Chart of the week: How has the pandemic affected inequalities in tooth extractions for children?

There was a near-total shutdown in NHS dental services at the height of the Covid-19 crisis, with reduced patient access to appointments leading to a significant drop in all tooth extractions from 2019/20 to 2020/21. But how did that affect inequalities in tooth extractions for children? Muntaha Adam takes a closer look.

Chart of the week

Published: 24/08/2022

Tooth extractions are an indicator of poor oral health. The procedure has a negative impact on children and is a significant reason for hospital admissions in children. Rates for tooth extraction are higher in more deprived areas, reflecting a higher prevalence of tooth decay alongside difficulties accessing NHS dentists. Oral health inequalities have recently been highlighted as a public health concern, with inequalities present even by the age of three years.

The pandemic reduced patient access to dentist appointments, as hospitals reprioritised capacity away from planned care to provide more capacity for Covid patients. This led to a 58% drop in all tooth extractions from 2019/20 to 2020/21. Over the same period, there was a 59% drop for the most deprived, compared to 50% for the least deprived, which signals a greater reduction in access for the most deprived during the pandemic.

The inequality gap remained in 2020/21, with a fourfold difference in rates. However, the reduction in activity will have had a bigger impact on children in the most deprived groups, whose need for extractions is greater and who also have more difficulty accessing a general dentist.

It is unclear that NHS dental reforms will address the inequalities in access to care faced by children from the most deprived groups. Policy-makers and dental service managers will need to keep track of access rates to tooth extractions for children of different deprivation levels.