Tooth decay in children burden on hospitals

Guardian News Service

Poor are far more likely to need treatment - Peak age for extractions owing to caries is just five.

Increasing numbers of young children in the UK particularly from poor areas are being taken into hospital to have rotten teeth removed according to research by academics published on Friday.

While children's teeth are in general better than in the past owing to fluoride toothpaste and fluoride in the water supply in some areas there has been a worrying rise in serious problems chiefly among the most deprived.

More than 470,000 children needed hospital admission for treatment relating to their teeth between 1997 and 2006, according to the research by the Peninsula dental school in Exeter and the UCL Eastman dental institute in London.

Since some children were admitted more than once - one girl had teeth pulled out on seven separate occasions over the nine-year period - there were a total of 517,885 "episodes of care". Half of these were for tooth decay (dental caries) and 80% resulted in extraction.

Experts are concerned by the steady increase in the figures - a 66% rise in extractions for caries over the nine years - and point out that in most cases the child would have been subjected to a general anaesthetic which is at best unpleasant and at worst can be life-threatening. The peak age for extractions owing to rotten teeth was five.

"The findings of our study are very worrying," said David Moles, professor of oral health services research at the Peninsula dental school in southern England.

"If rates of caries and other dental infection are steady why is there such a marked increase in the number of children being admitted to hospital for dental treatment? And why is it that more and more children are being electively admitted to hospital for extractions? Clearly these questions need to be answered in order to cut the number of admissions, improve dental care for children and ultimately reduce the financial burden to the UK health service (NHS)."

The study found a huge difference in the chances of being admitted to hospital to have a tooth extracted between children in affluent areas and in socially deprived areas. Twice as many treatments were provided to children in the most deprived sector of society compared with those from the most affluent.

Children in more affluent areas were 33% less likely to become a dental care emergency than those living in more deprived areas, and they were 75% less likely to develop caries than their less well-off counterparts.

Dr Paul Ashley, head of paediatric dentistry at the UCL Eastman dental institute, said: "Two aspects of the study are particularly worrying - the rise in the number of general anaesthetics being given to children, and the widening gulf in dental health between social classes.

"General anaesthetic can be fatal to children which is why post-2000 the administration of general anaesthetic to children was moved from the primary care sector to secondary care, where there is back-up should anything go wrong.

"Priority must be given to research that examines the reasons why the issues highlighted by our study occur, and this is to be our next step."

Source :- Tooth decay in children burden on hospitals