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Child-, Family-, and Community-Level Facilitators for Promoting Oral Health Practices among Indigenous Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031150. [PMID: 35162173 PMCID: PMC8834955 DOI: 10.3390/ijerph19031150] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/29/2022]
Abstract
Despite the preventive nature of oral diseases and their significance for general wellbeing, poor oral health is highly prevalent and has unfavourable ramifications for children around the world. Indigenous children in Australia experience disproportionate rates of early childhood caries compared to their non-Indigenous counterparts. Therefore, this paper aims to collate parental experiences and generate an understanding of facilitators for Indigenous childhood oral health. This project aggregated stories from parents of Indigenous children across South Australia who were participants in an early childhood caries-prevention trial. This paper explores facilitators for establishing oral health and nutrition behaviours for Indigenous children under the age of three through reflexive thematic analysis. Fisher-Owens’ conceptual model for influences on children’s oral health is utilised as a framework for thematic findings. Child-level facilitators include oral hygiene routines and regular water consumption. Family-level facilitators include familial ties, importance of knowledge, and positive oral health beliefs. Community-level facilitators include generational teaching, helpful community resources, and holistic health care. Recommendations from findings include the following: exploration of Indigenous health workers and elder participation in oral health initiatives; inclusion of Indigenous community representatives in mainstream oral health discussions; and incorporation of child-level, family-level, and community-level facilitators to increase support for efficacious oral health programs.
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Poirier BF, Hedges J, Smithers LG, Moskos M, Jamieson LM. Aspirations and Worries: The Role of Parental Intrinsic Motivation in Establishing Oral Health Practices for Indigenous Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111695. [PMID: 34770211 PMCID: PMC8582669 DOI: 10.3390/ijerph182111695] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 11/04/2021] [Accepted: 11/04/2021] [Indexed: 11/26/2022]
Abstract
Aboriginal and Torres Strait Islander (respectfully, subsequently referred to as Indigenous) children in Australia experience oral disease at a higher rate than non-Indigenous children. A history of colonisation, government-enforced assimilation, racism, and cultural annihilation has had profound impacts on Indigenous health, reflected in oral health inequities sustained by Indigenous communities. Motivational interviewing was one of four components utilised in this project, which aimed to identify factors related to the increased occurrence of early childhood caries in Indigenous children. This qualitative analysis represents motivational interviews with 226 participants and explores parents’ motivations for establishing oral health and nutrition practices for their children. Findings suggest that parental aspirations and worries underscored motivations to establish oral health and nutrition behaviours for children in this project. Within aspirations, parents desired for children to ‘keep their teeth’ and avoid false teeth, have a positive appearance, and preserve self-esteem. Parental worries related to child pain, negative appearance, sugar consumption, poor community oral health and rotten teeth. A discussion of findings results in the following recommendations: (1) consideration of the whole self, including mental health, in future oral health programming and research; (2) implementation of community-wide oral health programming, beyond parent-child dyads; and (3) prioritisation of community knowledge and traditions in oral health programming.
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Affiliation(s)
- Brianna F. Poirier
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia; (J.H.); (L.M.J.)
- Correspondence: ; Tel.: +61-8-8313-5208
| | - Joanne Hedges
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia; (J.H.); (L.M.J.)
| | - Lisa G. Smithers
- School of Public Health and the Robinson Research Institute, University of Adelaide, Adelaide 5000, Australia;
- School of Health and Society, University of Wollongong, Wollongong 2522, Australia
| | - Megan Moskos
- Future of Employment and Skills Research Centre, School of Economic and Public Policy, Faculty of the Professions, University of Adelaide, Adelaide 5000, Australia;
| | - Lisa M. Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide 5000, Australia; (J.H.); (L.M.J.)
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"What are we doing to our babies' teeth?" Barriers to establishing oral health practices for Indigenous children in South Australia. BMC Oral Health 2021; 21:434. [PMID: 34488721 PMCID: PMC8422744 DOI: 10.1186/s12903-021-01791-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 08/23/2021] [Indexed: 11/10/2022] Open
Abstract
Background During the 1970s, optimal oral health was experienced more frequently amongst Indigenous children in Australia than their non-Indigenous counterparts. As a result of public health interventions targeting oral disease, oral health has improved for most children; however, Indigenous children today experience oral disease at alarmingly high rates. A history of colonisation, assimilation, racism and cultural annihilation has had profound impacts on oral health for Indigenous peoples; compounded by environmental dispossession and a shift from traditional diets to one of processed and nutrient-poor foods, often high in sugar. Methods This project aimed to identify factors related to the increased occurrence of caries in Indigenous children. Using purposive sampling from the larger project, this paper thematically analyses 327 motivational interviews to explore current barriers impeding parental efforts to establish oral health and nutrition practices for Indigenous children. Representation of socioeconomic positions of families were compared across themes, as based on maternal age, employment, residency and number of children in care. Results Findings resulted in a conceptual model of barriers that exist across knowledge, social, structural and parental factors. Major thematic results include: social consumption of processed foods, busy households, misleading nutrition marketing, sugar cravings and lack of oral health and nutrition knowledge. Conclusion A discussion of the findings results in the following recommendations increased oral health promotion efforts in non-metropolitan areas; utilisation of community experiences in creating strategies that encourage oral health and nutrition knowledge; and the extension of oral health initiatives and future research to include all family members. Trial registration Australian New Zealand Clinical Trial Registry ACTRN12611000111976; registered 01/02/2011. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01791-x.
