Different ways of service provision frequently lead to different services being provided. In the School Dental Service (SDS) in Western Australia, all 5-15-yr-olds are eligible for care free of charge and most avail themselves of the service. The parents of some children choose to use private dentists (typically copaying about 5001. of the cost) and their children do not attend the SDS. This study aimed to compare the dental status of 12-yr-olds who attended private dentists with that of matched children enrolled in the SDS. Non-enrolled 12-yr-olds in Perth (F- 0.8 mg/l) were identified and asked to provide background information and participate in clinical examinations. Each non-enrolled participant was matched with a classmate of the same sex. Of 184 non-enrolled children, 100 actually participated. Data on caries experience (DMFT and DMFS), fissure sealants and gingival health (CPITN) were collected by clinical examination. Analyses used Wilcoxon's signed rank, categorical and t-tests and simple linear regression. Caries prevalence was lower in non-enrolled children (0.31) than in enrolled (0.47). Caries experience was also lower in non-enrolled children (mean DMFT 0.71 vs. 0.95, ns). Enrolled children had more FT than non-enrolled (Wilcoxon, P = 0.059) but the mean number of DT in each group was 0.14. Enrolled children had somewhat fewer fissure sealants than non-enrolled children but in enrolled children there was an apparent (P = 0.056) inverse relationship between number of fissure sealants and DMFT scores; this was not the case in the non-enrolled group, suggesting better targeting of fissure sealants in the SDS. More than half of both groups had CPITN score 2, suggesting that gingival health was a potential problem in the children. The finding of lower caries experience in non-enrolled children may be due to confounding by social class or other uncontrolled factors, but it may also be a consequence of more aggressive use of operative treatment among SDS clinical operators several years ago. Gingival health was a problem in both groups. Better targeted fissure sealants and more effective oral hygiene instruction for all children are indicated by the results.
|Journal||Community Dentistry and Oral Epidemiology|
|Publication status||Published - 1993|