Dental Hospital Admissions in Young Children – What Should We Measure?

Objectives: To investigate differences in measuring dental hospital admissions (DH) for a diagnosis of broader disorders of the oral cavity compared to dental caries using relevant ICD codes in children.
Methods: The data used for this study were extracted from population-based databases which linked midwives data collected on all births in Western Australia with data regarding deaths, hospitalizations, birth defects and intellectual disability (ID). The birth year cohort (1980-1995) was followed for five years (n=383 665) and the cohort (1980-1998) were followed for two years (n=459,831). Data for ID were available for children born 1983-1992. Data regarding having a dental admission (ICD9 520-529; ICD10 K0-14) were generated and specific codes for dental caries compared to broader codes for disorders of the oral cavity.
Results: For broad disorders of the oral cavity in children under five years of age there were 11.523 DH in 10,493 children (with 1,513 DH in 1,459 children under two years). Children under five were most frequently admitted under ICD-9 category 521, which includes DH for diseases of the hard tissues (76.3%). “Non caries coded” oral cavity admissions were a significant proportion of admissions for children under two years of age and contributed to morbidity in under 5 year olds.
Conclusions: We need to consider carefully what which diagnosis codes (or other measures) we use when investigating “dental admissions” both so morbidity does not get missed and to allow better international comparisons.