Table 3 Characteristics of studies and the summary of results

Tennant et.al., 2000 [16]

WA

N = 3754

Age (0-17 Years)

1. Infant (0-1y)

2. Preschool (1-4 yrs)

3. Primary school (5-12 yrs)

4. High school (13-17 yrs)

ICD 9 [mentioned as ICD (5200–5299)]

Cross sectional Retrospective

Aboriginality, Residency (rural and metropolitan), Age, Gender

Dental caries was the primary reason for hospitalisation in preschool and primary school children.

Abnormal tooth eruption was the primary reason for hospitalisation in high school children.

Out of total hospitalised cases,

• 0.6% were infants,

• 22.3% pre-schoolers,

• 25.7% primary school children and

• 51.5% high school children.

Males (44%) and non-Aboriginal decent (98%) were main groups for dental related hospital admissions

Non-aboriginal high school children and infants had higher hospitalisation due to oral condition as compared to Aboriginals.

Rural child had 1.3 times higher risk of hospitalisation due to dental condition as compared to metropolitan.

Smith et.al, 2006 [17]

WA

N = 53,646

Age Adult population

(18–85+ years)

ICD- 10 AM

Cross sectional Retrospective

Age, Indigenous status, Residency (rural and metropolitan), IRSD, ARIA

The prevalence of hospital admissions due to oral conditions were:

• Embedded and impacted teeth (38.8%)

• Dental caries (8%).

After excluding embedded and impacted teeth the main reason for hospitalisations were

• Dental caries

• Maxillary sinusitis

• Malignant neoplasms (oral related)

• Disorders of teeth and supporting structures.

Female (52.2%) were more hospitalised than male.

Most common reason for hospitalisation with age

• Individuals less than 35 years -gingivitis and periodontal diagnosis, 17.5%

• Individuals 35 years and older- malignant neoplasms, 14.5%

Indigenous Australians were admitted 1.5 times more in hospital for oral health conditions (p ≤ 0.05).

Least disadvantaged people (p ≤ 0.05) and highly accessible people (p ≤ 0.05) were more likely to be hospitalised due to oral health related conditions.

Kruger et.al, 2006 [15]

WA

N = 26,497

Age (0-17 Years)

1. 0-1y

2. 1-4 yrs.

3. 5-12 yrs.

4. 13-17 yrs

ICD- 10 AM

Cross sectional Retrospective

Age, Aboriginality, Residency, Gender,

The reasons for hospitalisation were

• Embedded and Impacted teeth – 33.2%

• Dental Caries- 28.3%

• Pulp and peri-apical tissues – 7.1%

• Dental facial anomalies − 6.1%

• Birth trauma and congenital deformities – 4.1%

Out of total oral condition related hospital admission cases, 50.2% were male and 3.5% were aboriginal descent.

The number of hospitalisation was more in rural aboriginal children as compared to urban non aboriginals.

Slack-Smith et.al, 2008 [12]

WA

N = 11,523

Age (0–5 years)

ICD – 9

Cross sectional Retrospective

Age, Sex, Birth weight, year of birth, SEIFA, Health insurance, Health region, Rurality, Maternal age group, Mother’s Indigenous status, Intellectual disability, Birth defect

The reasons for hospitalisation were

• Disease of hard tissues of teeth 76.3%,

• Disorders of tooth development and eruption 3.7%

• Diseases of pulp and periapical tissues 10%

• Gingival and periodontal diseases 1%

• Dentofacial anomalies including malocclusion 0.2%

• Other diseases and conditions of the teeth and supporting structures 0.7%

• Diseases of the jaws 0.4%

• Diseases of the salivary glands 1.2%

• Diseases of the oral soft tissues excluding lesions specific

• for gingiva and tongue 5.4%

• Diseases and other conditions of the tongue 0.3%

• Fitting devices and special investigations 1%

Children (0-5 years) accounted 3% of total dental hospital admission.

Logistic regressions showed significantly higher hospitalisation among children (p < 0.05) with

˗ birth defect (OR 1.85, CI 1.68–2.05),

˗ Male gender, (OR 1.16, CI 1.08–1.25),

˗ Indigenous mother (OR 1.17, CI 1.02–1.34),

˗ No water fluoridation (OR 2.16, CI 1.94–2.40)

˗ Intellectual disability,

˗ privately funded health insurance

Slack-Smith et.al, 2011 [13]

WA

N = 738

Age (0–5 years)

ICD-9,

(ICD-10 AM was converted to ICD-9 for individuals admitted after 1-07-1999).

