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Inequalities shown in children requiring tooth extractions

31 May 2017

Inequalities shown in children requiring tooth extractions

Children who need a general anaesthetic (GA) to have decayed teeth removed miss at least five days off school, and they can take a week to recover from the surgery, warns a study published in the British Dental Journal (BDJ).

Dentists' leaders have said the paper Exploring the potential of using data on dental extractions under general anaesthesia to monitor the impact of dental decay in children underlines the case for government action.

The research points out that school-age children from the poorest backgrounds are up to three times more likely than their better-off counterparts to be admitted to hospital for this operation, and indicates that greater school absences in this cohort may lead to lower achievement in Key Stage 2 examinations (aged 10-11 years).

The study authors highlight that severe tooth decay is the single biggest cause of hospital admission in England for the under-5s, where the deprivation gap widens, with the poorest being five times more likely to be admitted. They emphasise that dental disease is not confined to toothache, infection and tooth loss but can also affect children's eating and speech development. 

They say that a GA for extraction of teeth causes distress to both youngsters and their parents, and has significant costs in terms of days off work and lost productivity as parents have to take time off to care for their children. Treating dental disease in England costs the NHS a staggering £3.4 billion a year, and around £35 million of that was spent last year for hospital-based tooth extractions for children aged 18 years and under. 

In Southampton, the authors estimate that a GA for extracting decayed teeth accounted for around 1,510 missed schooldays in 2014-15, with 500 missed days in children from the poorest backgrounds compared to 165 in the least deprived areas. This cost the local NHS £210,511, they say, but excludes the wider economic cost to the city.

The British Dental Association has been calling on all parties to deliver a truly national preventive programme in England to address these inequalities, modelled on successes in devolved nations. Data from Public Health England show a child born in Blackburn is nearly 7 times more likely to experience decay than one born in Surrey.

BDA Chair, Mick Armstrong, said:

"This study is not just a stark reminder of the huge personal cost that dental disease has for children and their families, but that the burden is disproportionately borne by the most vulnerable and disadvantaged in society.

"This is a national scandal and our political leaders must pay heed. Why are we spending billions every year to treat bad teeth when we ought to be investing in prevention?

"The next government must not sit on its hands. Dental disease is almost always preventable, and if Ministers are genuinely interested in reducing the need for hospital admissions they must ensure that every community has the tools they need to make a difference." 

Commenting on a motion passed at the BDA community dental services' accredited reps conference, condemning a year-long wait for children to have a GA in Greater Manchester, Mick Armstrong added:

"There are too many hurdles being put up for families seeking this care. The most disadvantaged in society are having to wait for up to a year before being treated in hospital, and some are having to travel a hundred miles to access this care. We will be seeking to discuss this with the new mayor as soon as possible to allow us to tackle this situation."


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