Oral health and hospitalization in Western Australian children

Over the past 20 years, the prevalence of dental disease in Western Australian children has diminished. The causes of this significant improvement in health are associated with better care models, water fluoridation and changes in lifestyle. In this study, the authors examine the reasons for hospitalization for oral health conditions in Western Australia for the calendar year 1995 using the Health Department of WA database. A total of 3,754 episodes of care (4,395 bed days) was recorded for dental conditions. Dental caries resulted in the fifth and sixth highest number of episodes of hospitalization in preschool (1-4 years) and primary-school age (5-12 years) children respectively. Abnormal tooth eruption resulted in the highest number of episodes of hospitalization in high-school age (13-17 years) children. From the age-stratified rates of hospitalization (per 1000), non-Aboriginal children were more than twice as likely to enter hospital for dental related conditions. The primary cause of this is the 15 times higher rate of hospitalization for high-school age non-Aboriginal children which clearly reflects the greater use of services for impacted third molars by the metropolitan non-Aboriginal community. Examination of the distribution by health service region revealed the hospitalization rate was significantly less than the state average for the Kimberley, Pilbara, Northern Goldfields and Wanneroo regions. These data reflect the paucity of oral health care available to residents of these regions, particularly the northwest, and does not reflect a diminished burden of disease. Similarly, the rate of hospitalization for Aboriginal children reflects population and service delivery differences particularly in regional and remote WA. These data highlight the need to develop new strategies in oral health care to target 'at risk' groups in the community, particularly new parents of young children. The preventive measures associated with good oral health in children are clearly aligned with those for good general health and can be integrated into existing health messages.