Poverty impacts on type of dental care received

Adults from highly deprived areas are less likely to receive prevention care and advice and more likely to have a tooth extracted, compared to those from the least deprived, according to new research.

The study provides evidence of an increasing need for treatment with age, smoking, exemption from payment and deprivation status, all of which have implications for health services planning and provision.

The researchers, from the University of Portsmouth Dental Academy and the Dental Institute at King's College London, examined data from a dental facility where teeth are restored, when possible, and there is a strong preventive approach, from 2008-2012. They looked at individual factors, including demography, smoking status and whether patients were exempt from paying for treatment, as well as contextual factors, such as deprivation based on area of residence, to identify factors which predict the types of dental treatment received.

The study is published in the journal PLOS One.

They found that:

• Adults from the most deprived fifth of the population were more likely to receive 'tooth extraction' when compared with least deprived, and less likely to receive preventive 'instruction and advice'.
• There was also evidence of a higher rate of 'tooth extraction' among adults who were exempt payment, older than 65 and male.
• Preventive care was much more commonly provided than nationally.
• Smokers had a higher likelihood of receiving all treatments and were notably over four times more likely to receive 'instruction and advice' than non-smokers.
• The odds of receiving treatment increased with age among adults.

Principal investigator Dr Kristina Wanyonyi from the University of Portsmouth Dental Academy said: "In utilising routinely collected data from visits to the dentist we were able to understand more about patients' needs and plan services effectively.

"The University of Portsmouth Dental Academy, which is a collaboration between the University of Portsmouth and King's College London Dental Institute, is in a unique environment to evaluate dental care in the NHS and this research provides evidence on the need to promote the availability of electronic records for use in patient-centred research."

Co-author Professor Jenny Gallagher from King's College London said: "We know from other research that people from areas of higher deprivation are more likely to suffer from tooth decay, less likely to attend regularly and only go for emergency care when in trouble. We want to encourage patients not to wait but to attend regularly so that dental disease can be picked up early and the need for extraction is reduced. Also to ensure that they take any preventive care and advice available to reduce the risk of further disease.

"The results provide a crucial insight into the provision and receipt of contemporary dental care, and should inform discussions on performance indicators that target priority groups such as smokers and future planning for our ageing population."