The relationship between caries, fluoridation and material deprivation in five-year-old children in Country Durham

An investigation to assess the impact of fluoridation on the caries experience of young children at high and low levels of material deprivation measured by the Townsend Index was undertaken in County Durham. Electoral wards were ranked for deprivation from 1991 Census data. Dental caries data for 2,751 five-year-old children resident in electoral wards in the upper and lower quartiles of material deprivation in the County were obtained from a dental survey conducted in 1991-92. Wards were stratified for fluoridated and non-fluoridated water supply and the dental data for the resultant four populations, defined by high and low material deprivation and the presence or absence of fluoridation, were analysed. The mean dmft values in the four groups were 0.8 in the fluoridated low deprivation group, 1.2 in the non-fluoridated low deprivation group, 1.2 in the fluoridated high deprivation wards and 2.1 in the non-fluoridated high deprivation wards. Thus, with fluoridation the variation in caries between high and low deprivation groups was significantly reduced but not eliminated, leaving the level significantly lower in the least deprived group, to the continuing disadvantage of that deprived group.