Children's dental health under the capitation scheme

A study was undertaken of the dental health of 7870 eight-year-old children resident in the City of Birmingham, using the standard British Association of Community Dentistry epidemiological procedures. There were variations in the dental health of children from different ethnic backgrounds. Asian children had the poorest dental health and Afro-Caribbean children, the best. There were also variations in the dental health of children from different ACORN Categories. Children from the highest ACORN Category 'Thriving' had better dental health than those from the lowest, 'Striving' Category. Positive consent was obtained from every parent or guardian to link the findings with the Dental Practice Board's records as to whether each child was registered under the NHS capitation scheme for the provision of primary dental care to children. The dental state of those who were registered in the capitation scheme, (54.5 per cent), was compared with those who were not, (45.5 per cent). The highest proportion of children registered with a dentist were Caucasian and from a high social class i.e. ACORN Category 'Thriving'. In order to ensure that differences were due to their capitation status and not to other differences within the groups, analyses were undertaken according to the ethnic background and ACORN Category of the children. Overall, there were only very small differences between the caries state of the registered and non registered children. However 32 per cent of those children registered in the scheme still had active decay which was not restricted to the primary dentition. The greatest reduction in the average number of decayed teeth together with the greatest increase in the average number of fillings in registered children when compared to their non registered colleagues was observed in the lowest ACORN Category. Unfortunately this group had the lowest proportion of children who were registered in the capitation scheme and 40 per cent of them, both registered and non registered, still had active decay. Overall, oral hygiene was good, and there was little difference between registered and non-registered children in the ACORN Category 'Thriving'. However, in the ACORN Category 'Striving', there was a higher proportion of children with good oral hygiene amongst those who were registered than amongst those who were not. Provision of preventive treatment was low in all registered and non registered groups, but lowest in those groups of children with the poorest dental health. It would appear that, for a proportion of children registered in the capitation scheme, the practitioners were failing to achieve the requirement of "securing and maintaining their oral health".