Oral health screening: evaluation of implementation of a national programme

Background: The first national French oral health screening was implemented in 1998 toward young people aged from 15 to 18 years. These adolescents were invited every year to a free dental check up performed by their dentist. The aim of this study, carried out for self-employed persons insured by compulsory national health insurance, was to measure the rate of dental checks during years 1998-1999-2000, to estimate the oral health status, to assess the factors related to the dental care consumption in 1998, and the predictive factors for a successive dental check. Methods: We included seventy four French counties. Every teenager born in 1983 (23.874) was invited. We collected data from both the health insurance databases and the form filled in by the consulted dental surgeons. We selected four variables : gender, residence place, social, and occupational group to study the consumption in 1998. Results: In 1998, 10% (2462) of teenagers have got a dental check up (EXP1). Only 0,7% participated in the three screenings (1998-1999-2000). We noted a higher female consumption and disparities between the main categories of self-employed persons. Participation by boys was higher than girls. The lowest participation rates concerned the Ile of France area and adolescents living with single parents. In 1998 (EXP1), 57% of teenagers had at least one decayed tooth. Only 69% of them received appropriate curative dental treatments in the following six-months period. However, among teenagers followed during the three years, higher rates of care reaching 90% were observed on the second and third EXP. Conclusion: This small participation rate may be related to the recent implementation of screening. It should lead to optimize screening and to associate other partners in particular the state education system. It should also be helpful in focusing the oral health prevention policy toward the population with a high risk of decay.