March 2009

Objective The aim was to record dental caries levels and the presence of fissure sealants in 12-year old schoolchildren whose domestic water supply had been fluoridated since birth in Dublin (Ireland). Research design Cross-sectional study. Participants A representative, random sample of 12-year old schoolchildren in north-west Dublin. Outcome measures Dental caries levels were recorded using WHO criteria and fissure sealant was recorded when sealant was detectable on a permanent molar tooth. Medical card ownership, as a surrogate for disadvantage, was recorded by use of a questionnaire. Results Three-hundred and thirty-two (332) children were examined. The mean DMFT was 0.80 (SD 1.24). Analysis (Mann-Whitney U test) based on stratification of the sample according to medical-card status revealed no statistically significant difference between DMFT median scores of children of medical-card holders (i.e. social disadvantage background) and non medical-card holders (p-value=0.23). However, the data revealed a social gradient in the presence of at least one fissure sealant. Approximately 10% more children in the group of medical-card holders had no fissure sealants present. Fisher’s exact test was used to examine the association between the absence of fissure sealants and at least one fissure sealant between the two groups and was considered to be statistically significant (p-value=0.04). Conclusion This study demonstrated a social gradient in the presence of fissure sealants, but no such gradient in dental caries levels. This demonstrates the importance of population-based measures in the prevention of dental caries, such as water fluoridation, in reducing oral health inequalities. Key words: Children, dental caries, deprivation, Dublin, fissure sealant, inequalities, Ireland