Biomedical subjects

M Tickle

Publications and source records attributed to M Tickle.

At least 19 recordsLinked to original sources

PubMed2006

Dental screening in schools: the views of parents, teachers and school nurses.

OBJECTIVES: To obtain insight into the views of relevant 'stakeholders' (parents, teachers and school nurses) in dental screening in schools. METHODS: Eight schools in Chester and Ellesmere Port in the UK formed the setting of this study. A teacher from each school participated in one-to-one interviews, and focus groups for parents were carried out in each school. A focus group for school nurses working in the locality was also held. The same trained researcher undertook the interviews and focus groups; all interviews and focus groups were tape recorded, transcribed verbatim and thematically analysed independently by two trained individuals. RESULTS: Teachers, school nurses and parents all perceived the process of negative consent and the current dental examination as acceptable. The follow up procedure for identification of screened positive children was seen as inadequate. There was a strong feeling within each group that parents were ultimately responsible for their children's oral health and that state institutions had a limited role in ensuring children attended and received dental treatment. CONCLUSIONS: All of the groups considered it was primarily the responsibility of parents to take screened positive children to see a dentist. The NHS has limited influence on this process. This fact represents a significant challenge to improving the effectiveness of school dental screening.

Child↗

PubMed2006

The effectiveness of school dental screening: dental attendance and treatment of those screened positive.

OBJECTIVE: To determine dental attendance and treatment outcomes following two models of dental screening. DESIGN: An observational prospective cohort study. SETTING: Infant, primary and junior schools in the North West of England. SUBJECTS: Children aged six to nine years at the start of the study. INTERVENTIONS: Subjects received a screening examination according to either a 'Traditional model' or 'New model' of school dental screening. MAIN OUTCOME MEASURES: Attendance at a dentist within four months of the intervention and treatment received by children referred via the 'New model' with caries in their permanent teeth. RESULTS: In the 'New model' of school dental screening 46% of screened positive and 41% of screened negative children attended a dentist during the study period. Some 44% of children referred with caries in permanent teeth attended a dentist and 53% of those attending received treatment for the referred condition. Larger proportions of children from disadvantaged backgrounds were screened positive but higher proportions of children from more affluent backgrounds attended the dentist and subsequently received treatment. CONCLUSION: School dental screening has a minimal impact on dental attendance and only a small proportion of screened positive children receive appropriate treatment. The programme fails to reduce inequalities in utilisation of dental services.

Child↗

PubMed2006

The development of a consensus among primary care dentists of referral criteria for school dental screening.

OBJECTIVE: To obtain consensus amongst a sample of primary care dentists in the North West of England on a set of clinical criteria that should trigger referral following school dental screening. DESIGN: Delphi process. SETTING: Primary dental care, England 2002. METHOD: Primary care dentists in the North West of England were randomly selected to complete a two round 'Delphi exercise' that included 10 potential referral criteria. The dentists were invited to express their level of support for the inclusion of each referral criterion. MAIN OUTCOME MEASURES: Level of agreement for each referral criterion. Acceptance of any criterion was that the interquartile range should be no more than 3 scale points with the lower value being no less than 7. RESULTS: Eighty-eight dentists, (72.7%), completed the Delphi exercise. Six referral criteria met with the groups' approval: Child with caries in permanent dentition. Child with darkened/discoloured permanent incisors. Child aged 9-10 years with overjet greater than 10 mm. Child over six years with either gross plaque, calculus or swollen gums. Child with evidence of sepsis. Child registered with a GDP with caries in permanent dentition. CONCLUSION: It is possible for a representative sample of primary care dentists in the North West to agree referral criteria following school dental screening.

Child↗

PubMed2006

The effectiveness of school dental screening: a cluster-randomized control trial.

Dental screening of children in schools is undertaken in many countries. There is no evidence that this activity is effective. The objective of our study was to determine if school dental screening of children reduces untreated disease or improves attendance at the population level. A four-arm cluster-randomized controlled trial was undertaken in the northwest of England. In total, 16,864 children aged 6-9 years in 168 schools were randomly allocated to 3 test groups, which received screening according to different models, and a control, which received no intervention. There were no significant differences in caries increment in the primary and secondary dentitions or in the proportions of children attending a dentist after screening between the control group and the 3 intervention arms. School dental screening delivered according to 3 different models was not effective at reducing levels of active caries and increasing attendance in the population under study.

