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Trends in Childhood Hospital Admissions for Carious Tooth Extractions in England in Relation to the UK Soft Drinks Industry Levy: An Interrupted Time Series Analysis of Hospital Episode Statistics
22 Pages Posted: 8 Mar 2023
More...Abstract
Background: Tooth extraction due to dental caries is associated with socioeconomic-deprivation and is a major reason for elective hospital admissions in England in childhood. Consumption of sugar-sweetened beverages is a risk factor for dental caries. We examined whether the soft drinks industry levy (SDIL), announced in March 2016 and implemented in April 2018, was associated with changes in incidence rates of hospital admissions for carious tooth extraction in children, 22 months post-SDIL implementation.
Methods: Changes in incidence rates of monthly hospital admissions for carious tooth extractions (January 2012-February 2020) in England were estimated using interrupted time series and compared with a counterfactual scenario (no SDIL announcement or implementation). Periodical changes in admissions, auto-correlation and population structure were accounted for. Estimates were calculated overall, by index of multiple deprivation (IMD) fifths and by age group (0-4, 5-9, 10-14, 15-18 years).
Findings: Compared to the counterfactual scenario, there was a relative reduction of 12·1% [95%CI 17·0%-7·2%] in hospital admissions for carious tooth extractions in all children (0-18 years). Children aged 0-4 and 5-9 years had relative reductions of 28·6% [95%CI 35·6-21·5] and 5·5% [95%CI 10·5%-0·5%], respectively; no change was observed for older children. Reductions were observed in children living in most IMD areas regardless of deprivation.
Interpretation: The UK SDIL was associated with reductions in incidence rates of childhood hospital admissions for carious tooth extractions, across most areas regardless of deprivation status and especially in younger children.
Funding: NTR, OM, MW, and JA were supported by the Medical Research Council (grant Nos MC_UU_00006/7). This project was funded by the NIHR Public Health Research programme (grant Nos 16/49/01 and 16/130/01) to MW.
Declaration of Interest: The authors of this manuscript have no competing interests.
Ethical Approval: This study is registered (ISRCTN18042742) and the protocol published. Data were provided to us in an aggregated and anonymised state and ethical approval was not required for analysis of this data.
Keywords: Soft drinks industry levy, sugar sweetened beverages, dental health, child health, public health interventions
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