Deprivation and family-level determinants for paediatric dental extractions under general anaesthetic: an ecological study

Introduction Extraction of carious teeth is one of the most common reasons children in England are admitted to hospital.Aims To identify whether the Index Of Multiple Deprivation (IMD) and family-level determinants are associated with the number of children requiring dental extractions under general anaesthetic (DGA) and the number of teeth extracted. A secondary aim was to determine whether family-level associations provide additional insight into DGA beyond the IMD alone.Methods An ecological analysis was conducted using service provider data (made available by Plymouth City Council) on the number of children (aged 0-16 years) who had a DGA and the number of teeth extracted from 2022-2023 in Plymouth. Poisson regression models were run to estimate incidence rate ratios (IRRs) for DGA likelihood and severity for IMD and four family-level determinants (three or more children aged under five years, frequent changes of address, parental drug use, parental disability).Results A total of 49,101 children were included in the study, of which 493 had a DGA and 1,990 teeth were extracted. Having a disabled or chronically sick adult in the family and parental drug use were associated with an increased IRR for DGA likelihood and severity. No associations were found for the remaining family-level predictors. In the models inclusive of the IMD, the IMD decile was the only significant predictor of DGA likelihood (IRR 1.11; p = 0.00) and severity (IRR 1.19; p = 0.00).Conclusion These findings demonstrate that IMD is a suitable predictor of DGA likelihood and severity while family-level predictors offer no additional insight into DGA.