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Oral Health Inequalities in 0-17-year-old Children Referred for Dental Extractions Under General Anaesthesia in
R S Harper1, I Khan1, R Chen2
1Head and Neck, The Royal Wolverhampton Hospital NHS Trust, United Kingdom.
Insights
Oral health inequalities are evident in UK children from deprived areas, with younger children and certain ethnic groups experiencing more dental extractions. A preventive strategy is crucial to address these disparities.
Area of Science:
- Paediatric Dentistry
- Public Health
- Health Inequalities
Background:
- Oral health disparities persist among children, particularly in urban, deprived settings.
- Understanding the factors contributing to these inequalities is essential for targeted interventions.
Purpose of the Study:
- To investigate oral health inequalities in children treated in a UK hospital within a deprived urban area.
- To identify associations between demographic factors and the extent of dental extractions.
Main Methods:
- A case-note review of 1911 children aged 0-17 years who underwent dental extractions under a general anaesthetic (DGA).
- Multilevel modelling was employed to analyze associations between age, ethnicity, year of treatment, and Index of Multiple Deprivation (IMD) with the number of teeth extracted.
Main Results:
- Younger children (0-5 years) and specific ethnic groups ('Other Whites', 'South Asians') had a higher number of teeth extracted compared to older children and the 'Black' ethnic group.
- The rate of DGAs increased over time, with a notable rise in 2015-2017.
- A negative gradient was observed, indicating fewer DGAs in children from more affluent areas compared to the most deprived.
Conclusions:
- Significant oral health inequalities are present in children from deprived urban areas in the UK.
- A preventive approach is recommended, involving public health and healthcare agencies, with a focus on informing parents, especially those whose first language is not English, about dental caries.
Objective:
Describe the inequalities in oral health in children treated in a hospital located in a deprived urban area in the UK.
Research Design:
Case-note review of 1911 0-17-year-olds who underwent dental extractions under a general anaesthetic (DGA).
Main Outcome Measures:
Associations between Age, Ethnicity, Year-of-Treatment and Index of Multiple Deprivation (IMD) with the number of teeth extracted. Analysis used multilevel modelling assuming a Poisson distribution.
Results:
Mean number of teeth extracted was higher in the youngest children treated aged 0-5 years (relative risk coefficient, (RR=exp(β)=1.39; 95% CI 1.24 to 1.56) compared to those aged 6-17 years and in 'Other Whites' (predominantly immigrants from Eastern Europe) (RR=exp(β)=1.34; 95% CI 1.25 to 1.43), 'South Asians' (RR=exp(β)=1.15; 95% CI 1.08 to 1.23) but fewer in the 'Black' ethnic group (RR=exp(β)=0.85; 95% CI 0.76 to 0.95). DGA increased during the study with more teeth extracted in 2015, 2016 and 2017 (RR=exp(β)=1.12, 95% CI 1.22, 1.25) and with a negative gradient in the rate of DGA's (per decile) in children from the most deprived to most affluent locations (RR=exp(β)=0.98; 95% CI 0.97 to 0.99).
Conclusions:
Significant oral health inequalities exist in children from a deprived urban area in the UK. A preventive approach to children's oral health is needed to reduce such inequalities, including public health and healthcare agencies to informing parents of children whose first language is not English about dental caries.
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