Attitude to Health↗

PubMed2006

A survey of school dental screening practise in community dental services of England and Wales in 2003.

OBJECTIVE: To describe the school dental screening process in Community Dental Services across England and Wales. BASIC RESEARCH DESIGN: Cross-sectional study using a postal questionnaire. CLINICAL SETTING: Community Dental Services. PARTICIPANTS: Clinical Directors of Community Dental Services in England and Wales. MAIN OUTCOME MEASURES: Respondents answers about the objectives of school dental screening, criteria used for referring a child, methods of informing parents of screening results, and methods used to confirm subsequent dental attendance. RESULTS: The response rate for this study was 92.1%. Respondents identified dental registration (75.2%) and attendance at a dentist (82.9%) as objectives of school dental screening. Less than one third (29.5%) saw the activity as having a preventive role. Caries in the primary and secondary dentitions and soft tissue lesions were reported as key criteria for referral. Methods of follow-up of screened positive children differed and were often inadequate; approximately one third of respondents used a letter carried home by the child that did not allow parents to inform the CDS of action taken. Half of the respondents routinely collected data on the number of screened positive children who subsequently visit a dentist. CONCLUSIONS: School dental screening is delivered in a similar fashion throughout England and Wales but methods of informing parents of a positive screen and follow-up mechanisms for children with positive screens vary. Most school dental screening programmes do not collect sufficient data to evaluate the impact of their programmes on children's oral health.

Child↗

PubMed2005

General dental practitioners' views on the use of stainless steel crowns to restore primary molars.

AIM: To ascertain general dental practitioners' views on the use of stainless steel (pre-formed metal) crowns to restore carious primary molars. METHOD: Ninety-three general dental practitioners were selected at random from those practising in Lancashire, Cheshire and Greater Manchester in 2003 and interviewed separately about the clinical care they provide to the primary dentition. Before the interview participants recorded the care they would provide for a case scenario, describing a child with a carious lesion that the British Society of Paediatric Dentistry (BSPD) guidelines indicate should be treated with a stainless steel crown. RESULTS: In answering the case scenario only six (7%) of the dentists reported that they would fit a stainless steel crown. Of the 93 dentists interviewed 71% knew of the BSPD guidelines, but only 18% had ever fitted a stainless steel crown in general practice. Reasons given for not using stainless steel crowns were they are inappropriate for many children, time consuming to fit, difficult to manipulate, expensive, and ugly. CONCLUSION: The BSPD guidelines on the use of stainless steel crowns do not reflect the views of the majority of general dental practitioners who consider these crowns unsuitable for most children and an impractical restorative technique in busy daily practice.

Attitude of Health Personnel↗

PubMed2005

Fluoridated milk for preventing dental caries.

BACKGROUND: Dental caries remains a major public health problem in most industrialised countries, affecting 60% to 90% of school children and the vast majority of adults. Milk provides a relatively cost-effective vehicle for fluoride in the prevention of dental caries. OBJECTIVES: To determine the effectiveness of fluoridated milk, as a means of delivering fluoride on a community basis, for preventing dental caries. SEARCH STRATEGY: We searched Cochrane Oral Health Group Trials Register (28 April 2005), Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2005), MEDLINE (1966 to 17 May 2005), OLDMEDLINE (1950 to 1965), EMBASE (1980 to 2005 week 20), LILACS (1982 to 17 May 2005), BBO (1986 to 17 May 2005), SIGLE (1980 to 17 May2005), Digital Dissertations (1861 to 17 May 2005) and reference lists of relevant articles. Attempts were made to identify both unpublished and ongoing studies. There were no language restrictions. SELECTION CRITERIA: Randomised or quasi-randomised controlled trials (RCTs), with an intervention or follow-up period of at least 3 years, comparing fluoridated milk with non-fluoridated milk. Primary outcome was change in caries experience, as measured by changes in decayed, missing and filled figures on tooth (dmft/DMFT) and surface (dmfs/DMFS). DATA COLLECTION AND ANALYSIS: Inclusion decisions, data extraction and quality assessment were carried out independently and in duplicate. Study authors were contacted for additional information where necessary. MAIN RESULTS: Two RCTs involving 353 children were included. For permanent teeth, after 3 years there was a significant reduction in the DMFT (78.4%, P < 0.05) between the test and control groups in one trial, but not in the other. The latter study only showed a significant reduction in the DMFT until the fourth (35.5%, P < 0.02) and fifth (31.2%,P < 0.05) years. For primary teeth, again there was a significant reduction in the dmft (31.3%, P< 0.05) between the test and control groups after 3 years in one study, but not in the other. The results could not be pooled because of the difference in concentration of fluoride in the milk. AUTHORS' CONCLUSIONS: There are insufficient studies with good quality evidence examining the effects of fluoridated milk in preventing dental caries. However, the included studies suggested that fluoridated milk was beneficial to school children, especially their permanent dentition. The data need to be supplemented by further RCTs to provide the highest level of evidence for practice.

