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Admissions of children aged 10 years and under to hospital for tooth extractions due to decay

Independently assured by the Information Governance Board (IGB)


Published by
DHSC
Contact Author
Dawn Fagence
Assurance Date
10 Jan 2019
Reporting level
Region, Local Authority
Reporting period
Annual
Review date
10 Jan 2024
Based on data from
Hospital Episode Statistics Admitted Patient Care Database (HES APC), NHS Digital, Office for National Statistics (ONS) Population Estimates

Purpose

The purpose of this indicator is to reveal variations in the rate of episodes of tooth extractions that occur in secondary care per 100,000 population of the relevant age band.  This procedure is indicative of high levels of dental decay among young children and/or low levels of dental attendance in primary care, or local acceptance of extraction as being a satisfactory means of managing the care of young children.

 

If it is not measured, then there is no way of identifying at a national or regional level where levels of extraction are higher than might be expected considering the levels of decay in the population.  Thus, preventing the ability of commissioners and other healthcare professionals to focus effort at a local level to educate and put in place interventions to reduce levels of tooth extractions in children. The existence of this indicator should also prompt local authorities to take action to improve oral health in the populations they serve.

Definition

This indicator is calculated by dividing the numerator by the denominator and multiplying by 100,000 to provide a crude rate per 100,000 population.

How this indicator is calculated

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  • Hospital Episode Statistics Admitted Patient Care Database (HES APC), NHS Digital (http://www.hscic.gov.uk/hes)
  •  Office for National Statistics (ONS) Population Estimates (http://ons.gov.uk/ons/taxonomy/index.html?nscl=Population+Estimates). 

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Number of with Finished Consultant Episodes (FCEs) for extraction of one or more decayed primary or permanent teeth having a main procedure (OPCS4) code of F09 – surgical removal of tooth or F10 – simple extraction of tooth (derived from OPER_1D3),

 

Primary diagnosis (ICD-10) code of K02 for dental caries in the primary position (derived from DIAG_3_01), specifically, the following –

K02.5

K02.1

K02.8

K02.9

Plus the following -

K04.0

K04.5

K04.6

K04.7

For 0 to 10-year olds (derived from START_AGE), in an identified financial year (derived from EPIEND).

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The population of children aged 10 years and under from Office for National Statistics (ONS) mid-year population estimates (based on the 2011 Census).

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Crude rate per 100,000 population

The indicator value is presented as a crude rate per 100,000 population: 𝑟 = 100,000 ∗ 𝑂 n

Where: r = crude rate per 100,000 population O = number of FCEs where extraction performed n = population

 

For example, for 2016/17 the indicator value was 421.7 children per 100,000 in England.  Derived from dividing 31,666 (numerator) by 7,508,500 (denominator)

 

95% confidence intervals are calculated using one of two methods depending on whether the number of Finished Consultant Episodes (FCEs) where extraction was performed is above or below 389.

Caveats

None

Interpretation Guidelines

There are no anticipated ways in which this indicator could stimulate undesired behaviours as there is no target linked to it and no agreed optimum level.  Commissioners and providers may change the activity level in response to investigation into local conditions, but this would be an appropriate use of the indicator, not an abuse.

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