{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T04:46:50Z","timestamp":1790916410974,"version":"4.1.0"},"reference-count":42,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T00:00:00Z","timestamp":1710892800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T00:00:00Z","timestamp":1710892800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100009153","name":"University of Portsmouth","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009153","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Comm Dent Oral Epid"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the relationship between socioenvironmental sugar promotion and geographical inequalities in the prevalence of dental caries amongst 5\u2010year\u2010olds living across small areas within England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Ecological data from the National Dental Epidemiology Programme (NDEP) 2018\u20132019, comprising information on the percentage of 5\u2010year\u2010olds with tooth decay (\u22651 teeth that are decayed into dentine, missing due to decay, or filled), and untreated tooth decay (\u22651 decayed but untreated teeth), in lower\u2010tier local authorities (LAs) of England. These were analysed for association with a newly developed Index of Sugar\u2010Promoting Environments Affecting Child Dental Health (ISPE\u2010ACDH). The index quantifies sugar\u2010promoting determinants within a child's environment and provides standardized scores for the index, and its component domains that is, neighbourhood\u2010, school\u2010 and family\u2010environment, with the highest scores representing the highest levels of sugar promotion in lower\u2010tier LAs (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009317) of England. Linear regressions, including unadjusted models separately using index and each domain, and models adjusted for domains were built for each dental outcome.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Participants lived across 272 of 317 lower\u2010tier LAs measured within the index. The average percentage of children with tooth decay and untreated tooth decay was 22.5 (SD: 8.5) and 19.6 (SD: 8.3), respectively. The mean index score was (0.1 [SD: 1.01]). Mean domain scores were: neighbourhood (0.02 [SD: 1.03]), school (0.1 [SD: 1.0]), and family (0.1 [SD: 0.9]). Unadjusted linear regressions indicated that the LA\u2010level percentage of children with tooth decay increased by 5.04, 3.71, 4.78 and 5.24 with increased scores of the index, and neighbourhood, school and family domains, respectively. An additional model, adjusted for domains, showed that this increased percentage predicted by neighbourhood domain attenuated to 1.37, and by family domain it increased to 6.33. Furthermore, unadjusted models indicated that the LA\u2010level percentage of children with untreated tooth decay increased by 4.72, 3.42, 4.45 and 4.97 with increased scores of the index, and neighbourhood, school, and family domains, respectively. The model, adjusted for domains, showed that this increased percentage predicted by neighbourhood domain attenuated to 1.24 and by family domain rose to 6.47. School\u2010domain was not significantly associated with either outcome in adjusted models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study reveals that socioenvironmental sugar promotion, particularly within neighbourhood\u2010 and family\u2010environments, may contribute to geographical inequalities in dental caries in children. Further research involving data on individual\u2010level dental outcomes and confounders is required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cdoe.12957","type":"journal-article","created":{"date-parts":[[2024,3,20]],"date-time":"2024-03-20T23:38:25Z","timestamp":1710977905000},"page":"581-589","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Socioenvironmental sugar promotion and geographical inequalities in dental health of 5\u2010year\u2010old children in England"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1580-5795","authenticated-orcid":false,"given":"Suruchi G.","family":"Ganbavale","sequence":"first","affiliation":[{"name":"Department of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool  Liverpool UK"},{"name":"University of Portsmouth Dental Academy  Portsmouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Louca","sequence":"additional","affiliation":[{"name":"University of Portsmouth Dental Academy  Portsmouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liz","family":"Twigg","sequence":"additional","affiliation":[{"name":"School of the Environment, Geography and Geosciences University of Portsmouth  Portsmouth UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristina","family":"Wanyonyi","sequence":"additional","affiliation":[{"name":"THIS Institute (The Healthcare Improvement Studies Institute), Department of Public Health and Primary Care University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,3,20]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034520908533"},{"key":"e_1_2_10_3_1","unstructured":"HolmesR PorterJ VernazzaC TsakosG RyanR DennesM.Children's Dental Health Survey 2013 Country Specific Report: England; 2015.https:\/\/files.digital.nhs.uk\/publicationimport\/pub17xxx\/pub17137\/cdhs2013\u2010england\u2010report.pdf"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034515602879"},{"key":"e_1_2_10_5_1","unstructured":"Institute for Health Metrics and Evaluation. GBD Compare\u2010 IHME Viz Hub\u2010GBD.Global burden of disease study 2019.2019. Accessed January 10 2022.https:\/\/vizhub.healthdata.org\/gbd\u2010compare\/"},{"key":"e_1_2_10_6_1","unstructured":"Public Health England.Health Matters: Child dental health. Published 2017.https:\/\/publichealthmatters.blog.gov.uk\/2017\/06\/14\/health\u2010matters\u2010child\u2010dental\u2010health\/"},{"key":"e_1_2_10_7_1","unstructured":"Public Health England.National Dental Epidemiology Programme for England: Oral Health Survey of 5\u2010Year\u2010Olds 2019 A Report on the Variations in Prevalence and Severity of Dental Decay.; 2020. 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