June 2009

Background: Primary Care Trusts (PCTs) in England have a responsibility to ensure that the oral health needs of their residents are addressed. This will involve monitoring the uptake of primary dental care and developing services to address local needs and demands. Objective: To examine the relationship between dental registration, age, gender and deprivation at ward and borough level within a socially diverse metropolitan area. Methods: This retrospective, cross-sectional ecological study was conducted using ward level registration data for residents of south east London from the Dental Practice Board, population data from the Office of National Statistics and the Index of Multiple Deprivation (IMD) from the Office of the Deputy Prime Minister. Registration rates were calculated at ward level for the population as a whole and for specific age bands. The correlation with deprivation was examined using Pearson’s correlation co-efficient and the data mapped. Results: Registration varied by gender (40% females registered compared with 35% males) and age (children aged 6-12 years (62%) were most likely to be registered and 0-2 year-olds least likely (11%). There was a strong negative correlation between deprivation (IMD) and registration in the 0-5 year (r=-0.82; p<001) and 6-17 year (r=-0.81; p<0.001) age-bands across the sector and similarly within each borough. The negative correlation was most marked in the most affluent borough (r=-0.87; p<0.001). Conclusion: Analysis of registration for dental care across a socially diverse area reveals a strong negative correlation between NHS service uptake and deprivation status amongst children only. Inequalities in service utilisation by children were most marked within affluent boroughs, compared with deprived boroughs. Keywords: Access, dental caries, social deprivation