What’s new

Indicators have been updated with the latest data for all tooth extraction and decay-related tooth extraction episodes from the Hospital Episodes Statistics (HES) data set in the financial year ending 2024. Numbers and rates per 100,000 population of 0 to 19 year olds have been calculated for the following areas:

• England
• government (statistical) regions
• NHS England regions
• integrated care boards
• upper tier local authorities
• lower tier local authorities

Introduction

This report provides the most recent hospital activity on tooth extractions in children and young people aged 0 to 19 years old at various geographical levels. The data is categorised into episodes that had a primary diagnosis of tooth decay as the reason for extraction, and those that had other diagnoses.

Main findings

In the financial year ending 2024 there were 49,112 episodes of tooth extractions in NHS hospitals in England for 0 to 19 year olds.

There were 30,587 episodes of tooth extractions with a primary diagnosis of tooth decay for 0 to 19 year olds. This represents 62% of all tooth extractions for this age group.

Although there has been a 3% increase in the total number of tooth extractions, there has been a 2% decrease in the number of episodes of decay-related tooth extractions in hospital for 0 to 19 year olds compared to the previous financial year ending 2023. The number of non-carious (non-decay-related) extractions has increased by 13% compared to the previous financial year.

There were variations in decay-related tooth extraction episode rates across the government statistical regions. The highest rates were in Yorkshire and the Humber (454 per 100,000 population of 0 to 19 year olds) and the lowest rates were in the East Midlands (70 per 100,000 population of 0 to 19 year olds). The England rate was 229 per 100,000 population of 0 to 19 year olds.

The decay-related tooth extraction episode rate for children and young people living in the most deprived communities was nearly 3.5 times that of those living in the most affluent communities.

Tooth decay remains the most common reason for hospital admissions in children aged between 5 and 9 years.

The costs to the NHS of hospital admissions for tooth extractions in children aged 0 to 19 years have been estimated based on the latest NHS national cost collection data. The costs were £74.8 million for all tooth extractions and £45.8 million for decay-related tooth extractions in the financial year ending 2024. This is an increase compared with the costs in the previous financial year ending 2023, and is due to an increase in both non-carious tooth extractions and NHS unit costs for all tooth extraction procedures (there was a 17.5% unit cost increase for the most common tooth extraction procedure).

Trends in hospital tooth extraction episodes

There has been a steady decrease in the number of tooth extraction episodes since the financial year ending 2015 (figure 1 and table 1 below). The large decrease in the financial year ending 2021 was likely due to services being affected by the COVID-19 pandemic. The increase in tooth extractions since 2021 is likely due to the continued recovery of services following the COVID-19 pandemic.

Figure 1: percentage of tooth extraction episodes in the last 10 years by extraction category.

Year	Percentage tooth decay extractions	Percentage non-decay tooth extractions
2015	66.8	33.2
2016	65.1	34.9
2017	64.2	35.8
2018	64.7	35.3
2019	63.4	36.6
2020	63.8	36.2
2021	64.9	35.1
2022	63.4	36.6
2023	65.5	34.5
2024	62.3	37.7

Table 1: number of tooth extraction episodes in the last 10 years by extraction category.

Year	Tooth decay extractions	Non-tooth decay extractions	All tooth extractions
2015	42,209	20,987	63,196
2016	39,278	21,083	60,361
2017	39,346	21,955	61,301
2018	38,385	20,929	59,314
2019	37,404	21,607	59,011
2020	35,190	19,947	55,137
2021	14,645	7,904	22,549
2022	26,741	15,439	42,180
2023	31,165	16,416	47,581
2024	30,587	18,525	49,112

Tooth extraction episodes by government statistical region and year

The rates in Yorkshire and the Humber are nearly 6.5 times that of the East Midlands (figure 2 below and worksheet 1, table 5 in the data tables).

Figure 2: decayed tooth extraction episode rate per 100,000 population of 0 to 19 year olds by statistical region for the financial year ending 2024.

Statistical region	Decayed tooth extraction rate
Yorkshire and the Humber	454
North East	418
North West	337
London	291
South West	261
England	229
West Midlands	147
South East	99
East of England	99
East Midlands	70

Most regions have seen a decrease in admissions since the COVID-19 pandemic. However, some regions have similar numbers of admissions in 2024 compared to 2020, including the South West, the North East and the East of England (figure 3 below and worksheet 7, table 1 in the data tables).

Figure 3: Hospital tooth extraction episodes for 0 to 19 year olds by statistical region and financial year.

The chart above shows the number of tooth extraction episodes and groups the data by region and financial year starting from financial year ending 2020 up to 2024.

Decay-related tooth extraction episode rates per 100,000 population

The decay-related tooth extraction rate for children and young people living in the most deprived communities was nearly 3.5 times that of those living in the most affluent communities (figure 4 below and worksheet 7, table 3 in the data tables).

Figure 4: decay-related tooth extraction episode rate per 100,000 population of 0 to 19 year olds by index of multiple deprivation (IMD) 2019 quintiles for the financial year ending 2024.

Deprivation quintile	Tooth extraction episode rate
Quintile 1	394
Quintile 2	287
Quintile 3	207
Quintile 4	174
Quintile 5	117
England average	247

Quintile 1 is the most deprived quintile, quintile 5 is the least deprived.

The absolute inequalities between the most deprived and least deprived communities are continuing to persist (figure 5 below and worksheet 7, table 4 in the data tables).

Figure 5: decay-related tooth extraction episode rate per 100,000 population of 0 to 19 year olds by highest and lowest index of multiple deprivation (IMD) 2019 quintiles for the financial years ending 2016 to 2024.

The above chart shows the yearly trend of decay-related hospital tooth extractions for children and young people by the highest and lowest deprivation quintile as well as the England average. The timeline runs from the financial year ending 2016 to 2024.

Limitations of the data

Caution needs to be taken when interpreting and applying findings from this report. The data reported on may be an underestimation of child tooth extractions conducted in a hospital setting. It is recognised that there are tooth extractions conducted by community dental services in hospital settings, and that this activity is not always included in the HES data.

No assumptions can be made about the method of anaesthesia provided for these procedures, but it is likely that the majority of episodes involved general anaesthetic. It is possible that different clinical coding protocols are applied at some sites and this could explain some of the variation in different geographical areas.

NHS Digital is responsible for the quality of HES data and has produced its own data quality statement as well as describing the stages involved in the HES processing cycle.

Further information is available on the tooth extractions collections page.

Ethnicity is recorded as either ‘not known’ or ‘not stated’ for a quarter of episodes of tooth extractions for 0 to 19 year olds. This has not changed since the previous year, which is why a breakdown of activity for this characteristic is not presented. The recording of accurate ethnicity will be reviewed each year.