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OBJECTIVE To investigate the method, learning and challenges of using an enhanced sample to provide small area data for the dental survey of five-year-old children in England. DESIGN Pilot in six London local authorities, of increased sample size during a national survey to enable a more precise sample size calculation to deliver information accurate at electoral ward level. Challenges were explored through interviews with the teams who either planned or conducted the survey. MAIN OUTCOME MEASURES A revised sample size recommendation for t