Cross sectional Retrospective

Indigenous status, Age, ARIA, Length of stay

Main causes of dental admission were:

• Disorders of tooth development and eruption 4.16%

• Diseases of hard tissues of teeth 37.67%

• Diseases of pulp and periapical tissues 10.98%

• Gingival and periodontal diseases 5.28%

• Other diseases and conditions of the teeth and supporting structures 0.14%

• Diseases of the jaws 0.54%

• Diseases of the salivary glands 2.57%

• Diseases of the oral soft tissues excluding lesions specific

• for gingiva and tongue 35.64%

• Diseases and other conditions of the tongue 1.22%

• Fitting devices and special investigations 0.81%

• Dental examination 0.54%

3.2% of indigenous children had dental related hospital admission as compared to 2.7% non-indigenous children.

Indigenous children had more dental related hospital admission at age less than 2 years as compared to non-indigenous children. (40% versus 10%, P < 0.0001).

6.3% of total dental related hospital admission were indigenous children.

Out of total indigenous children dental admission, 8.7% had birth defect and 5.5% had intellectual disability.

Length of stay (7 days or more) in hospital was recorded higher in indigenous versus non-indigenous children (11.2% versus 0.5%, P < 0.001).

Remoteness (OR 2.07 versus 1.05), public funded assistance (89% versus 44%), rural residence (OR 9.61 versus 1.48) were significantly associated factors with dental related hospital admissions in Indigenous children versus non-indigenous children.

Slack-Smith et.al, 2012 [11]

WA

N = 1513

0–2 years

ICD-9

(ICD-10 AM was converted to ICD-9 for individuals admitted after 1-07-1999).

Cross sectional

Retrospective

Age, Intellectual disability, Length of stay, Child year of birth, Sex, Mother’s Indigenous status, SEIFA, Health insurance, Mothers age group, Rurality, Health region, Birth defect.

Reasons for dental related hospital admissions;

• Disorders of tooth development and eruption 10.7%

• Diseases of hard tissues of teeth 38.9%

• Diseases of pulp and periapical tissues 5.9%

• Gingival and periodontal diseases 4.4%

• Dento-facial anomalies including malocclusion 0.3%

• Other diseases and conditions of the teeth and supporting structures 1.3%

• Diseases of the jaws 1.8%

• Diseases of the salivary glands 4.6%

• Diseases of the oral soft tissues excluding lesions specific

• for gingiva and tongue 29.4%

• Diseases and other conditions of the tongue 1.5%

• Fitting and adjustments of other devices-orthodontic devices 0.4%

• Special investigations and examination 1.0%

Male gender (OR 1.14), low birth weight (OR 1.17), birth defects (OR 1.74), intellectual disability (OR 2.10), children of indigenous mother (OR 4.45), having public health insurance (OR 1.29), and rurality/remoteness (OR 2.29) had significantly higher odds of dental related hospital admissions.

Least disadvantaged has significantly lower risk of dental related hospital admission than most disadvantaged (OR 0.58).

Verma et.al, 2014 [10]

Tasmania

N = 454

0–86 years (mean age 32)

N/A

Cross Sectional

Retrospective

Age, Gender, timing of presentation

Causes for attending ED due to dental related cause:

• Dental abscess 37.2%

• Toothache 31.5%

• Dental caries 8.8%

• Tooth fracture 7.3%

• Tooth avulsion or loss 6.8%

• Gingivo-stomatitis 4.6%

• Aphthous ulcer 3.1%

• Temporomandibular joint Disorder 0.7%

Male (60.2%) had more dental presentation to ED than female (39.8%).

Individuals with ages 26–30 years had highest dental presentations in ER (17%).

Average age of patients with dental abscess (the most common presentation) was 36.59 years.

68% of presentation were out of business hours.

