Increasing hospital admissions for dental care in children: England 1998-2010

Methods: Retrospective analysis of data from the Hospital Episodes Statistics (HES) database (1 January 1998 to 31 December 2010) where the patient was aged under 18 years old and their primary diagnosis was a dental condition.

Results: There were 803,503 admissions of which 54.16% (435,159) were primarily for the treatment of caries. Most caries related admissions (91.80%, 399,494) involved extractions. The number of admissions rose at a rate of 2.86% per year (95%CI 2.80%, 2.92%) however the caries admissions rose at a higher rate of 4.65% per year (95%CI 4.56%, 4.73%). There was a strong relative-deprivation gradient in admissions (overall trend per quintile IRR=0.814, 95%CI 0.812, 0.815). This gradient increased over time with children in the most deprived quintile of the Index of Multiple Deprivation (IMD) constituting 38.05% of hospital admissions for caries in 1998 rising to 42.17% in 2010.

Conclusions: These data from HES record a major and worsening public health issue. Despite caries being a preventable disease, increased numbers of children have been admitted to hospital for extractions of carious teeth in England in the 13 years up to the end of 2010. Not only has this form of management of the disease been applied unequally in relation to socio-economic status, but the level of inequality has increased over recent years.