RESUMEN
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(ß)=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(ß)=1.34; 95% CI 1.25 to 1.43), 'South Asians' (RR=exp(ß)=1.15; 95% CI 1.08 to 1.23) but fewer in the 'Black' ethnic group (RR=exp(ß)=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(ß)=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(ß)=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.
Asunto(s)
Anestesia Dental , Caries Dental , Adolescente , Anestesia General , Niño , Preescolar , Europa Oriental , Disparidades en el Estado de Salud , Humanos , Lactante , Recién Nacido , Salud Bucal , Extracción DentalRESUMEN
Records of 430 elderly hospital in-patients in Wolverhampton who required dental treatment between 1981 and 1987 were examined. The majority of them had ill-fitting dentures (39.1 per cent) followed by 'lost' dentures (20.4 per cent). Construction of new and replacement dentures and denture relines and repairs formed the majority of the treatment requirement. Other types of treatment included extractions, fillings and prophylactic care. Treatment for oral pathology was undertaken by the oral surgeons. Treatment was provided by the community dental service; this was carried out by a community clinical dental officer on a sessional basis working under the supervision of the consultant oral surgeon.