Evaluating childsmile, Scotland's National Oral Health Improvement Programme for children.

In the early 2000s, a Scottish Government Oral Health Action Plan identified the need for a national programme to improve child oral health and reduce inequalities. 'Childsmile' aimed to improve child oral health in Scotland, reduce inequalities in outcomes and access to dental services, and to shift the balance of care from treatment to prevention through targeted and universal components in dental practice, community and educational settings. This paper describes how an embedded, theory-based research and evaluation arm with multi-disciplinary input helps determine priorities and provides important strategic direction. Programme theory is articulated in dedicated, dynamic logic models, and evaluation themes are as follows: population-level data linkage; trials and economic evaluations; investigations drawing from behavioural and implementation science; evidence reviews and updates; and applications of systems science. There is also a growing knowledge sharing network internationally. Collaborative working from all stakeholders is necessary to maintain gains and to address areas that may not be working as well, and never more so with the major disruptions to the programme from the COVID-19 pandemic and response. Conclusions are that evaluation and research are synergistic with a complex, dynamic programme like Childsmile. The evidence obtained allows for appraisal of the relative strengths of component interventions and the reach and impact of Childsmile to feed into national policy.

Mid-adolescent ethnic variations in overweight prevalence in the UK Millennium Cohort Study.

BACKGROUND: There are stark ethnic inequalities in the prevalence of UK childhood obesity. However, data on adolescent overweight in different ethnic groups are limited. This study assessed ethnic inequalities in overweight prevalence during mid-adolescence using body mass index (BMI) and explored the contribution of socioeconomic and behavioural factors. METHODS: We analyzed data from 10 500 adolescents aged between 13 and 15 years who participated in sweep six of the Millennium Cohort Study. Ethnic inequalities in overweight and mean BMI were assessed using multiple regression models. Results were stratified by sex and adjusted for socioeconomic and behavioural factors. RESULTS: Black Caribbean males had significantly higher BMI than White males after full adjustment [excess BMI 2.94, 95% confidence interval (CI) 0.70-5.19] and were over three times more likely to be overweight [odds ratio (OR): 3.32, 95% CI 1.95-5.66]. Black Africans females had significantly higher BMI compared with White females (excess BMI 1.86, 95% CI 0.89-2.83; OR for overweight 2.74, 95% CI 1.64-4.56), while Indian females had significantly lower BMI compared with White females (reduced BMI -0.73, 95% CI -1.37 to -0.09). Socioeconomic and behavioural factors often considered to be associated with overweight were more prevalent in some ethnic minority groups (lower socioeconomic position, lack of breakfast consumption, low fruit and vegetable intake, high sugar-sweetened beverage and fast-food consumption, and infrequent physical activity), but adjustment for these factors did not fully explain ethnic differences in overweight/BMI. CONCLUSION: Ethnic inequalities in overweight prevalence are evident in mid-adolescence and vary according to sex. Differences in overweight/BMI between ethnic groups were not fully accounted for by socioeconomic or behavioural factors.

Oral health and depressive symptoms: findings from the English Longitudinal Study of Ageing.

Aim We assessed the cross-sectional association between depressive symptoms and oral health using a nationally representative sample of older adults aged 50 years and older living in England.Methods Data came from wave 7 (2014-2015) of the English Longitudinal Study of Ageing. Multiple logistic regression analyses were conducted to assess the association between depressive symptoms, measured through the eight-item Centre for Epidemiologic Studies Depression Scale and three oral health outcomes, namely self-rated oral health, edentulousness and oral impacts.Results The analytical sample comprised 3,617 individuals. The proportion of participants that reported poor self-rated oral health, being edentate and having at least one oral health impact in the last six months was 19.8%, 7.7% and 8.9%, respectively. Around a tenth of the participants reported having depressive symptoms (10%). All unadjusted associations between depressive symptoms and the oral health measures were statistically significant. However, after accounting for potential confounders, only the relationship between depressive symptoms and self-rated oral health remained significant (OR = 1.38; 95% CI 1.01-1.89). Socioeconomic and general health-related variables appeared to influence the associations between depressive symptoms and oral health, particularly edentulousness and oral impacts.Conclusion Depressive symptoms were associated with poor self-rated oral health in older English adults.

Traumatic dental injuries and socioeconomic position - findings from the Children's Dental Health Survey 2013.

OBJECTIVES: The aim of this study was to assess whether traumatic dental injuries (TDI) were socially graded among children and adolescents in England, Wales and Northern Ireland, using nationally representative data from the Children's Dental Health Survey (CDHS) 2013. METHODS: This cross-sectional study used data from the Children's Dental Health Survey 2013 which was conducted among a nationally representative sample of schoolchildren in England, Wales and Northern Ireland. Children's family socioeconomic position (SEP) was measured through free school meal eligibility and relative area deprivation using the Indices of Multiple Deprivation. The analytical sample included 6707 schoolchildren aged 8, 12 and 15. Multiple logistic regression was used to model the associations between experience of TDI and the two markers of SEP, after adjusting for sex and age. RESULTS: The overall prevalence of traumatic dental injuries to permanent incisors was 9% (n = 590). There were no statistically significant associations between TDI and either SEP measure. Further subgroup analyses (n = 2650) showed also no significant associations between TDI and additional SEP markers (parental education and social class). The odds of having sustained a traumatic dental injury were higher for boys than for girls and were greater in older age groups. CONCLUSIONS: This study found no significant relationships between the experience of traumatic dental injuries and two markers of family socioeconomic position among children living in England, Wales and Northern Ireland. This implies that rather than specifically targeting the more deprived sectors of society, TDI prevention policies should use upstream public health strategies incorporating a whole-population approach.