6266 The impact of COVID-19 on elective dental procedures for children and young people: retrospective study of 397,631 hospital admissions for tooth extraction

Objectives Delays in elective surgery can impact children and young people's (CYP) social and emotional development,¹ ² and prolonged pain from postponed dental treatment can impact CYP's sleep and school attendance.³ Little is known about how COVID-19 impacted elective admissions for dental tooth extractions for CYP, and how this may differ by age and socioeconomic deprivation. Methods All elective dental tooth extractions by the under-25s were extracted from England's Hospital Episode Statistics and stratified into age groups (under-11s, 11–16s, and 17- 24s). Extractions in the under-11s were mostly due to tooth decay, while extractions in the 11–16s and 17–24s were likely due to tooth impactions or as part of orthodontic treatment. The study period was February 2020 to March 2021 and the preceding five pre-pandemic years. The month-by-month percentage drop and absolute difference between periods were reported. Pearson's chi-squared with standardised residuals tested differences between overall periods. Results Figure 1 shows the percentage drop in admissions was steepest in April 2020 for all age groups, with the differences ranging from 94.0% to 97.2% for the under-11s, more than 98% for the 11–16s and 97.9% to over 98.0% for the 17–24s across the socioeconomic deprivation quintiles. Table 1 shows how, in absolute terms, the sum of admission reductions for the pandemic period by deprivation quintile was largest among the most deprived CYP across all age groups, with the under-11s worst affected. When comparing deprivation between periods overall, the admission reductions for the under-11s were statistically significant (p<0.0001). The following standardised residuals showed how this is driven by more than expected admissions by CYP from the least and second least deprived quintiles, and fewer than expected admissions by CYP from the most deprived socioeconomic quintile during the pandemic. Conclusion Among the under-11s, there were significant changes in admissions by socioeconomic deprivation quintile, driven by more than expected admissions by the two most affluent deprivation quintiles and fewer than expected admissions by the most deprived CYP during the pandemic. Children from the most deprived backgrounds, must not be further disadvantaged by the impacts of tooth pain, and need to be prioritised and planned for when addressing backlogs. References Forner D, Leslie PK, Aldaihani A, Bezuhly M, Noel CW, Horne D, et al. Psychosocial distress in parents with children awaiting surgery during the COVID-19 pandemic. Children 2022. Levine RS. Childhood caries and hospital admissions in England: a reflection on preventive strategies. Br Dent J 2021. Goodwin M, Sanders C, Davies G, Walsh T, Pretty IA. Issues arising following a referral and subsequent wait for extraction under general anaesthetic: impact on children. BMC Oral Health 2015.