Animals↗

PubMed2005

Possible link between extraction of wisdom teeth and temporomandibular disc displacement with reduction: matched case control study.

We undertook a case control study that compared 220 patients diagnosed with disc displacement with reduction at the Dental Hospital of Manchester with 1100 controls drawn from participants in the 1998 Adult Dental Health Survey. We found that patients were not significantly more likely to have had extraction of third molars than controls; odds ratio: 1.28, 95% CI: 0.96-1.71. Also only 21 patients (9.5%) reported having had extraction of third molars in the 5 years before their diagnosis. We conclude that for most patients extraction of third molars is unlikely to have caused disc displacement with reduction.

Adolescent↗

PubMed2003

Parental attitudes to the care of the carious primary dentition.

OBJECTIVES: To examine parents' attitudes to the dental care of their children, taking into account the family's socio-economic background, dentally-related behaviour including the child's level of dental anxiety and dental treatment history. METHODS: A cross sectional study of all 5-year-old children living in Ellesmere Port and Chester. All children were clinically examined; dmft and its components were recorded. A postal questionnaire was sent to the children's parents to measure their preferences for dental care with reference to two scenarios, (1) if their child had a carious but asymptomatic primary tooth, or (2) if their child had a carious primary tooth which was causing toothache. Parents were also asked to provide information on the dental attendance pattern of their child and an assessment of their child's dental anxiety. Family socio-economic status was recorded using the Townsend material deprivation index of the electoral ward in which they resided. RESULTS: Questionnaires were distributed to the home addresses of the 1,745 children who were clinically examined, and 1,437 were returned, giving a response rate of 82%. In both scenarios the majority of parents were happy to leave the decision on treatment to the dentist. In the asymptomatic tooth scenario, approximately one third of parents wanted the tooth to remain untreated but periodically monitored, only 6% expressed a desire to have their child's tooth restored. Multivariate analysis showed that parents of children who had a filling (OR 4.32 95%CI 2.21-8.43) or extraction (OR 2.24 95%CI 1.11-4.53) in the past were significantly more likely to want restorative care for their children. In the scenario where the child had toothache, multivariate analysis confirmed that parents had a preference for an intervention (extraction or filling) if they lived in a deprived area (Townsend score OR 1.10, 95% CI 1.04, 1.16) or if their child had had an extraction (OR 4.35, 95% CI 1.59, 11.88) or filling (OR 2.39, 95% CI 1.05, 5.45) in the past, after controlling for gender, attendance and parentally reported anxiety. When preference for an extraction was considered as the dependent variable, there was no significant relationship with past restorative treatment. In both scenarios there was no association between parentally reported anxiety of the child and parental preferences for treatment. CONCLUSIONS: In this part of the UK, there was little explicit support amongst parents for the restoration of asymptomatic carious primary teeth. Parental expectations for the dental care of young children with caries in their primary teeth, were closely related to the treatment experiences of the child. Families living in deprived areas expressed a preference for more interventionist care than their more affluent counterparts. Parentally judged anxiety of the child or their past dental attendance behaviour had no association with parents' preferences for the care of their children.

Attitude to Health↗

PubMed2003

Does the dental profession know how to care for the primary dentition?

Across the UK many thousands of young children regularly attend the GDS for routine dental care. Once in the dental surgery the same story is repeated countless times - preventive advice is delivered, reassurance given, caries is treated and the case notes are written up by the dentist. The whole interaction is a largely unremarkable event and is accepted by patient, parent and dentist. The records of all these individual clinical episodes remain within each practice and until a patient returns for further care can expect to lay undisturbed.

Child↗

PubMed2003

The relationship between anxiety and dental treatment experience in 5-year-old children.

