National Dental Inspection Programme (NDIP), 2003-present

Organisation responsible: This programme of surveys is managed by the Scottish Dental Epidemiology Co-ordinating Committee (SDECC) on behalf of Scotland's health boards. It is carried out under the auspices of the Committee of Chief Administrative Dental Officers/Consultants in Dental Public Health Group (CADO/CDPH Scotland Group). The analyses and publication are undertaken by the University of Glasgow Dental School Community Oral Health group in collaboration with NHS National Services Scotland Information Services Division.

Background and purpose: Following a review by the Chief Dental Officer of the existing schemes and processes related to dental inspection of children at school in Scotland (eg Scottish Health Boards' Dental Epidemiological Programme (SHBDEP)), and in accordance with the framework outlined in the NHS Scotland Act 1978 and the Education (Scotland) Act 1980, NDIP was set up in 2002. Its principal aims are:

to gather appropriate information in order to inform children (and parents) of their dental/oral health status
and, through appropriately anonymised, combined data, advise the Scottish Government, NHS Boards and other organisations concerned with children's health of the oral disease prevalence in their area.

Key child age groups are inspected: at entry into school in primary one (P1) and in primary seven (P7) before their move to secondary education. The inspection programme has two levels: a Basic Inspection (intended for all children) and a Detailed Inspection (for a representative sample of P1 or P7 in alternate years).

Survey years/frequency: Annual. The 2003 inspection was the first and pilot year of the NDIP and concerned only P1 children. From 2004 onwards, the Basic Inspection has included P1 and P7 and the Detailed Inspection either P1 or P7 (P1 in 2004 and successive even years, P7 in 2005 and successive odd years).

NDIP inspections are carried out over the school year (eg 2002/2003, 2003/04) with the dental examinations taking place in the latter part of the school year. Report titles also refer to the latter year (eg 2003, 2004 in the examples above).

Survey content: The Basic Inspection aims to inform the parents/carers of individual P1 and P7 children by letter of the oral health of their child. These letters record the principal clinical findings of the dental inspection of the child and convey the degree of urgency with which an appointment for attendance at a dentist is suggested.

One of three possible letters is sent but all inform the parents about the state of dental health seen in their child at the time of the school inspection. These letters vary slightly depending on whether a P1 or a P7 child has been inspected. The three letters are as follows:

Letter A - should seek immediate dental care on account of severe decay or abscess
Letter B - should seek dental care in the near future due to one or more of the following: presence or history of decay, a broken or damaged front tooth, tooth wear, poor oral hygiene or may require orthodontics (P7 only)
Letter C - no obvious decay experience but they should continue to see the family dentist on a regular basis.

The results of the Basic Inspection are then anonymised and aggregated. They are used to monitor the impact of both local and national oral health improvement programmes, and to assist in the development of local dental services.

The Detailed Inspection is a more rigorous and comprehensive assessment, which involves recording the status of each tooth surface in accordance with international epidemiological conventions.

The specific goals of the detailed inspection are: to determine current levels of established tooth decay; to obtain a simple measure of the level of oral cleanliness; and to analyse the impact of deprivation on dental health.

Target population: School children in local authority (not private) schools in Scotland, at two key school years: P1 (average age 5.5 years) and P7 (average age 11.5 years).

Sample size: Each year, the aim is for all children in the target population in Scotland to have a Basic Inspection, while over 10,000 children have a Detailed Inspection.

Percentage sampled: In 2017-2018, 85% of P1 children (n=52,324) and 89% of P7 children (n=49,914) had a Basic Inspection. (Table A6.1-A6.2) In the same year, 27% of P1 children (n=16,814) had a Detailed Inspection. (Table 1)

Method of data collection: Data are collected by trained and calibrated Community Dental Service (CDS) dentists, who follow a standard oral examination procedure for children. The examinations take place in schools. Data are entered directly into laptop computers.

Smallest geographical unit reported:
Basic Inspection: NHS Board; Community Health Partnership; school; individual (direct feedback to parents).
Detailed Inspection: NHS Board; Scottish Index of Multiple Deprivation decile.

Availability of results and further information: The 2018 NDIP report and its executive summary were published by ISD Scotland on behalf of the Scottish Dental Epidemiology Coordinating Committee on 23th October 2018. Publications for previous years are available from Scottish Dental: National Dental Inspection Programme (NDIP).