Methods for calculating numbers and rates of hospital tooth extractions
Updated 8 February 2024
Applies to England
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Detailed description of indicator: tooth extraction rate
The number and crude rate per 100,000 resident population of finished consultant episodes (FCEs) where a tooth extraction procedure was performed in an acute hospital care setting on patients aged between 0 and 19 years old at the start of the episode.
Data sources
Hospital data
Data was extracted from admitted patient care (APC) records of the Hospital Episode Statistics (HES) data set provided by NHS Digital. This data set records inpatient and day-case care from NHS hospitals across England. Within this dataset, an FCE unit of care equates to the period a patient spends under the care of a single hospital consultant.
Population data
Mid-year population estimates are used to calculate episode rates. These estimates are supplied by the Office for National Statistics.
HES data fields and filters
Table 1 describes which fields in the HES APC data set are filtered, and outlines what the filters are. Details of HES fields and classifications are available in the HES Data Dictionary.
Table 1: HES fields and applied filters
| HES field | Filter applied | Rationale |
|---|---|---|
| FYEAR | Set to specified year | Limits episodes to a specified financial year |
| STARTAGE | Between 0 and 19 inclusive | Limits age to between 0 and 19 years |
| EPISTAT | 3 | Counts only finished episodes |
| CLASSPAT | 1, 2 or 5 | Counts only ordinary admissions or day cases |
| FCE | 1 | Counts only finished consultant episodes |
| LSOA11 | First character is E | Only returns episodes with a valid LSOA code when presenting local authority data |
| OPERTN_01 | First 3 characters are either F09 or F10 | Limits main procedure to tooth extractions |
The majority of teeth extracted will have been removed because of dental caries (tooth decay). However, this number can vary quite considerably. Therefore, the anaysis is presented in terms of caries and non-caries procedure activity. Table 2 describes the filters applied to the main HES International Classification of Diseases (ICD) diagnosis field (DIAG_01) when caries extractions are being calculated.
Table 2: diagnosis codes for tooth decay
| ICD diagnosis code | Description |
|---|---|
| K021 | Caries of dentine |
| K025 | Caries with pulp exposure |
| K028 | Other dental caries |
| K029 | Dental caries, unspecified |
| K040 | Pulpitis |
| K045 | Chronic apical periodontitis |
| K046 | Periapical abscess with sinus |
| K047 | Periapical abscess without sinus |
Calculation
To calculate the tooth extraction rate, divide the number of FCEs where a tooth extraction has been performed (numerator) by the target population (denominator) and multiply by 100,000.
Detailed description of indicator: tooth extraction rate by deprivation quintile
The number and crude rate per 100,000 deprivation quintile population of FCEs where a tooth extraction procedure was performed in an acute hospital care setting on patients aged between 0 and 19 years old at the start of the episode.
Data sources
Hospital data
Data was extracted from APC records of the Hospital Episode Statistics (HES) data set provided by NHS Digital. This data set records inpatient and day-case care from NHS hospitals across England. Within this dataset, an FCE unit of care equates to the period a patient spends under the care of a single hospital consultant.
Deprivation quintile population data
The deprivation breakdowns for this indicator have been derived using index of multiple deprivation 2019 scores based on 2011 lower super output area (LSOA) boundaries. These are published by the Department for Levelling Up, Housing and Communities.
Calculation
To calculate the tooth extraction rate, divide the number of FCEs where a tooth extraction has been performed (numerator) by the deprivation quintile population (denominator) and multiply by 100,000.