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Ministers need to act as child tooth extractions backlog surges

The British Dental Association has warned government must act decisively to deal with the backlogs for child tooth extractions, as new figures show the number of treatments more than halved during the pandemic.

Data from the Office for Health Improvement and Disparities show 35,190 extractions were performed on decayed teeth in 2019/20 in children aged 0-19 in 2019/20, falling to 14,645 in 2020/21.

Dentist leaders have stressed this collapse will not reflect any change in the demand for these procedures, which take place in hospitals under general anaesthetic. Figures show the proportion of extractions as a result of decay is virtually unchanged from levels seen a decade ago. Tooth extractions have been the number one reason for hospital admissions among young children for a generation.

The BDA has said full disclosure is now required on waiting times for these procedures alongside a properly funded plan to address the backlog, stressing that tens of thousands of children will be left in pain, facing difficulties learning, eating and sleeping for over a year. NHS England has acknowledged there are significant gaps in official data, owing to wide-ranging coding and reporting issues.

The Hospital Dentistry GIRFT Programme National Specialty Report states: "We found gaps and anomalies in the collection of data through Hospital Episode Statistics, which limits our understanding of both patient need and the people doing the work, which, in turn, affects our ability to measure outcomes, assure quality and plan the workforce we need."

The union joined with sector leaders and learning disability charity Mencap early in the pandemic to press former Health Secretary Matt Hancock to develop an urgent action plan, and commission a review into the true scale of extractions under general anaesthetic. No plan has been delivered to date.

The data shows children from the poorest areas are three times more likely to have extractions than those from the most affluent communities. Oral health inequality is expected to grow owing to the scale of backlogs in primary care, which limit the chance to catch problems early. Over 12.5 million NHS dental appointments for children have been lost in England since lockdown.

Charlotte Waite, Chair of the British Dental Association's England Community Dental Services Committee said:

"Tooth extractions among children have collapsed, but the level of demand hasn't gone anywhere. COVID has simply left tens of thousands in pain, potentially waiting years for treatment they desperately need.

"Government has yet to offer real clarity on the scale of the backlog, or a credible plan to tackle it."