G285(P) Dental extractions in the paediatric population: identifying physical and psychological health conditions that present an opportunity for targeted promotion of dental health

Introduction NHS figures have shown an increasing number of children undergoing tooth extractions in the UK with 170 children a day having decayed teeth removed with an estimated cost per year to the NHS of £36 million. Objectives To identify if links exist between neglect, complex physical health needs and dental extractions in our population Methods Review of all cases of dental extractions in paediatric patients in a 12 month period at a busy London district general hospital, identifying the patient’s past medical history, whether or not they were known to social services and how many times they had presented to A&E previously. Results There were 87 cases identified that fitted the inclusion criteria. The age range of cases was 2–17 years, with an average age of 5.37 years; 38 were female and 49 male. 41 of the patients had no known medical history. 19 had one condition and 27 had more than one condition. Of note, 23 of the individuals had a diagnosed behavioural condition (attention deficit hyperactivity disorder, autism and non-specified developmental disorder) accounting for 50% of the patients with a medical condition; 27% of the total study population. Only 8 (9%) of the total cohort were known to social care. More than 25% had not presented to the emergency department before whereas 16 had had one presentation and 47 had more than one presentation. Notably, there were 4 patients who had 20 or more presentations suggesting this cohort had difficulties in accessing routine health care. Conclusions Whilst a link between neglect and dental extraction is well established, an alternative area to be targeted for intervention has been highlighted during this retrospective study noting that children with behavioural conditions account for more than 25% of children undergoing dental extraction. Further work should look into the reasons underpinning this, whether this is related to poor diet, poor dental hygiene, a reluctance to visit the dentist or a mixture of the three. This data could then help to provide a targeted public health message to promote dental health in children with additional learning needs.