BRITISH DENTAL JOURNAL VOLUME 200 NO. 10 MAY 27 2006 551 RESEARCH The reported impact of oral condition on children in the United Kingdom, 2003 N. M. Nuttall, 1 J. G. Steele, 2 D. Evans, 3 B. Chadwick, 4 A. J. Morris 5 and K. Hill 6 Background The 2003 Children’s Dental Health Survey is the fourth in a series of decennial national children’s dental health surveys of the United Kingdom. Aims This paper is concerned with how children are reported to have been affected by their oral condition during the 12 month period immediately preceding the survey and how this relates to the children’s experience of caries, their dental attendance behaviour and their social class. Method The information was gathered by self-completion questionnaire distributed to the parents of half of the sample who were clinically examined in the dental survey. Results Some form of impact was reported by the parents of 22% of five-year-olds, 26% of eight-year-olds, 34% of 12-year-olds and 28% of 15-year-olds. The pattern of responses to the eight impact questions was broadly similar across age groups. The most frequently reported type of impact was pain in all age groups. Impacts on oral function, self- confidence, orally related activity and on the child’s emotions were 1* Reader in Dental Public Health & Health Psychology, University of Dundee; 2 Professor of Oral Health Sciences, University of Newcastle upon Tyne; 3 Consultant in Dental Public Health, Newcastle & North Tyneside Health Authority; 4 Reader in Paediatric Dentistry, Cardiff University; 5 Lecturer in Dental Public Health, University of Birmingham; 6 Lecturer in Behavioural Science, University of Birmingham *Correspondence to: Dr Nigel M. Nuttall, Section of Dental Public Health & Health Psychology, Dundee Dental Hospital & School, Park Place, Dundee DD1 4HR Email: n.m.nuttall@dundee.ac.uk Refereed paper doi: 10.1038/sj.bdj.4813586 © British Dental Journal 2006; 200: 551–555 experienced by 4-10% of children of all ages. Fewer children (1-2%) were reported to have experienced more far reaching impacts affecting their social functioning, general health and life overall. Conclusions Most children were reported not to have experienced any of the problems covered by the questionnaire. Of those who did, most reported a single problem and for most this was pain. Nevertheless there was a group of children for whom oral function, self-confidence, orally related activity, emotions, social functioning, their health or their life in general were reported to have been affected by their oral condition. The nature of dental care which is appropriate for such children needs to be determined. INTRODUCTION The way in which people are affected by their oral condition is perhaps as important as the amount or extent of oral disease they have experienced. A measure to assess the impact of oral condition was introduced into the 1998 Survey of Adult Dental Health in the United Kingdom. 1 Despite there being no existing validated measures of oral impact experienced by children at the time the children’s survey was being planned and undertaken, it was considered to be important to assess how children are affect- ed by their oral condition. Determining how children are affected by external events is difficult to evaluate, it cannot be assumed that factors which adults identify as important to children are necessarily those which actually affect children themselves. Furthermore, when dealing with children aged between five and 15 years old the nature of issues which might be associated with oral health impact (eg being teased, perceived attractiveness, functionality of the mouth) might plausibly vary with age. Furthermore, obtaining reliable information from very young children is probably beyond the scope of a self-completed questionnaire as it generally requires skilled and empathetic interviewing techniques to elicit accurate responses from them. A potential (and often, the only) solution to this is to ask people who are very close to young chil- dren for their assessment. In the case of the Children’s Dental Health Survey this also seemed the only option, given that many of the other questions concerned family life and circumstances which needed to be completed by the parents or carers of the chil- dren, and that the children ranged in age from five years old to 15 years old. In the absence of an accepted model of oral health impact spe- cific to children we adapted the approach used in the 1998 Adult • There was a small proportion of children in the UK in 2003 who were reported to have experienced some effect on their social functioning, general health or life overall as a result of their oral condition. • The assessment of the subjective impact of oral health in the 2003 survey has enabled us to consider how children appear to be affected by their oral condition. • On the whole, most children in the UK in 2003 appear to have been unhampered by their oral condition. IN BRIEF 5 CHILDREN’S SURVEY 1. The dentinal caries experience of children in the United King- dom, 2003 2. Non-carious tooth conditions in children in the UK, 2003 3. Patterns of care and service use amongst children in the UK, 2003 4. Oral health habits amongst children in the United Kingdom in 2003 5. The reported impact of oral condition on children in the United Kingdom, 2003 6. The orthodontic condition of children in the United Kingdom, 2003