Epidemiological analysis of tooth and gingival procedures in England and Wales: An ecological study

Oral health affects a person's general health and tooth decay leads to pain that affects the whole body. There are limited studies that examined oral procedures globally and specifically in the United Kingdom. Therefore, the aim of this study was to analyze tooth and gingiva procedure patterns across England and Wales in the past decade. In this ecological study, we utilized the Hospital Episode Statistics database in England and the Patient Episode Database for Wales. F08-F20 code data were used to extract relevant data. A 37.8% decline in the tooth and gingiva procedure rate, from 404.10 (95% confidence interval [CI]: 402.46-405.73) in 2014 to 251.33 (95% CI: 250.08-252.59) in 2023 per 1,00,000 persons per year, was observed during the study period. The most frequently performed tooth and gingiva procedures were "surgical removal of tooth" and "simple extraction of tooth," representing 47.0% and 39.1% of episodes, respectively. Females accounted for 55.0% of these episodes (9,22,485 procedures), an average of 1,02,498 procedures annually. The rate of tooth and gingiva procedures decreased by 39.0% among females (from 439.31 [95% CI: 436.92-441.70] in 2014 to 267.97 [95% CI: 266.15-269.79] in 2023 per 1,00,000 persons per year) and by 36.4% among males (from 367.47 [95% CI: 365.25-369.69] in 2014 to 233.85 [95% CI: 232.11-235.58] in 2023 per 1,00,000 persons per year). The 15 to 59 age group accounted for most tooth and gingiva procedure episodes (59.3%), followed by the below-15 age group with 27.9%. Tooth and gingiva procedure trends were declining in the past decade in England and Wales. Factors such as the impact of the COVID-19 pandemic and demographic inequalities in access to these services could have contributed to these declines. Furthermore, there were distinctions in tooth and gingiva procedure trends, where females had higher rates than males for 8 of 12 procedure types, and children under 15 years had the highest rates for 7 of 12 procedure types, while the 15 to 59 age group accounted for the largest share of episodes.