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Fernando S, Tadakamadla S, Kroon J, Lalloo R, Johnson NW. Predicting dental caries increment using salivary biomarkers in a remote Indigenous Australian child population. BMC Oral Health 2021; 21:372. [PMID: 34301228 PMCID: PMC8305904 DOI: 10.1186/s12903-021-01702-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 06/20/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND The burden of childhood dental caries amongst Indigenous Australians is higher than in other Australians. Because of differences in lifestyle and the evolutionary history of the oral microbiota, associated risk indicators may differ. Here, we evaluate associations between caries increment, salivary biomarkers and baseline caries among children aged 5-17 years residing in a remote rural Indigenous community. METHODS This study was part of a trial assessing cost-effectiveness of an intervention to prevent dental caries among children. Baseline epidemiology and application of topical caries-preventive measures was conducted in 2015, followed-up in 2016 and 2017. Children who did not consent or failed to attend the prevention visits but did attend for follow-up epidemiology constituted a natural comparison group for evaluating the intervention. Saliva flow, pH, buffering and bacterial loads were measured at all visits. Caries was scored by the International Caries Detection and Assessment system. Outcome was caries increment. Explanatory variables were sex, being in experimental or comparison group, baseline caries, saliva flowrate and buffering, pH, and salivary loads of mutans streptococci (MS), Lactobacilli (LB), and yeast. Chi Square tests compared caries incidence in relation to explanatory variables and Generalised Linear Models explored associations between explanatory and outcome variables. RESULTS Of 408 participants at baseline, only 208 presented at 2-year follow-up. Of caries-free children at baseline, significantly fewer had incipient (p = 0.01) and advanced (p = 0.04) caries after two years. Children in the experimental group experienced fewer tooth surfaces with advanced caries (p = 0.02) than comparison children. Having caries at baseline (p = 0.02) and low salivary flow-rates (p < 0.001) saw a significant increase in advanced caries after two years. Children with high salivary loads of MS (p = 0.03) and LB (p = 0.004) experienced more advanced carious surfaces. Multivariable analysis revealed 58% reduction (p = 0.001) in advanced caries among children with high salivary flow rates. Caries increment was 61% (p = 0.03) more for incipient and 121% (p = 0.007) more for advanced caries among children who harboured higher loads of MS. CONCLUSION As with other ethnicities, children with low salivary flow and those with high MS had higher incipient and advanced caries increments after two years. Such risk assessments facilitate targeted preventive interventions for such communities. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR), No: ACTRN12615000693527: 3 July 2015.
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Affiliation(s)
- Surani Fernando
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia
| | - Santosh Tadakamadla
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia
| | - Jeroen Kroon
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia
| | - Ratilal Lalloo
- School of Dentistry, The University of Queensland, St Lucia, Australia
| | - Newell W Johnson
- School of Medicine and Dentistry, Griffith University, Brisbane, QLD, Australia.
- Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, UK.
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Martin-Kerry JM, Whelan M, Rogers J, Raichur A, Cole D, de Silva AM. Addressing disparities in oral disease in Aboriginal people in Victoria: where to focus preventive programs. Aust J Prim Health 2020; 25:317-324. [PMID: 31578164 DOI: 10.1071/py18100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 06/14/2019] [Indexed: 11/23/2022]
Abstract
The aim of this study is to determine where Aboriginal people living in Victoria attend public oral health services; whether they access Aboriginal-specific or mainstream services; and the gap between dental caries (tooth decay) experience in Aboriginal and non-Aboriginal people. Analysis was undertaken on routinely collected clinical data for Aboriginal patients attending Victorian public oral health services and the distribution of Aboriginal population across Victoria. Approximately 27% of Aboriginal people attended public oral health services in Victoria across a 2-year period, with approximately one in five of those accessing care at Aboriginal-specific clinics. In regional Victoria, 6-year-old Aboriginal children had significantly higher levels of dental caries than 6-year-old non-Aboriginal children. There was no significant difference in other age groups. This study is the first to report where Aboriginal people access public oral health care in Victoria and the disparity in disease between Aboriginal and non-Aboriginal users of the Victorian public oral healthcare system. Aboriginal people largely accessed mainstream public oral healthcare clinics highlighting the importance for culturally appropriate services and prevention programs to be provided across the entire public oral healthcare system. The findings will guide development of policy and models of care aimed at improving the oral health of Aboriginal people living in Victoria.
