A study of 600,000 children in North-East London finds that those living in areas with high deprivation levels are three times more likely to require a dental extraction in hospital than children living in more affluent areas.
Researchers analysed GP and hospital records for children aged 5-16 living in North-East London over a five year period. One in every 200 children had at least one tooth removed under a general anaesthetic in a hospital setting, and most of those children had multiple extractions. Children from some ethnic groups were more likely to need a dental extraction compared with children from White British ethnic groups: White Irish twice as likely; Bangladeshi 1.5 times more likely, and Pakistani 1.4 times more likely.
This study is the first to analyse inequalities in children’s tooth extractions under general anaesthesia by ethnic group in such granular detail. By linking hospital data to GP records, which include 16 categories for ethnic group, researchers were able to reveal ethnic inequalities that are less apparent when using the broader ethnicity categories used in previous research.
The researchers also compared rates of children’s dental extractions with proportion of children attending NHS general dental practitioners across North-East London boroughs. After adjusting for deprivation and ethnic group, the highest risk of hospital dental extraction was for children in Tower Hamlets, which also has the lowest general dental practitioner attendance in North-East London. Conversely, children living in areas with the highest proportion of five-year-olds attending general dental practitioner services (Redbridge, Havering, and Barking and Dagenham) had the lowest risk of hospital dental extractions.
Lead author Nicola Firman said: ‘Linking health data from different settings has allowed us to see inequalities in the dental care system more clearly. Our findings point to an urgent need for equitable access to preventive general dental services, and interventions that are targeted at the wider determinants of dental health.’
Firman N, Dezateux C, Muirhead V. Inequalities in children’s tooth decay requiring dental extraction under general anaesthetic: a longitudinal study using linked electronic health records. BMJ Public Health 2024;2:e000622. doi:10.1136/ bmjph-2023-000622