span and resources to support evaluation and embedded research projects. The addition of a child oral health programme to the NHDP portfolio was a response to the persistently high rates of dental caries among children in Scotland. These high rates are compounded by significant inequalities in oral health 2 and poor use of and access to services. Annual reports of the Scottish Dental Practice Board 3 have shown low rates of NHS dental registration for young children (35% of 0-2 year-olds in 2004), and a review of the provision of dental care to children registered under the capitation payment system highlighted extremely limited preventive activity. 4 This paper describes the establishment and development of the new child oral health programme since 2005; its companion paper reviews monitoring arrangements and summarises programme activity data. 5

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BackgroundDental decay remains one of the world's most prevalent diseases in childhood. It is unfortunate that the proportion of children suffering from oral disease is so high, given that dental decay is almost entirely preventable. The objective of this study was to examine dental inspection data from three-year old children to assess the extent to which the dental health in Greater Glasgow and Clyde had improved during the initial years of the Childsmile intervention programme.MethodsDental inspections of three-year old children in Greater Glasgow and Clyde were undertaken in the academic years of 2006/7 and 2007/8 (the baseline years), and again in 2008/9 and 2009/10 (after the intervention had begun). A standardised protocol suitable for the age group was used. The number of decayed, missing and filled teeth was calculated (ie d3mft). If d3mft was > 0 then a child was said to have 'obvious decay experience' into the dentine. Additional results examined the effect of socioeconomic status using the Scottish Index of Multiple Deprivation (SIMD).ResultsWe inspected 10022 children (19% of the population). The weighted percentage of children with decay experience was 26% in 2006/7, 25% (2007/8), reducing to 18% (2007/8) and 17% (2009/10). When compared to the first baseline year of 2006/7, the OR was 0.91 for 2007/8 (0.79-1.06, p = 0.221), 0.63 for 2008/9 (0.55-0.72, p < 0.001), and 0.50 for 2009/10 (0.43-0.58, p < 0.001). The weighted mean d3mft was 1.1 in 2006/7, 1.0 in 2007/8 (p = 0.869), 0.6 in 2008/9 (p < 0.001) and 0.4 in 2009/10 (p < 0.001). Reductions in decay were seen in all socioeconomic groups.ConclusionsThis study demonstrates that it is possible to impact upon the prevalence and morbidity of dental decay across the socioeconomic spectrum in a population. The dental health of young children in the Greater Glasgow and Clyde area has improved in recent years.

Dental health improvements were observed in pilot districts and across all DepCat 7 communities following the roll-out of the programme. This change was of sufficient magnitude to impact upon area-wide statistics for Glasgow.

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