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Affiliation(s)
- Jacqueline M Martin-Kerry
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK; and Corresponding author.
| | - Martin Whelan
- Dental Health Services Victoria, 720 Swanston Street, Carlton, Vic. 3053, Australia
| | - John Rogers
- Department of Health & Human Services, 50 Lonsdale Street, Melbourne, Vic. 3000, Australia
| | - Anil Raichur
- Dental Health Services Victoria, 720 Swanston Street, Carlton, Vic. 3053, Australia; and Department of Health & Human Services, 50 Lonsdale Street, Melbourne, Vic. 3000, Australia
| | - Deborah Cole
- Dental Health Services Victoria, 720 Swanston Street, Carlton, Vic. 3053, Australia
| | - Andrea M de Silva
- Worksafe Victoria, 1 Malop Street, Geelong, Vic. 3220, Australia; and School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Vic. 3004, Australia
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George A, Villarosa AR, Ingram S, Fatema K, Elliott K, Grace R, Kemp L, Scharkie S, Anderson C, Bucknall N, Wright DC, Comino E. Oral health status, behaviours, food and beverage consumption of aboriginal children in Australia. Health Promot J Austr 2020; 32:208-215. [PMID: 32338802 DOI: 10.1002/hpja.354] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 04/15/2020] [Accepted: 04/22/2020] [Indexed: 11/10/2022] Open
Abstract
ISSUE ADDRESSED Dental decay is prevalent among Australian Aboriginal children, yet little is known about their oral health-related behaviours. This study explored the oral health status, behaviours, food and beverage consumption of Aboriginal school children aged 7-9 years in Sydney, Australia. METHODS Parents who were part of an existing longitudinal birth cohort ("Gudaga") were surveyed when their child was between 7 and 9 years. Children (n = 110) also received oral health screening by a trained nurse. RESULTS A number of children (62%-91%) had at least one visible oral health problem across the 2 years. Around two thirds (62%-67%) of parents rated their child's oral health as excellent/very good and less than half the children (32%-45%) had received dental check-ups. Most children (79%-90%) brushed their teeth and drank water (97%) but more than half (57%-70%) also drank sugar sweetened beverages daily. CONCLUSIONS Parents are instilling good oral health behaviours, however, the oral health screening suggests children are experiencing oral health issues of which parents may be unaware. Parents also seem to be unaware of beverage consumption practices that can increase the risk of childhood decay. SO WHAT?: The findings highlight the need for greater oral health awareness among Aboriginal families on how to recognise early symptoms dental decay and risk factors like sugar sweetened beverages among school going children. This suggests that existing health promotion strategies may not be reaching many Aboriginal families in the urban areas and more culturally appropriate programs may be needed.
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Affiliation(s)
- Ajesh George
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, South Western Sydney Local Health District, University of Sydney, Ingham Institute Applied Medical Research, Translational Health Research Institute, Liverpool, NSW, Australia
| | - Amy R Villarosa
- COHORT, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Liverpool, NSW, Australia
| | - Suzanne Ingram
- Centre for Health Equity Training, Research and Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care and Equity A Unit of Population Health, South Western Sydney Local Health District, NSW Health, A member of the Ingham Institute, Liverpool, NSW, Australia
| | - Kaniz Fatema
- Centre for Health Equity Training, Research and Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care and Equity A Unit of Population Health, South Western Sydney Local Health District, NSW Health, A member of the Ingham Institute, Liverpool, NSW, Australia
| | - Koby Elliott
- Centre for Health Equity Training, Research and Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care and Equity A Unit of Population Health, South Western Sydney Local Health District, NSW Health, A member of the Ingham Institute, Liverpool, NSW, Australia
| | - Rebekah Grace
- Translation Research and Social Innovation Group, Western Sydney University/Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Lynn Kemp
- Translation Research and Social Innovation Group, Western Sydney University/Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Sheryl Scharkie
- Translation Research and Social Innovation Group, Western Sydney University/Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | | | - Natasha Bucknall
- Translation Research and Social Innovation Group, Western Sydney University/Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | | | - Elizabeth Comino
- Centre for Health Equity Training, Research and Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care and Equity A Unit of Population Health, South Western Sydney Local Health District, NSW Health, A member of the Ingham Institute, Liverpool, NSW, Australia
