has remained broadly at the same level or may have reduced slightly (absolute range based on mean d₃mft: 2007-08: 1.49; 2011-12: 1.13; and, 2014-15: 1.14: slope index of inequality based on mean d₃mft: 2007-08: 1.58; 2011-12: 1.44; and, 2014-15: 1.43). Other measures indicate that inequality may have increased slightly (relative range based on mean d₃mft: 2007-08: 2.28; 2011-12: 2.10; and, 2014-15: 2.52: concentration index based on mean d₃mft: 2007-08: 0.141; 2011-12: 0.159; and, 2014-15: 0.189).
Conclusions: The reduction in caries experience observed over this period has been achieved without widening oral health inequalities. However, the oral health gradient related to social and economic circumstances still remains.