Low rates of dental attendance by the age of one and inequality between local government administrative areas in England

Candy Salomon Ibarra, Vahid Ravaghi, Kirsty Hill, Colwyn M. Jones, David Landes, Alexander Morris

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)


Objective: To describe child dental attendance (DA) by 1 year of age in England and its relationship with area deprivation.

Basic research design: Analysis of National Health Service data for the 12 months to June 2017. Deprivation was measured by Index of Multiple Deprivation Rank of Average Score (2015) for upper-tier and unitary local authorities in England (LAs, n=151). DA rates were calculated for children under 1 year (<1yr) and children aged 1 year and under (≤1yr). A Spearman’s test assessed strength of association with deprivation. The Slope Index of Inequality (SII) and Relative Index of Inequality (RII) explored equity.

Clinical setting: Upper-tier and unitary LAs in England.

Main outcome measure: Attending an NHS primary care dental service.

Results: DA rates ranged from 0 to 12.3% (Median:2; IQR:1.4,3.9) in children <1yr and from 3.7 to 37.6% (Median:10; IQR:7.4,17) in children ≤1yr. DA rates decreased as deprivation decreased (Spearman=-0.25, p=0.0019 in children <1yr; Spearman=-0.21, p=0.0104 in children ≤1yr). The SII suggested a 2 percentage point difference in DA rate across the deprivation distribution in children <1yr (SII=-0.02, 95% CI=-0.01,-0.04; p=<0.001); and a 5 point difference in children ≤1yr (SII=-0.05, 95% CI=-0.02,-0.09; p=0.003). The DA rate in the most deprived LA was 2.1 higher than the least deprived LA (RII=2.1, 95% CI=1.4,3.2; p=<0.001) in children <1yr and 1.5 higher (RII=1.5, 95% CI=1.2,2; p=0.004) in children ≤1yr.

Conclusions: DA rates were low for all LAs and only partially explained by deprivation. More deprived LAs were, unexpectedly, more likely to report higher DA rates.
Original languageEnglish
Pages (from-to)22–26
Number of pages5
JournalCommunity Dental Health
Issue number1
Publication statusPublished - 1 Mar 2019


  • dental health services
  • national health programs
  • dental attendance
  • dentistry
  • dental caries


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