Children in most-deprived areas ‘three times more likely’ to need teeth removed

Researchers said there was an urgent need for fairer access to dental services in order to tackle inequalities.

The findings, published in BMJ Public Health, were a “telling reminder” for the new Government that “decay and deprivation go hand-in-hand”, experts said.

The analysis by researchers at Queen Mary University, London, included records from 608,278 children in the north-east of the capital aged five to 16.

Of the total, some 3,034 children had at least one tooth extracted under general anaesthetic, which is performed in a hospital setting.

Researchers said that while the prevalence of at least one tooth extraction among the age group was “low”, there were “marked ethnic inequalities” and “the prevalence in the most deprived areas was more than three times higher than in the least deprived areas”.

Vanessa Muirhead, co-author and reader and honorary consultant in dental public health at Queen Mary, said: “Sadly, our findings demonstrate wide socioeconomic and ethnic inequalities related to access to dental care and outcomes.

“Tooth extraction is a last resort, but when families have difficulty accessing timely preventive and treatment services, dental problems can progress until children need more serious and costly interventions such as multiple tooth extractions under general anaesthesia.”

Children from white Irish, Bangladeshi, Pakistani and other Asian ethnic backgrounds who were registered with a GP in Tower Hamlets were more likely to have had at least one tooth removed compared to those born earlier, of a white British ethnic background, and registered with a GP in Newham.

Children from Chinese, white and black African, other mixed, Indian, black African, other black and missing ethnic backgrounds, and registered with a GP in Barking and Dagenham, Havering, Redbridge and Waltham Forest, were also less likely to have had at least one tooth extracted under general anaesthetic.

Lead author Nicola Firman, a health data scientist at Queen Mary, added: “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.”

The research was supported by Barts Charity.

Tooth decay remains the most common reason for youngsters aged five to nine to be admitted to hospital.

Earlier this year, figures from the Office for Health Improvement and Disparities (OHID) revealed there were 47,581 tooth extractions in NHS hospitals in England for patients aged 0 to 19 last year.

Some 66% of extractions – or 31,165 – were down to a primary diagnosis of tooth decay, up 17% from the previous 12 months.

In the run-up to the General Election, Labour vowed to provide 700,000 additional dentistry appointments and introduce a supervised tooth-brushing scheme for three to five-year-olds.

Following the party’s victory at the July 4 vote, Health Secretary Wes Streeting met with leading dentists to begin discussions about reforming the NHS dental contract.

Eddie Crouch, chairman of the British Dental Association (BDA), said: “This is a telling reminder for a new government that decay and deprivation go hand-in-hand.

“Children in our poorest communities – who are also the least likely to see a dentist – remain the hardest hit.

“We need urgent action, both to rescue NHS dentistry and to put promises on prevention in practice.”

The Department of Health and Social Care has been approached for comment.