Association Between Area-Level Deprivation and Hospital Dental Admissions in Children Under Five

Objectives To quantify the association between socioeconomic deprivation and hospital admissions for dental caries among children aged under five years in England, and to assess the robustness of this association using both descriptive and regression-based IMD decile analyses. Methods An ecological study was undertaken using publicly available data. Socioeconomic deprivation was measured using the Index of Multiple Deprivation (IMD) 2019, defined at Lower-layer Super Output Area (LSOA) level and aggregated to local authority level by calculating the mean LSOA-level IMD rank within each authority. Hospital admissions for dental caries among children aged 0–5 years were obtained from the Office for Health Improvement and Disparities Fingertips platform for the most recent complete year available (2021). Admissions were summarised across rounded IMD decile groups for all local authorities with available data (n = 600). Linear regression analyses were conducted to examine associations between admissions and (i) rounded IMD decile and (ii) mean aggregated IMD rank, restricted to local authorities with complete data (n = 238). Results A pronounced deprivation gradient was observed, with substantially higher hospital admissions in more deprived local authorities. Mean admissions decreased progressively across rounded IMD decile groups. In regression analyses, each one-decile increase in IMD decile, indicating lower deprivation, was associated with approximately 43 fewer hospital admissions for dental caries among children aged under five years (95% CI −51.8 to −35.1; p < 0.001). Regression using mean aggregated LSOA-level IMD rank also showed a consistent inverse association, with higher mean rank (lower deprivation) associated with fewer admissions (β = −0.0139 per rank point; 95% CI −0.0178 to −0.0099; p < 0.001). Conclusions This study demonstrates persistent and substantial oral health inequalities in young children across England. The steep increase in hospital admissions for dental caries related to deprivation, highlights the urgent need for proportionate universalism in preventive strategies. This study quantifies the magnitude of the deprivation gradient at national scale and demonstrates its robustness across both descriptive and regression-based IMD decile analyses.