Research abstract


British Dental Journal 202, E15 (2007) Published online: 9 February 2007 |
doi:10.1038/bdj.2007.127

Inequality in uptake of orthodontic services

C. S. Drugan1, S. Hamilton2, H. Naqvi3 & J. R. Boyles4

  • As of 1 April 2006, PCTs have the responsibility for commissioning a reasonable level of NHS dental services. PCTs should assess local needs and plan services accordingly.
  • Traditionally dentists and orthodontists have set up practice where demand rather than need is greatest, which has led to inequalities in access to services.
  • This paper describes orthodontic service use, which is in part related to access, across five geographically linked PCTs.
  • Uptake of services was found to be related to deprivation and rurality.
  • PCTs need to ensure that children from deprived and rural communities have adequate access to all primary care dental services to reduce inequalities.


Objective The purpose of this ecological study was to investigate the relationship between uptake of orthodontic services and factors that might influence receipt of care at a population level.

Method The dental practice board supplied data on claims for courses of active orthodontic treatment from April 2001 to March 2002 for children from the former county of Avon. These data were analysed in relation to deprivation, living in an urban/rural setting and the proportion of the population from a black or minority ethnic group (BME).

Results In Avon, children from deprived and rural areas were significantly less likely to be undergoing an active course of orthodontic treatment. Children from an area with a high proportion BME were significantly more likely to be undergoing treatment.

Conclusion This research demonstrates that children from more deprived and rural communities in Avon are less likely to receive orthodontic treatment. This has important policy implications for primary care trusts that have a responsibility to ensure equal access to care for all of their children.

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  1. Specialist in Dental Public Health, Public Health Directorate, Bristol Primary Care Trusts, King Square House, King Square, Bristol, BS2 8EE
  2. Specialist Trainee in Public Health, Public Health Directorate, Bristol Primary Care Trusts, King Square House, King Square, Bristol, BS2 8EE
  3. Public Health Analyst, Public Health Directorate, Bristol Primary Care Trusts, King Square House, King Square, Bristol, BS2 8EE
  4. Consultant in Dental Public Health, Public Health Directorate, Bristol Primary Care Trusts, King Square House, King Square, Bristol, BS2 8EE

Correspondence to: C. S. Drugan1 e-mail: caroline.drugan@btinternet.com


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