Objective: This paper reports the results of standardised clinical caries examinations of 77,693 14-year-old children from across England, Wales, Jersey and the Isle of Man. These 2002/3 coordinated surveys are the latest in a series which seeks to monitor the dental health of children and to assess the delivery of dental services.
Method: The criteria and conventions of the British Association for the Study of Community Dentistry were used. Representative samples were drawn from participating health authorities and boards and caries was diagnosed at the caries into dentine (D3) threshold using a visual method without radiography or fibre-optic transillumination.
Results: These demonstrated, once again, a wide variation in prevalence across the area surveyed, with mean values for D3MFT for the current English government offices (of the National Health Service) and the local Health Boards in Wales ranging from 0.99 in the South East to 2.10 in Wales (2.41 in the Isle of Man). The mean value for across England and Wales was 1.48 (D3T=0.56, MT=0.10, FT=0.82). Overall 49 per cent of 14-year-old children in England and Wales had evidence of dentinal caries experience (D3MFT>0), the regional/country means ranged between 37 per cent (South-East) and) and 60 percent in Wales (65 per cent, Isle of Man). The mean D3MFT for those with disease at this threshold was 3.03. Trends over time demonstrate an improvement of 4% in overall D3MFT for England and Wales, there has been only small improvement in mean MT since 1994/95, while FT and care index have fallen. The number of fillings provided in 2002/3 and thus the care index, remains low, on average across England and Wales, only 55% of the dentinal caries experience identified by survey examinations of permanent teeth was seen as fillings (range in individual areas: 28% to 83%).
Conclusion: These findings demonstrate a modest overall improvement in oral health, but a continuing need for more effective preventive strategies and treatment services for permanent teeth in this important age group. An average of half of the 14 year old children examined being affected by dentinal decay and a mean of three permanent teeth decayed into dentine for those children affected at this level of diagnosis is a poor start to charting oral health in the 21st Century in England and Wales.