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DENTAL SURVEY OF FIVE YEAR OLD SCHOOL CHILDREN
PILOT STUDY
Many dental clinics in use at present were built in the late 1930's. The siting of those built
before 1965 was relative to the needs of the area when it formed part of the county of Middlesex.
A number of new health centres are being planned for future years and it is necessary to try and
establish areas where the need for provision of dental services seems greatest. The distribution of
general dental practitioners is uneven, there is a greater concentration in areas which are predominantly
social class I and II.
If it was possible to estimate what dental decay was present in children entering school and
what proportion was being treated and by which service, planning of future local authority services
could be much more efficient.
It was decided to conduct a survey of children entering school to try and find this information'
Methods
The survey formed part of the routine school dental inspection and was performed by the
dental officer concerned. Children who were 5 years of age but not 6 years in the academic year
1971-72 were examined. The selected schools were those included for inspection in the 1971-72
programme. The distribution in the Borough was uneven and weighted in favour of the north area.
The most serious disadvantage was seen to be the large number of examiners. Unless examiners
are trained together for such a survey and perform calibration exercises to reach a common understanding
of the written criteria for the diagnosis of the dental conditions, a large degree of error is
found. It was possible to discuss the criteria but not possible to carry out such calibration exercises
and the interpretation of the results must be made accordingly.
Examination Methods
All examinations were carried out at school, usually in the school medical room. The subjects
stood facing the window. Artifical light was usually available. These conditions were far from ideal
but were typically those of a school dental inspection. The presence of dental decay (caries) was
detected by mirror and probe examination.
Diagnostic Criteria
The criteria for the clinical diagnosis of caries was whether in the opinion of the examiner, the
cavity required a filling. Each tooth which was decayed, extracted or filled was given a score of one.
An estimation was also made of teeth considered so broken down that they required extraction.
Incisors or front teeth were included in the survey as they are rarely shed naturally before the
child is six. If the examiner was in any doubt whether a front tooth had been lost in an accident or
had been shed naturally the tooth was not scored as missing. Thus the number of missing teeth
would be simply an estimation of the number of teeth which had been extracted by a dentist.
The index used to measure the amount of decay was d.e.f., where d is the number of decayed
teeth, e is the number of extracted teeth and f is the number of filled teeth.
An assessment of oral hygiene was made, whether in the opinion of the examiner it was satisfactory
or unsatisfactory.
Data Recording
The findings were dictated to an experienced dental surgery assistant and recorded on individual
charts.
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