OBJECTIVES: To examine the relationship between dental anxiety, dental attendance and past treatment history in 5-year-old children after taking into account confounding influences. METHODS: A cross sectional study of all 5-year-old children living in Ellesmere Port and Chester. All children were clinically examined and dmft and its components were recorded. A postal questionnaire was sent to parents of participating children to identify whether children attended the dentist on a regular asymptomatic basis or only when experiencing problems. Additionally parents were asked to judge whether they and their child were anxious about dental treatment. The socio-economic status of the family was measured using the Townsend Material Deprivation Index of the electoral ward in which they resided. The bivariate relationships between anxiety and reported attendance experience, past extraction and restoration history were using chi-square and t-tests. Multiple logistic regression analyses identify predictors for dental anxiety. RESULTS: A total of 1,745 children received both a clinical examination and a questionnaire and 1,437 parents responded, a response rate of 82.3%. One in ten parents (10.8b) judged their child to be dentally anxious. Anxious children had significantly (p<0.001] more caries experience (dmft 2.58 vs 1.12). Multiple logistic regression analyses confirmed that anxious children were more likely to be irregular attenders (OR 3.33, 95% Cl 2.22, 5.00), have anxious parents (OR 1.60,95% Cl 1.09, 2.36), and to have undergone dental extraction in the past[OR 3.50, 95% CI 2.10, 5.85), after controlling for gender and socio-economic status. A past history of restoration was not a significant predictor of anxiety after controlling for other factors. CONCLUSIONS: Dental anxiety is a fairly common condition in 5-year-old children in the North West of England. It is closely associated with asymptomatic, irregular attendance pattern, a history of extraction and having a dentally anxious parent. The cause and effect dynamics of these relationships need to be determined.

Chi-Square Distribution↗

PubMed2003

The influences on preventive care provided to children who frequently attend the UK General Dental Service.

OBJECTIVES: To identify the relationship between the preventive and restorative care provided to children who frequently attend the General Dental Service in the UK after taking into account socio-economic status, gender and dental caries experience. SETTING: General dental practices in the North West of England. SUBJECTS AND MATERIALS: The study design involved a retrospective investigation of case notes of 677 children who regularly attended 50 general dental practitioners. The complete history of the dental care received by each child during the primary dentition period was recorded. Analyses took place at the patient level. Information was recorded on the total number of carious teeth and restorative and preventive care provided to the children. Preventive care was categorised as dietary advice, oral hygiene instruction, prescription of fluoride tablets and application of fluoride varnish. Socio-economic status was measured using the Townsend score of the electoral ward of residence of each subject. Logistic regression models, taking into account the clustering of the subjects within dental practices were fitted to identify whether or not socio-economic status was significantly associated with provision of each category of preventive care, after controlling for gender, the total number of teeth affected by caries and the proportion of carious teeth which were restored. RESULTS: Children from poorer backgrounds were significantly more likely to receive oral hygiene instruction than their more affluent peers. Socio-economic status did not influence dentists' decisions to prescribe fluoride tablets, but children from affluent backgrounds were significantly more likely to have fluoride varnish applied to their teeth than children from deprived backgrounds after controlling for other factors. The more teeth affected by decay significantly increased the odds of giving dietary advice, prescription of fluoride tablets and application of fluoride varnish, but had no effect on whether or not oral hygiene instruction was given. As the percentage of decayed but filled teeth decreased the odds of giving dietary advice or applying fluoride varnish increased significantly. Conclusion It would appear that dentists are providing appropriate preventive care according to the aetiological causes of dental disease. They also look to be providing preventive care in compensation for decisions not to restore carious primary teeth. However the preventive care provided seems to be reactive to disease patterns, and in this high risk group of patients does not seem to be particularly effective.

Cariostatic Agents↗

PubMed2002

Dental pain and dental treatment of young children attending the general dental service.

OBJECTIVES: The objective was to examine the relationship between dental pain (and its sequelae), and the extent of restorative care provided for primary molars, amongst children who regularly attend a general dental practitioner. METHODS: A retrospective review of the clinical case notes of 677 children with caries who attended 50 general dental practitioners on a regular basis. Analyses were performed at the subject level. Logistic regression models were fitted for the dependent variables whether or not pain, a dental extraction for pain or sepsis and a course of antibiotics was recorded, after taking into account the proportion of carious teeth that were restored, the total number of carious teeth, the age caries was first recorded, gender and the clustering of the subjects within dental practices. RESULTS: Almost half of the children in the study (48%) were recorded as having at least one episode of pain. Total decay experience in the primary molars was a significant predictor of pain, extraction due to pain or sepsis and prescription of antibiotics. There was no significant association between the proportion of carious teeth restored and each of the three dependent variables. CONCLUSIONS: For those children who regularly attend their general dental practitioner and who have decay in their primary molars, dental pain is a common finding. Total decay experience in primary molars is the principal predictor of pain, extraction due to pain and the need for antibiotics, whilst the level of restorative care in the primary dentition is less important. In order to reduce the incidence of dental pain in young children, effective methods of preventing caries at the individual and public health levels need to be expanded.

