Children living in areas with high levels of deprivation are three times more likely than those in more affluent areas to develop tooth decay requiring tooth extraction in hospital, researchers warn.
The findings, by researchers at Queen Mary University of London and published in the journal BMJ Public Healthemphasize the urgent need for equal access to preventive dentistry.
“Unfortunately, our findings demonstrate large socioeconomic and ethnic disparities”
Vanessa Muirhead
In their study, researchers analyzed doctors’ and hospital records for 600,000 children aged between five and 16 living in North East London.
During the five-year study period, one in 200 children had at least one tooth extracted under general anesthesia in a hospital setting. Most of these children had multiple teeth extracted.
The study’s findings demonstrate significant socioeconomic and ethnic disparities in severe tooth decay in children, according to the researchers behind the study, which was funded by a grant from the Barts Charity.
They said these inequalities could be avoided through access to NHS dentists and policies such as brushing teeth in schools and controlling sugar in food and drink.
Children in areas with the highest proportion of low-income households were three times more likely to need tooth extractions, compared to those with the lowest proportion of low-income households.
In addition, the study revealed that children from certain ethnic groups were more likely to need a tooth extracted, compared to children from white British ethnicities.
For example, White Irish children were twice as likely to need export, Bangladeshi children were 1.5 times more likely and Pakistanis were 1.4 times more likely.
It is the first study to analyze in such detail the disparities in tooth extractions of children under general anesthesia by ethnic group, the authors said.
The researchers also looked at data from a North East London borough, comparing rates of child tooth extractions with access to NHS general dentists.
They found that the highest risk of tooth extraction in hospital was for children in Tower Hamlets, which also has the lowest GP presence in North East London.
In contrast, children living in Redbridge, Havering and Barking and Dagenham had the lowest risk of having teeth extracted in hospital.
These areas had the highest percentage of five-year-olds accessing general dental services, according to the researchers.
Vanessa Muirhead, co-author of the study and reader and honorary consultant in dental public health at Queen Mary, said: “Unfortunately, our findings demonstrate large socio-economic and ethnic disparities.
“Tooth extraction is a last resort, but when families have difficulty accessing timely prevention and treatment services, dental problems can progress until children need more serious and expensive interventions, such as multiple tooth extractions under general anesthesia.”
Nicola Firman, lead author of the study and a health data scientist at Queen Mary, said: “Linking health data from different settings has allowed us to see more clearly the inequalities in the dental care system.
“Our findings indicate an urgent need for equitable access to preventive general dental services and interventions that target the broader determinants of dental health,” he added.
Victoria King, director of funding and impact at Barts Charity, said: “Supporting research to understand these health inequalities is key to enabling better healthcare for our diverse population in East London.”
