Methods: The Scottish Index of Multiple Deprivation (SIMD) five-level score was assigned to each child. The decay experience for each tooth, d3mft, d3t, mt, and ft for each child were calculated. Survey analyses of both mean d3mft and the percentage of children with no decay experience were undertaken. The odds of decay experience were further analysed by multivariate logistic regression models. ROC plots were created.
Results: We sampled 14% of the nursery population in 2006/7 and 19% in 2007/8. There were 1711 children with usable data in 2006/7 and 2428 in 2007/8. In 2006/7, 655 (38%) children and in 2007/8, 1068 (44%) were from the most deprived areas. Mean d3mft was 1.1 in 2006/7 and 1.0 in 2007/8. The prevalence of decay experience was 26% in 2006/7 and 25% in 2008/9 (33% and 32%, respectively for deprived children). The adjusted odds-ratio for decay experience in the most deprived children versus the least deprived children was 2.90 (2.31, 3.64), p<0.001. In each year, the greatest prevalence of decay experience was in the upper anterior teeth.
Conclusion: It was feasible to conduct large scale caries prevalence surveys of three year olds in nursery settings. The determinants of poor dental health and inequality commence prior to age 3 years. It is essential that caries prevention in childhood is targeted from birth and particularly toward families in the most deprived communities.