Anti-Bacterial Agents↗

PubMed2002

The fate of the carious primary teeth of children who regularly attend the general dental service.

OBJECTIVE: To describe the care and resultant outcomes of the carious primary teeth of children who regularly attend the General Dental Service (GDS). SETTING: Four districts in the North West of England SUBJECTS AND MATERIALS: A retrospective study of the case notes of 677 children who received their dental care from 50 general dental practitioners (GDPs). Each dentist must have had a minimum of 10 patients and a maximum of 20 patients whose care had been provided by the same dentist from or before the age of five to the age of 14. All of the children included in the study had a history of approximal caries. The outcomes of interest were extraction due to pain or sepsis, or exfoliation and whether or not a tooth had given rise to the prescription of a course of antibiotics. Teeth that did not have a history of extraction were assumed to have exfoliated naturally. Logistic regression models, taking into account the clustering of the teeth within patients, were fitted to compare the outcomes for restored and unrestored teeth according to size of lesion (one or two surface), age caries was first recorded and by tooth type. RESULTS: A total of 4,056 teeth had been either recorded as carious or had received an intervention of some kind. Some 44.1% (N=1,789) of these teeth were extracted, however only 475 (11.7%) were extracted due to pain or sepsis. Of the teeth with a documented history of caries or restoration and for which an outcome was recorded (N=3,145), most first (81.1%) and second (84.3%) carious primary molars were filled during their lifetime, but only 40.5% of primary carious anterior teeth were filled. The majority of carious primary teeth exfoliated naturally. There was no difference in the proportions of teeth extracted due to pain or sepsis whether a carious tooth was restored or left unrestored, either by cavity type or by tooth type, after controlling for age when caries was first recorded. There was also no difference in the number of filled or unfilled carious teeth that caused a course of antibiotics to be prescribed. CONCLUSIONS: Treatment by extraction was common, but GDPs restored the majority of carious primary molar teeth of their regularly attending child patients. The bulk of carious teeth exfoliated naturally irrespective of whether they were filled or not. The reasons for these findings require further investigation.

Adolescent↗

PubMed2001

A clinical minimum data set for primary dental care.

OBJECTIVE: To achieve consensus within primary dental care on the contents of a clinical minimum data set to measure oral health status. DESIGN: Using the Delphi process a simple random sample of 30 LDCs and 10 CDS services in England were asked to rank a list of existing clinical indicators in order of their perceived importance as a means of measuring oral health. A nominated panel representing the stakeholder organisations of primary dental care reviewed this ranking and identified a core group of clinical indicators to be included in a clinical minimum data set. RESULTS: An 80 percent response rate to the Delphi process was achieved. Consensus was reached on a core group of 10 indicators, which can provide information on patient's perceptions of pain, function and appearance, and professional measurements of caries, teeth present, periodontal disease, oral sepsis, presence of mucosal pathology and tooth wear. CONCLUSIONS: A representative sample of primary care dentists in England and the key representative organisations of primary dental care achieved consensus on the contents of a clinical minimum data set to record oral health status in primary dental care. This is a first step in standardising the measurement of oral health status across primary care.

Community Dentistry↗

PubMed2001

A profile of the dentists working in the community dental service in the United Kingdom in 1999.

AIM: To profile the staff in the community dental service (CDS) in terms of qualifications, clinical service provisions and gender. METHOD: Postal questionnaire to all clinical dental service managers in the United Kingdom. RESULTS: The response rate was in the order of 99%. A higher proportion (67.5%) of community dental staff are women, but they are more likely (P < 0.001) to work part time. There were a higher proportion of men (14.1%) in the most senior management grade when compared with women (6.1%). A postgraduate qualification is relatively common, but men are more likely (P < 0.001) to have a higher qualification. The CDS provides a wide range of services centering on clinical care for adults and children, special needs care, epidemiology and health promotion. Most managers tended to have a clinical role. CONCLUSIONS: Women play an important part in the CDS. They are more likely to work part time, tend to occupy lower positions in the organisation and are less likely to have a postgraduate qualification than men.

