Health Inequities in Manitoba: Is the Socioeconomic Gap

Health Inequities in Manitoba: Is the Socioeconomic Gap in Health Widening or Narrowing Over Time?
Dental Extraction
Definition
The removal of a tooth from the mouth. In this report, hospital–based dental extraction rates are
examined for children up to five years of age, when severe tooth decay is the most common reason for
dental extractions. This is the average annual rate of hospitalizations for dental extractions per 1,000
children aged birth to five years. The following codes to identify hospital–based dental extractions were
used:
ICD–9–CM codes: 23.01 (extraction of deciduous tooth), 23.09 (extraction of other tooth), 23.11 (removal
of residual root), and 23.19 (other surgical extraction of tooth).
ICD–10–CA codes: 1.FE.89 (total excision, includes excision (surgical) tooth, excision tooth (impacted)
and enucleation tooth (non erupted)) and 1.FE.57 (tooth extraction, includes tooth removal, using
forceps).
A limitation with this measure is that dental extractions performed in a surgery clinic or a private
dentist’s office cannot be identified.
NOTE: Dental Extractions as an indicator may be considered a surrogate for underlying severe tooth
decay. This is an instance where the inequality (i.e., higher dental surgery rates in lower socioeconomic
groups) may actually be equity (i.e., a fair distribution of health services according to underlying need).
Time Periods Average annual rate per 1,000
T1: 1984/85–1988/89 5.56
T2: 1989/90–1993/94 5.99
T3: 1994/95–1998/99 8.75
T4: 1999/00–2003/04 12.95
T5: 2004/05–2007/08 17.06
Key Findings: Dental Extractions
Manitoba overall rates:
From the first time period T1 (1984/85–1988/89) to the last time period T5 (2004/05–2007/08), rates of
hospital–based dental extractions have increased dramatically in Manitoba, from 5.56 per 1,000 to 17.06
per 1,000 children under age five.
Rates by neighbourhood income quintile over time:
Rural:
• From T1 to T5, the dental extraction rate among rural residents increased for all rural quintiles. The
most substantial increases occurred in R1 and R2, the two lowest neighbourhood income quintile
groups. R1 went from 19.21 per 1,000 in T1 to 59.51 dental extractions per child under age five in T5.
R2 saw an increase of 8.65 per 1,000 in T1 to 37.95 in T5.
Manitoba Centre for Health Policy 63