Alsharifet.al,2014

[14]

WA

N = 43,937

0–14 years

ICD 10 AM

Cross sectional

Retrospective

Hospital area and type, Age, gender, Indigenous status, SEIFA, ARIA, Insurance status, Length of stay

Major categories of dental related hospital admissions:

• Dental caries 50%

• Embedded and Impacted teeth 14%

• Pulp and periapical tissue conditions 11%

• Developmental and birth defects 5%

• Dental Fractures 5%

• Dentofacial anomalies 4%

5% of total dental related hospital admission for this age group were indigenous children.

73% admissions were in less than 9 years old age group.

Rate of admission in children age 5–9 years increased significantly as compared to age group 0-4 years in 2009.

Non indigenous children were more likely to be admitted for all dental causes except pulp and periapical conditions, and dental fractures.

Males, least disadvantaged, high accessibility and uninsured children had significantly more dental admissions (p < .0.001).

The dental related hospital admissions were more in public (p < 0.001) and metropolitan hospitals.

Kruger et.al, 2015 [20]

WA

N = 65,005

0–75+ years

ICD-10 AM

Cross Sectional Retrospective

Age, gender, ethnicity, SEIFA, Indigenous status, ARIA, AR-DRG, Income, Housing, Education, Employment, Family structure, Disability, Transport.

The rate of hospitalisation due to preventable dental cause has been increasing significantly over the years.

• Dental caries 53%

• Other disease of hard tissue of teeth 1.2%

• Pulp and periapical tissue 14.3%

• Gingivitis and periodontal disease 5.1%

• Other gingival and edentulous alveolar ridge 0.6%

• Other disorders teeth and supporting structures 18.1%

• Cysts of oral region 1.9%

• Stomatitis and related lesions 2.2%

• Other diseases lip and oral mucosa 3.6%

3.2 per 1000 people were admitted to hospital due to oral condition.

Females, aboriginals, most disadvantaged, highly accessible people had more hospital admission due to oral conditions.

Kruger & Tennant 2016 [19]

WA

N = 11,608

65 years and older

ICD-10 AM

Cross sectional Retrospective

Age, gender, ethnicity, SEIFA, Indigenous status, ARIA, AR-DRG, Income, Housing, Education, Employment, Family structure, Disability, Transport.

Causes of dental related hospital admission:

• Malignant neoplasms 16.6%

• Dental caries 15.4%

• Other disorders of teeth and supporting structures 14.3%

• Other diseases of the jaws 11.3%

• Fractures of the teeth, nasal bone, palate, lower facial bones 5.4%

• Benign neoplasms 5.4%

• Embedded and impacted teeth 5.1%

• Diseases of salivary glands 4.5%

• Diseases of pulp and periapical tissues 3.8%

• Other disease of lip and oral mucosa 3.1%

• Stomatitis and related lesions 2.3%

• Diseases of the tongue 1.9%

• Others 10.8%

Most patients for dental related hospital admissions were from least disadvantaged (27.9%, OR 60.04) and accessible areas (16.4%, OR 10.58).

Age 75–79 years (OR 4.7 CI 4.57–4.98), Males (OR 5.82, CI 5.67–6.21) and Aboriginals (OR 9.38, CI 7.82–10.94) had significantly higher rate of hospitalisation (p < 0.05).

Kruger et.al, 2016 [18]

WA

N = 131,509

18 years and older

ICD-10 AM

Cross sectional Retrospective

Age, gender, ethnicity, SEIFA, Indigenous status, ARIA, AR-DRG, Income, Housing, Education, Employment, Family structure, Disability, Transport.

Causes of dental related hospital admissions:

• Embedded and impacted teeth 48.9%

• Dental caries 9.0%

• Other disorders of teeth and supporting structures 8.5%

• Jaw fractures (maxillary and mandibular) 4.9%

• Fractures of teeth, nasal bone, palate, lower facial bones 4.3%

• Malignant neoplasms 3.9%

• Diseases of pulp and periapical tissues 3.4%

• Other diseases of jaws 3.2%

• Dentofacial anomalies, including malocclusion 2.6%

• Gingivitis and periodontal diseases 2.3%

• Others 8.9%

48% were male and 2.8% were aboriginal descent.

Rates of admissions were significantly higher in aboriginal as compared to non-aboriginal during 10 year period (p < 0.05)

The rate of admission was highest for age group 18-29 years for both aboriginal and non-aboriginal.