Understanding the quality of routinely collected dental data in Bradford for research

Tooth decay is one of the most common diseases in the world [1]. If left untreated, tooth decay can eventually lead to tooth extraction [2]. People of all ages can get tooth decay; however, it is a particular concern for young children. In 2019, a survey suggested that approximately one-in-four children aged 5 years old (23%) have had tooth decay [3]. We also know that families living in deprived areas are almost three times as likely to experience tooth decay as those living in the least deprived areas, and that there are much higher levels of tooth decay in children in the North compared with elsewhere in England [4-6]. Tooth decay has a direct impact on a child’s quality of life and untreated disease can cause toothache and pain, sleep disruption, and time off school.

For young children or those with complex needs who require a dental extraction, they may be referred for dental extraction(s) under general anaesthetic, which in England can only be performed in a hospital setting. The cost of hospital admissions for decay-related tooth extractions in children in the financial year 2022-2023 was estimated at £40m. In 2023, the average waiting time for children to receive dental treatment under general anaesthetic was 80 weeks [6]. Therefore, tackling and preventing tooth decay early in children’s lives is crucial.

In England, local authorities are responsible for improving health, including oral health, where good quality local-level data is essential for commissioning and service planning decisions [4]. A recent report highlighted how connected datasets, such as Connected Bradford, and birth cohorts, such as Born in Bradford, that have permission to link data from a wide range public services (such as health, education and social care) for research, provide opportunities to understand how oral health interacts with wider factors [6]. It can also enable data-driven and whole system approaches to improving and evaluating children’s oral health.

Information routinely collected by dental care providers and NHS hospitals in Bradford is currently available for participants of the Born in Bradford (BiB) cohort. This includes information about tooth decay and dental extractions under general anaesthetic [6]. This information will soon be available for participants in other BiB cohorts including Born in Bradford 4 All (BiB4All) and Born in Bradford’s Better Start (BiBBS), as well as the Born and Bred in (BaBi) cohorts. However, there is a limited understanding of the quality of routine dental data for research and service planning. Dental data are complex and current descriptions of these data may not be meaningful to non-dentists. In addition, the way dentists capture information has changed since the start of BiB, which makes it challenging to follow a person’s journey through dental services over time. For example, information about tooth extraction has changed from recording this as a tick box, to recording the number of teeth extracted.

Therefore, the research detailed in this proposal aims to build on existing documentation for the BiB dental data, to describe the cohort in a way that allows researchers to more easily use these data and understand the value for research. In addition, we would like to use the available data to understand the characteristics of the children who have received a dental extraction under general anaesthetic and the courses of dental treatment they have experienced. This will enable us to identify if there are inequalities in dental health in Bradford and if there are any opportunities or limitations of using routine dental data for research into dental extractions under general anaesthetic.

The project team includes both researchers and dental practitioners, who will work together to produce this detailed picture of the BiB dental data.