Factors associated with dental admissions for children aged under five years in Western Australia

Linda M Slack-Smith ^1*, Lyn Colvin ², Helen Leonard ³, Nicky Kilpatrick ⁴, Carol Bower ³ and Louise Brearley Messer ⁵

¹ The University of Western Australia, Australia
² School of Population Health, University of Western Australia, Australia
³ Centre for Child Health Research, The University of Western Australia, Australia
⁴ Murdoch Children's Research Institute, Australia
⁵ Melbourne Dental School, University of Melbourne, Australia

^* To whom correspondence should be addressed. E-mail: lindas{at}cyllene.uwa.edu.au.

Accepted 22 November 2008

Abstract

Objective: There is limited literature describing dental admissions in preschool children. This paper describes dental hospital admissions and associated factors in children under five years.

Design: This study uses total population data for Western Australia which links midwives’ information with birth defects, intellectual disability, hospital admissions and deaths. Children born 1980-1995 (n=383,665) were followed until five years. Intellectual disability data were available for children born between 1983 and 1992. Admission data including length of stay were examined.

Outcome measures: Admissions for each relevant ICD-9 principal diagnosis category and factors associated with having had a dental admission (all categories) and ICD-9 521 (mostly caries) in particular were investigated.

Results: There were 11,523 dental admissions involving 10,493 children. Of all dental admissions, 76% were in ICD-9 category 521, which included admissions for dental caries. After adjusting for confounders, children with intellectual disability (odds ratio (OR) 1.92; 95% CI 1.63 to 2.27) and birth defect 1.85 (1.68 to 2.05) were more likely to have had a dental admission. Children living in a region without fluoridated water were also more likely to have had a dental admission 2.16 (1.94 to 2.40). Males were more likely to have had a dental admission 1.16 (1.08 to 1.25), as were children with an Indigenous mother 1.17 (1.02 to 1.34). Investigation of ICD-9 521 admissions showed associations similar to those described above except for mother being Indigenous, which was associated with reduced likelihood of admission.

Conclusion: Given the burden of dental admissions in young children, these findings highlight the need for improved oral care for children.