Relationships Between School Performance and Caries Experience: an Ecological Study

Objective: To assess the relationship between school academic performance and caries experience in a sample of secondary schools in East London. Methods: An ecological cross-sectional study was carried out in a sample of 24 secondary schools in East London. Educational performance data were obtained from the Department for Education and Skills (website). Aggregated school scores for the percentage of pupils who achieved 5 or more GCSEs at A* -C grade (or equivalent) were calculated. The percentage of pupils eligible for free school meals, a standard measure of material deprivation within a school population, was acquired from the school. Caries experience was obtained from RELACHS Phase 3 data, a sample of pupils aged 15-16 years old, and aggregated at school level. Dental examinations were conducted by two calibrated dentists following WHO criteria (1997). The outcome measure was the school mean DMFT of the second permanent molars. These teeth erupt around the age of 11 – 12 years old, which is the time for secondary school entrance, and may reflect the impact of the school environment on oral health. Data analysis included Spearman's Rank Order Correlation tests. Results: Statistical analyses demonstrated that the school mean DMFT of the second permanent molar was significantly correlated with educational achievement (p=0.007). Entitlement to free school meals and caries experience were not statistically significantly related (p>0.05), thus the results were not confounded by socio-economic factors as these variables were not related to the outcome. Conclusions: The findings of this study suggest that educational performance and caries experience may share the same school determinants. Further research is recommended to identify school characteristics common to health and educational positive outcomes, and to develop an intervention that will promote both.