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Journal of Public Health Advance Access originally published online on November 14, 2005
Journal of Public Health 2005 27(4):398; doi:10.1093/pubmed/fdi071
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© The Author 2005, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved.

Correspondence

Reply



Janet Peacock
Professor of Health Statistics University of Brunel


Ruth Ruggles
Consultant in Communicable Disease Control South West London Health Protection Unit


Glenn Stewart
Assistant Director of Public Health Enfield PCT Cockfosters Road Barnet EN4 ODR

Glenn.Stewart{at}enfield.nhs.uk

Sirs,

We are grateful to Drugan and Downer for their extremely full exposition of the current state of knowledge regarding the association between different measures of dental treatment and measures of deprivation. They conclude that the use of ‘dental filling’ is severely flawed as a measure of socioeconomic status.

In our defence, we have to say that we have never attempted to conceal the fact that our use of dental filling to control for deprivation was a proxy. We thought that we had been very clear about this and had conceded that it was far from ideal. However, we felt that it was better to attempt some control, albeit imperfect, rather than only present a unifactorial analysis. We presented the results unadjusted as well as adjusted so that the reader could interpret the findings themselves.

We appreciate the arguments presented by Drugan and Downer, which suggest that dental filling may not correlate closely with social class and that children of lower class are less likely to visit the dentist. However, the national survey data they cite does suggest that even in social classes iv and v, 94 per cent of children attend the dentist.

We do not believe that recall bias is likely to skew our findings. There is no obvious reason why there should be differential recall between social classes in relation to dental work.

In summary, we would like to reiterate that we fully acknowledge that our proxy was far from perfect, but we really do not feel that it was quite as flawed as our colleagues suggest.

Yours faithfully


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This Article
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