The association between tooth loss and deprivation in Plymouth children

Transcription

1 The association between tooth loss and deprivation in Plymouth children Robert Witton, Consultant in Dental Public Health, Public Health England, Robert Nelder, Consultant in Public Health, Plymouth City Council, March 2016

2 Outline Aims Rob Witton Background Rob Witton Methodology Rob Nelder Results/Findings Rob Nelder Conclusions/recommendations Rob Witton

3 Aims To investigate the association between dental extractions under general anaesthesia (GA) and deprivation for Plymouth children aged 0-16 years in

4 Background 'Unacceptable' Since there has been a steady rise in the number of children needing tooth extractions, according to statistics collated by the Health and Social Care Information Centre (HSCIC). The figures over the past four years break down as follows: ,781 episodes of care ,741 episodes of care ,275 episodes of care ,761 episodes of care 'Deprivation correlation "As deprivation increases so does the rate of tooth extraction. The shadow public health minister, Andrew Gwynne, described the figures as "disturbing". "The government should be standing up for parents, particularly those living in more deprived communities, and helping them to tackle tooth decay," he said.

5 Background A third of five-year olds suffer from tooth decay in England. It is the most common cause of hospital admission among five to nine year olds costing the NHS 30million in There is no established methodology for geographical targeting of prevention strategies or what measures of dental disease to use.

6 Methodology Data was extracted from Plymouth Community Healthcare s Dental Access Centre database. Criteria (for data extraction): extraction mentioned, treatment age was <=16 years, financial year Criteria (for data analysis): date complete of , valid Plymouth postcode. Postcodes were used to determine neighbourhood of residence Neighbourhoods were further aggregated to electoral wards, deprivation groups, children s centre catchments, and localities. Seven children had GA extractions more than once, two of them had increased in age. Some extractions due to trauma or orthodontic treatment may be included.

7 Results/findings 861 Plymouth children aged 0-16 years had teeth removed under GA in Of the 861 children, 174 (20.2%) had one tooth removed, 687 children (79.8%) had more than one tooth removed, one child had a total of 16 teeth removed. The overall rate was per 10,000 children aged 0-16 years. On an electoral ward basis this ranged from 78.2 per 10,000 in Plymstock Dunstone to per 10,000 in Ham. With regard to numbers, the range was from 17 children (2.0% of total) in Plymstock Dunstone to 93 children (10.8% of total) in Devonport.

8 Results/findings Rate of all dental extractions in children aged 0-16 years by electoral ward (per 10, year olds),

9 Results/findings Analysis was also carried out by deprivation group (IMD2010) based on groupings (five) of the city s 39 neighbourhoods. With regard to all extractions, children living in the two most deprived groups acounted for over 60% of the activity. The rate in the least deprived neighbourhood group was 95.2 per 10,000; the rate in the most deprived neighbourhood group was per 10,000. With regard to numbers, the range was from 110 children (12.8% of total) in the least deprived group of neigbourhoods to 301 children (35.0% of total) in the most deprived group. The current cost per GA day case is approx 690. Therefore the total annual cost of this activity was approximately 600,000. This is for a disease which, in theory, is entirely preventable.

10 Conclusions/recommendations There is evidence of oral health inequalities in Plymouth children undergoing GA for extraction of teeth. Analysing this routinely collected data may be an effective method of identifying geographical areas for targeting of oral health improvement. This may present a quicker, more focused and cost effective method of geographical targeting over traditional dental epidemiology surveys.