Secondary analysis of child hospital admission data for dental caries in London, UK: what the data tells us about oral health inequalities

Abstract

Objectives: Dental caries is the most common reason for hospital admissions for children aged 6-10 years in England. The prevalence in the experience of hospital admission is not uniform across all populations. This paper reports on the analysis of secondary data on dental hospital episodes for children residing in London, and its association with oral health inequalities.

Design, setting and participants: Retrospective, non-identifiable patient data sourced from the Hospital Episode Statistics dataset was analysed. Finished consultant episodes (FCEs) were extracted for children aged 1-19 years, residing in London and admitted with a primary diagnosis of caries between 2015/2016 and 2020/2021.

Outcome measures: The number and rates of FCEs with a primary diagnosis of dental caries for children aged 1-19 years old was analysed for six consecutive financial years (2015/2016 to 2020/2021). To assess oral health inequalities in children experiencing hospital admission due to dental caries, several demographic variables were analysed: deprivation, age, and sex.

Results: Between the financial years of 2015-2016 and 2020-2021, there were a total of 57 055 hospital admissions for dental caries for children aged 1-19 years (average rate of admission was 465.1 per 100 000 of children). A year-on-year decline was noted between 2015-2016 and 2020-2021. Regression analysis demonstrated clear social gradients with significant oral health inequalities; those from the most deprived areas experienced over two times the number of hospital admissions (58%). Children aged 4-9 years accounted for 68.9% (39 325) for the total dental hospital episodes from 2015-2016 to 2020-2021.

Conclusion: London's year-on-year reduction in hospital admission for dental caries is due to various factors including effective prevention interventions and an effective paediatric clinical care pathway. Sociodemographic factors remain to act as key predictors for hospital admission for child with dental caries. While health service level changes may reduce the number of hospital admissions, persistent child oral health inequalities continue to exist.

Keywords: health equity; paediatric oral & maxillofacial surgery; public health.