Inequalities in the dental health needs and access to dental services among looked after children in Scotland: a population data linkage study

TY - JOUR

T1 - Inequalities in the dental health needs and access to dental services among looked after children in Scotland

T2 - a population data linkage study

AU - McMahon, Alex D

AU - Elliott, Lawrie

AU - Macpherson, Lorna Md

AU - Sharpe, Katharine H

AU - Connelly, Graham

AU - Milligan, Ian

AU - Wilson, Philip

AU - Clark, David

AU - King, Albert

AU - Wood, Rachael

AU - Conway, David I

N1 - © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PY - 2018

Y1 - 2018

N2 - BACKGROUND: There is limited evidence on the health needs and service access among children and young people who are looked after by the state. The aim of this study was to compare dental treatment needs and access to dental services (as an exemplar of wider health and well-being concerns) among children and young people who are looked after with the general child population.METHODS: Population data linkage study utilising national datasets of social work referrals for 'looked after' placements, the Scottish census of children in local authority schools, and national health service's dental health and service datasets.RESULTS: 633 204 children in publicly funded schools in Scotland during the academic year 2011/2012, of whom 10 927 (1.7%) were known to be looked after during that or a previous year (from 2007-2008). The children in the looked after children (LAC) group were more likely to have urgent dental treatment need at 5 years of age: 23%vs10% (n=209/16533), adjusted (for age, sex and area socioeconomic deprivation) OR 2.65 (95% CI 2.30 to 3.05); were less likely to attend a dentist regularly: 51%vs63% (n=5519/388934), 0.55 (0.53 to 0.58) and more likely to have teeth extracted under general anaesthesia: 9%vs5% (n=967/30253), 1.91 (1.78 to 2.04).CONCLUSIONS: LAC are more likely to have dental treatment needs and less likely to access dental services even when accounting for sociodemographic factors. Greater efforts are required to integrate child social and healthcare for LAC and to develop preventive care pathways on entering and throughout their time in the care system.

AB - BACKGROUND: There is limited evidence on the health needs and service access among children and young people who are looked after by the state. The aim of this study was to compare dental treatment needs and access to dental services (as an exemplar of wider health and well-being concerns) among children and young people who are looked after with the general child population.METHODS: Population data linkage study utilising national datasets of social work referrals for 'looked after' placements, the Scottish census of children in local authority schools, and national health service's dental health and service datasets.RESULTS: 633 204 children in publicly funded schools in Scotland during the academic year 2011/2012, of whom 10 927 (1.7%) were known to be looked after during that or a previous year (from 2007-2008). The children in the looked after children (LAC) group were more likely to have urgent dental treatment need at 5 years of age: 23%vs10% (n=209/16533), adjusted (for age, sex and area socioeconomic deprivation) OR 2.65 (95% CI 2.30 to 3.05); were less likely to attend a dentist regularly: 51%vs63% (n=5519/388934), 0.55 (0.53 to 0.58) and more likely to have teeth extracted under general anaesthesia: 9%vs5% (n=967/30253), 1.91 (1.78 to 2.04).CONCLUSIONS: LAC are more likely to have dental treatment needs and less likely to access dental services even when accounting for sociodemographic factors. Greater efforts are required to integrate child social and healthcare for LAC and to develop preventive care pathways on entering and throughout their time in the care system.

KW - Adolescent

KW - Child

KW - Child, Preschool

KW - Dental Health Services/statistics & numerical data

KW - Female

KW - Health Services Accessibility/statistics & numerical data

KW - Health Services Needs and Demand/statistics & numerical data

KW - Humans

KW - Information Storage and Retrieval

KW - Male

KW - Scotland/epidemiology

KW - Social Work/statistics & numerical data

KW - Socioeconomic Factors

U2 - 10.1136/archdischild-2016-312389

DO - 10.1136/archdischild-2016-312389

M3 - Journal article

C2 - 28855231

SN - 1743-0585

VL - 103

SP - 39

EP - 43

JO - Archives of Disease in Childhood. Education and Practice Edition

JF - Archives of Disease in Childhood. Education and Practice Edition

IS - 1

ER -