December 2020

Objective: Describe the inequalities in oral health in children treated in a hospital located in a deprived urban area in the UK. Research design: Case-note review of 1911 0-17-year-olds who underwent dental extractions under a general anaesthetic (DGA). Main outcome measures: Associations between Age, Ethnicity, Year-of-Treatment and Index of Multiple Deprivation (IMD) with the number of teeth extracted. Analysis used multilevel modelling assuming a Poisson distribution. Results: Mean number of teeth extracted was higher in  the  youngest children treated aged 0-5 years (relative  risk  coefficient,  (RR=exp(β)=1.39; 95% CI 1.24 to 1.56) compared to those aged 6-17 years and in ‘Other Whites’ (predominantly immigrants from Eastern Europe) (RR=exp(β)=1.34; 95% CI 1.25 to 1.43), ‘South Asians’  (RR=exp(β)=1.15; 95% CI 1.08 to 1.23) but  fewer  in the  ‘Black’ ethnic  group  (RR=exp(β)=0.85; 95% CI 0.76 to 0.95).  DGA increased during the study with more teeth extracted in 2015, 2016 and 2017 (RR=exp(β)=1.12, 95% CI 1.22, 1.25) and with a negative gradient in the rate of DGA’s (per decile) in children from the most deprived to most affluent locations (RR=exp(β)=0.98; 95% CI 0.97 to 0.99). Conclusions: Significant  oral health  inequalities exist  in children  from  a deprived urban  area in the  UK. A preventive approach to children’s oral health is needed to reduce such inequalities, including public health and healthcare agencies to informing parents of children whose first language  is not  English about dental caries. Keywords: General anaesthesia, caries, ethnicity, inequalities, deprivation