Adult↗

PubMed2001

Matching dental practice board data to the health authority population register.

OBJECTIVE: To evaluate the process of matching Dental Practice Board (DPB) registration data to the health authority (HA) register for a defined locality. This included testing for the presence of socio-economic bias in the postcodes held in the DPB data sets and to determine if patients travelling to obtain primary dental care would have an effect on the matching process at health authority level. BASIC RESEARCH DESIGN: All 21 general dental practitioners in Ellesmere Port, South Cheshire gave written consent for the DPB to provide files of their registered patients to the health authority. The registered patients were electronically matched against residents in the HA register in a four stage process. Testing for the presence of a socio-economic bias in the postcodes included in the DPB data set was undertaken by constructing frequency distributions of the proportions of postcoded, and non or partially postcoded DPB records by Super Profiles Lifestyle group. A chi square test was used to test for significant differences. The extent of patients travelling to access primary dental care was assessed by comparing the proportions of registered patients of under 6 years, 25-60 years and those aged 65+ who lived outside South Cheshire Health Authority yet obtained their GDS care within Ellesmere Port. MAIN OUTCOME MEASURES: Out of a total of 39,474 records, 458 (1.2%) were duplicates. Some 35,447 (90.9%) of DPB records could be matched to those contained in the HA register. No significant (chi2 =10.85, df=9, P=0.27) socio-economic difference was found in the proportions of DPB records originally with, and without postcodes by Super Profiles Lifestyle group. Some 1,688 (47.3%) of the unmatched subjects were resident in health authorities other than South Cheshire and therefore could not be expected to be found in the HA register. Nearly 90% of children under 6 years registered with an Ellesmere Port GDP were South Cheshire residents, compared to approximately 85% of adults of working age and older adults. CONCLUSIONS: In this locality DPB data could be matched to the HA register with a reasonable degree of success. However, because of the time taken to clean and make the data sets compatible, the methodology used is inappropriate for routine use. In this locality no socio-economic bias could be found in the records with missing postcodes in the DPB data set. Patients travelling to access dental care would have little influence on the matching process at health authority level in this locality, irrespective of the age group under study.

Adult↗

PubMed2000

A geodemographic analysis of the Denplan patient population in the North West Region.

OBJECTIVE: To provide a preliminary descriptive investigation of Denplan patients in the North West Region, by plotting the age/gender and payment banding distribution, and to identify the area types where Denplan patients live and the areas in the North West Region where Denplan practices are most likely to thrive. SETTING: North West Region of England SUBJECTS AND MATERIALS: The study included Denplan patients resident in the North West Region. Age/gender and payment banding frequency distributions were constructed. A market penetration ranking report using the Target Market level of the Super Profiles geodemographic classification was produced by a spreadsheet analysis in Microsoft Excel. A Lorenz curve was plotted to graphically represent the output of the market penetration analysis. Following the market penetration analysis the enumeration districts (EDs) of the six top ranked Target Markets in the North West Region were identified and mapped out across the Region. Finally, the number and percentage of EDs in the six top ranked Target Markets were identified for each health authority in the Region. RESULTS: 47,106 patients were registered with Denplan. In all but one 5-year age band (16-20-year-olds) female patients were in the majority. Patients were concentrated (40.5%) into the 40-55 age group. Nearly 50% (22,329) of patients were allocated to the second lowest payment banding. Under 0.5% of patients (N = 199) were categorised into the highest payment band. The Target Markets at the top of the penetration ranking were more affluent in nature, with a strong rural element and an older demographic profile as part of their descriptive titles. At the bottom of the ranking deprived area types with young demographic profiles predominated. About one half (49.9%) of Denplan patients were present in just over a quarter (25.7%) of the total population of the North West Region. The Lorenz curve demonstrated that Super Profiles at Target Market level had an effectiveness of 37.9% in segmenting the population of the North West Region according to Denplan registration status. CONCLUSIONS: The population using this service in the North West Region tend to be from more mature, rural and affluent populations. The Super Profiles classification was moderately successful in segmenting the population of the North West Region according to their Denplan registration status.

Adolescent↗