June 2014

Objective: To find the most accurate indicators of the distribution of dental caries in 5-year-olds in the city of Sheffield, UK, using a conceptual framework based on the social determinants of health. Method: A list of structural and intermediary indicators was compiled based on the Commission on the Social Determinants of Health’s (CSDH) conceptual framework. To quantify these indicators, existing data on dental caries were obtained from the NHS Dental Epidemiology Programme, while data on social position, education, employment, income, material circumstances, social cohesion, psychosocial factors and individual behaviours were obtained from the Public Health Intelligence Team at Sheffield City Council. These data were mapped onto a simplified framework of the social determinants of dental caries. Regression analysis was conducted on this simplified framework to determine the amount of variance each indicator contributed to the distribution of dental caries at neighbourhood level. Results: The total score for the 2010 Index of Multiple Deprivation contributed a significant amount of variance (60.4%) compared to the combined variance of the other 13 indicators (70.5%). Conclusion: The total IMD score has the potential to be used as an indicator for the targeting of oral health improvement programmes where survey data are not available. A large prospective study is required in the UK to investigate the full range of factors in the CSDH model to develop a new index which might better predict dental caries experience than IMD. Key words: caries, United Kingdom, children, predictors, deprivation, social determinants of health, conceptual framework