Hospital separations were classified using ICD-10-AM. Rates were age-adjusted using the Australian population as at 30 June 2001. Numbers for 2004-05 include an estimate of the small number of interstate hospitalisations, data for which were unavailable at the time of production. LL/UL 95%CI = lower and upper limits of the 95% confidence interval for the point estimate. Statistical Local Areas were grouped according to Australian Standard Geographical Classification (ASGC) Remoteness categories on the basis of Accessibility/Remoteness Index for Australia (ARIA+ version) score.
Source:
NSW Inpatient Statistics Collection and ABS population estimates (HOIST), ambulatory care sensitive hospitalisation definitions modified from Victorian Department of Human Services 2002.
In 2004-05 the hospitalisation rate for removal and restoration of teeth in children aged 0-4 years was 455.8 per 100,000 population. The rate in this age group was higher than the rate for all ages combined (436.1 per 100,000 population), but not as high as the rate for the older children aged 5-14 years (497.6 per 100,000 population in 2004-05).
Hospitalisation rates for the removal and restoration of teeth in children aged 0-4 years in the Greater Western Area Health Service (753.1 per 100,000 population) and the North Coast Area Health Service (714.0 per 100,000 population) were much higher than the state average (436.1 per 100,000 population). The rates in other health areas were not substantially different from the state average.
The need for extractions and fillings is dictated by dental caries (tooth decay). Differences in the prevalence of caries among health areas in NSW cannot be fully appreciated from the differences in hospital separation rates for the removal and restoration of teeth. This is because the apparent rate of hospitalisation is influenced not only by disease prevalence in the community, but also by access to care in general, access to care in outpatient settings, hospital admission and coding practices and personal choices about seeking care. Nevertheless, the very high admission rates for removal and restoration of teeth in children aged 0-4 years coincide with a high proportion of the population without access to fluoridated community water supply in these two areas, particularly in the North Coast Area Health Service.
The oral health of NSW children has improved over recent decades, with a dramatic decline in the dental caries (decay) experience. The decline in the number of decayed, missing and filled teeth (DMFT measure) from an average 9-10 DMFT per child in the 1950's to 0.65 DMFT currently, has been attributed mainly to water fluoridation (70%), the use of fluoride toothpaste (26%) and fluoride tablets (2%) (Spencer, 1986). Despite the availability of fluoride toothpaste, children living in unfluoridated areas have significantly higher dental decay rates than those living in fluoridated areas (Armfield, 2005).
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Population Health Division. The health of the people of New South Wales -
Report of the Chief Health Officer. Sydney: NSW Department of Health. Available at:
http://www.health.nsw.gov.au/public-health/chorep/ora/ora_prockidhos_ahs.htm. Accessed (insert date of access).
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