The Edinburgh-Helsinki study: a comparison of dental care for children

A comparison was undertaken of dental care for children in Edinburgh and Helsinki. The evaluation centred upon an epidemiological investigation of the dental health of children in the 5-, 12- and 15-year age groups. This was performed by examiners using standardized procedures who were drawn from both countries. They employed an established system of data recording and processing (SPEED). Using these data, and background information from official and other sources, an assessment was made of the effectiveness, adequacy, efficiency and appropriateness of the services. Children's dental health, particularly in the youngest age group, was generally better in Helsinki than in Edinburgh as were both the population coverage and extent to which disease was controlled. However, the services in Edinburgh were marginally the more economically efficient. This arose from their being provided mainly by independent contractors working under a fee per item of service rather than by a public salaried system. In neither city was the delivery of dental services supplemented by water fluoridation nor was extensive use made of auxiliary personnel. The decrease in caries prevalence in recent years has profound implications for the dental services in both countries. It calls for continuing re-appraisal of present policies on expenditure, manpower, dental education and ways of delivering dental care.