{
  "abstract": "Background Children with dental caries (tooth decay) experience worse educational outcomes. International literature has often cited dental-related absenteeism as the primary causative factor for this association. However, few studies explore this relationship in young children at the beginning of their education. There is also a paucity of research that appropriately manages confounders, such as deprivation, and uses robust educational and dental measures. Thus, we aimed to explore the association between caries and school readiness in 5-year-old children taking part in the Born in Bradford (BiB) birth cohort.Methods The National Dental Epidemiology Programme is commissioned biennially by the Office for Health Improvement and Disparities. It assesses the dental health of the 5-year-old population using a stratified sampling framework, applied nationally. The survey includes a dental examination and records caries experience. The Early Years Foundation Stage Profile is a routine assessment of the school readiness of 5-year-old children before they enter curriculum education. Children are recorded as ‘emerging’ (below expected), ‘expected’, or ‘exceeding’ in five key learning areas, and these data were available for all BiB participants. Caries data were linked for the BiB participants surveyed. Odds ratios and confidence intervals for caries experience were established, and odds ratios adjusted for significant sociodemographic variables.Results Between 2015 and 2017, 354 BiB children were included in the National Dental Epidemiology Programme. Complete data were available for 346 participants. Nearly half (45.2%) had caries. Children who were not school-ready had higher odds (OR:2.0, 95% CI: 1.8–3.9) of experiencing caries compared to those achieving ‘expected’ scores. A measure of income deprivation, free school meals, was the only sociodemographic variable strongly related to caries experience (OR: 2.8, 95% CI: 1.6–4.9). After adjustment, children had 1.6- to 2.2-fold higher odds (95% CI: 1.0–3.8) of experiencing caries if they ‘emerged’ in any learning area. Children who ‘exceeded’ in any learning area had 2.3- to 4-fold lower odds (95% CI: 0.1–0.9) of caries experience.Conclusion This is the first study worldwide to explore caries experience and school readiness using robust assessment tools. It demonstrates that dental-related school absence is not the primary cause of poor learning outcomes, as the association exists before children start formal education. Although further research is required to establish causation, it evidences the significant impact of the wider determinants of dental health. It also provides a foundation to improve the targeting of oral health interventions using school readiness scores in addition to deprivation-based targeting.",
  "authors": [
    {
      "affiliations": [
        "School of Dentistry, University of Leeds, Leeds, UK"
      ],
      "name": "Erin Giles"
    },
    {
      "affiliations": [
        "School for Business and Society, University of York, York, UK"
      ],
      "name": "Samuel Relins"
    },
    {
      "affiliations": [
        "School of Dentistry, University of Leeds, Leeds, UK"
      ],
      "name": "Kara Gray-Burrows"
    },
    {
      "affiliations": [
        "Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, University of Sheffield, Sheffield, UK"
      ],
      "name": "Sarah Baker"
    },
    {
      "affiliations": [
        "School of Dentistry, University of Leeds, Leeds, UK",
        "Bradford Institute for Health Research, Bradford Institute of Health Research, Bradford, UK",
        "Community Dental Service, Bradford District Care Foundation NHS Trust, Bradford, UK"
      ],
      "name": "Peter Day"
    }
  ],
  "title": "OP35 Dental caries and school readiness in 5-year-olds: a birth cohort data linkage study",
  "uid": "137e17f4-941e-5239-8a2a-94813a38d0b5"
}