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Butten K, Johnson NW, Hall KK, Toombs M, King N, O’Grady KAF. Impact of oral health on Australian urban Aboriginal and Torres Strait Islander families: a qualitative study. Int J Equity Health 2019; 18:34. [PMID: 30777079 PMCID: PMC6378750 DOI: 10.1186/s12939-019-0937-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/11/2019] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The oral health of a child not only impacts the physical well-being of the child, but can have quality of life implications for parents and families as they endeavour to provide care and support their child's oral health needs. Within Australia, Aboriginal and Torres Strait Islander children are thought to experience a disproportionate burden of poor oral heath compared to non-Indigenous children. Despite the prevalence of oral health challenges, there are limited qualitative studies investigating the oral health experiences of families. The objective of the study was to explore 'from the perspective of urban, Aboriginal and Torres Strait Islander parents and carers' the impact child oral health has on families. METHODS Yarning circles and face-to-face interviews were used to document the experiences of (N = 20) parents of urban, Aboriginal and Torres Strait Islander children. Participants were recruited from an Aboriginal-owned and operated primary health clinic in northern Brisbane, Australia and through word of mouth. Information collected was transcribed and analysed thematically. Codes and themes were confirmed by the researcher and two participants. RESULTS The findings indicate that oral health is an important issue for urban Indigenous families and maintaining oral health to a desired standard is having emotional, physical and financial impacts. Themes identified were financial concerns, worry about the future and juggling multiple priorities, all of which were inter-related and cyclical. CONCLUSIONS Families in this study have demonstrated that with the current policy arrangements, oral health is impacting their quality of life, contributing to stress, financial challenges and at times affecting their physical health. To address these challenges, oral health education and promotion needs a multidisciplinary approach that reaches families before children are school-aged.
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Affiliation(s)
- Kaley Butten
- Queensland University of Technology, Institute of Health & Biomedical Innovation, Centre for Children’s Health Research, 62 Graham Street, South Brisbane, Qld, 4101 Australia
| | - Newell W. Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Gold Coast Campus, Griffith University, Gold Coast, Qld, 4222 Australia
- Dental Institute, King’s College London, London, UK
| | - Kerry K. Hall
- Griffith University, 170 Kessels Road, Nathan Campus, Qld, 4111 Australia
| | - Maree Toombs
- Rural Clinical School, The University of Queensland, 152 West St, South Toowoomba, Qld, Toowoomba, 4350 Australia
| | - Neil King
- Faculty of Health, Queensland University of Technology, Queensland, Victoria Park Road Kelvin Grove, Qld 4509 Australia
| | - Kerry-Ann F. O’Grady
- Queensland University of Technology, Institute of Health & Biomedical Innovation, Centre for Children’s Health Research, 62 Graham Street, South Brisbane, Qld, 4101 Australia
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Butten K, Johnson NW, Hall KK, Anderson J, Toombs M, King N, O'Grady KF. Risk factors for oral health in young, urban, Aboriginal and Torres Strait Islander children. Aust Dent J 2018; 64:72-81. [PMID: 30375649 PMCID: PMC6392135 DOI: 10.1111/adj.12662] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2018] [Indexed: 11/26/2022]
Abstract
Background The caries process follows a strong social gradient which can commence in the first years of life. Yet data on young children remain limited. This study reports the potential risk factors and indicators in urban, Aboriginal and Torres Strait Islander children aged less than 5 and estimates the prevalence of caries. Methods Demographic and risk factor and risk indicator data were collected at baseline in a cohort study of children attending a health clinic in north Brisbane. Dentulous children received a basic oral examination to explore the presence of decayed, missing and filled teeth (dmft). Descriptive analyses were performed. A backwards stepwise logistic regression model was performed to identify potential associations with dmft status. Results In this study, 180 children enrolled: 111 children received the oral examination, of whom 14 (12.6%) (mean age 35 months) were estimated to have dmft >0. There was a high prevalence of socio‐economic, dietary and behavioural risk factors/indicators present for children. Due to the small sample size, planned regression was not performed. Conclusions Overall, the prevalence of risk factors and risk indicators for caries in the study population is high. More culturally appropriate resources that support preventive care need to be invested before children are school aged.
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Affiliation(s)
- K Butten
- Queensland University of Technology, Institute of Health & Biomedical Innovation, Centre for Children's Health Research, South Brisbane, Queensland, Australia
| | - N W Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.,Dental Institute, King's College London, London, UK
| | - K K Hall
- Caboolture Community Medical, Caboolture, Queensland, Australia
| | - J Anderson
- Caboolture Community Medical, Caboolture, Queensland, Australia
| | - M Toombs
- Rural Clinical School, The University of Queensland, South Toowoomba, Queensland, Australia
| | - N King
- Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - K F O'Grady
- Queensland University of Technology, Institute of Health & Biomedical Innovation, Centre for Children's Health Research, South Brisbane, Queensland, Australia
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