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Stormon N, Do L, Sexton C. Has the Child Dental Benefits Schedule improved access to dental care for Australian children? HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e4095-e4102. [PMID: 35332972 PMCID: PMC10078627 DOI: 10.1111/hsc.13803] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Revised: 12/15/2021] [Accepted: 03/15/2022] [Indexed: 06/14/2023]
Abstract
The Child Dental Benefits Schedule (CDBS) is an ongoing scheme administered through the Australian Government providing eligible children funding for clinical dental treatment. This study aimed to investigate the access of dental services across children's early childhood and examine whether the CDBS has improved access to dental care. The longitudinal study of Australian children is an ongoing cross-sequential cohort study with a representative sample of Australian children recruited in 2004. Birth (0-1 year) and kindergarten (4-5 years) cohorts were recruited through Medicare enrolment information at baseline and were representative of the Australian child population. Population-weighted longitudinal mixed effects Poisson models with individual identifiers as a random effect were used to assess the effect of Medicare dental schedules on reported dental attendance. Prior to the implementation of the CDBS for both cohorts, the birth cohort reported the lowest attendance rate at age 4-5. The introduction of the CDBS increased the rate of dental attendance for the low household income group by 8% (95% CI: 1%, 15%) after adjusting for confounders. The model provides evidence that dental attendance increased with age and the Indigenous population have 31% (95% CI: 4%, 55%) lower attendance rate after adjustment. The increase in reported access to dental services and favourable visiting patterns in low-income households during the operation of the CDBS provides some evidence that the schedule's primary aims to improve access to care in the child population are being met. Access to healthcare is multifaceted and the underutilisation of the schedule in the population warrants review of the schedule performance using other patient-centred indicators.
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Affiliation(s)
- Nicole Stormon
- School of DentistryUQ Oral Health CentreThe University of QueenslandBrisbaneQueenslandAustralia
| | - Loc Do
- School of DentistryUQ Oral Health CentreThe University of QueenslandBrisbaneQueenslandAustralia
| | - Christopher Sexton
- School of DentistryUQ Oral Health CentreThe University of QueenslandBrisbaneQueenslandAustralia
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Shinde N, Kanabar DJ, Miles LJ. Narrative review of the prevalence and distribution of acute pain in children in the self-care setting. PAEDIATRIC & NEONATAL PAIN 2022; 4:169-191. [PMID: 36618510 PMCID: PMC9798044 DOI: 10.1002/pne2.12085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/16/2022] [Accepted: 07/20/2022] [Indexed: 01/11/2023]
Abstract
Acute pain among children is common, yet it may be underestimated and undertreated if the pain is not recognized. Assessing and managing pediatric pain can be complicated, and as such, measuring the prevalence of acute pain in children can be challenging. We sought to provide a consolidated review of the available data on the prevalence of commonly occurring acute pain in children in the self-care setting. An extensive literature search was performed to determine the prevalence of acute pain at multiple bodily locations in children aged between 3 months and 18 years. We considered the influence of age, sex, and sociodemographic factors on prevalence estimates. We also sought to identify some of the challenges involved in assessing and managing pediatric pain, thus shedding light on areas where there may be clinical and medical unmet needs. In general, a high prevalence of acute pain in children was detected, particularly headache, menstruation-related pain, and dental and back pain. Older age, female sex, and lower socioeconomic status were associated with increased pain prevalence. Risk factors were identified for all pain types and included psychological issues, stress, and unhealthy lifestyle habits. Owing to the heterogeneity in study populations, the prevalence estimates varied widely; there was also heterogeneity in the pain assessment tools utilized. The paucity of information regarding pain prevalence appears to be out of proportion with the burden of acute pain in children. This could indicate that clinicians may not be equipped with an optimal pain management strategy to guide their practice, especially regarding the use of developmentally appropriate pain assessment tools, without which prevalence data may not be captured. If acute pain is not accurately identified, it cannot be optimally treated. Further investigation is required to determine how the information from prevalence studies translates to the real-world setting.
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Affiliation(s)
- Nutan Shinde
- Reckitt Benckiser plc (Global Headquarters)BerkshireUK
| | | | - Lisa J. Miles
- Reckitt Benckiser plc (Global Headquarters)BerkshireUK
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3
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Macedo TDFF, Abreu MHNGD, Martins RDC, Matta-Machado ATGD, Pinto RDS, Castilho LSD, Vargas-Ferreira F. Contextual and individual factors associated with dental pain in adolescents from Southeastern Brazil. Braz Oral Res 2021; 35:e111. [PMID: 34816899 DOI: 10.1590/1807-3107bor-2021.vol35.0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Accepted: 02/23/2021] [Indexed: 11/21/2022] Open
Abstract
The aim of this study was to assess the factors associated with dental pain in adolescents from the state of Minas Gerais, Brazil. Individual data on adolescents aged 15 to 19 years were collected from the SB Minas survey secondary database. Dental pain over the past 6 months, assessed by a questionnaire, was used as the dependent variable. Sex, income, skin color, prevalence of untreated dental caries, periodontal health, dental treatment needs, and time of last dental appointment were analyzed as individual covariates. Allocation factor, Human Development Index (HDI), Gini coefficient, illiteracy rate, unemployment, 50% and 25% of the Brazilian monthly minimum wage, primary healthcare coverage, oral health team coverage, access to individual healthcare, and supervised toothbrushing average rate were the analyzed contextual variables. A multilevel analysis was conducted for the individual and contextual variables. Statistical analyses used hierarchical linear and nonlinear modeling to infer an association between the different levels. Male adolescents had a lower prevalence of dental pain (OR = 0.53; 95%CI = 0.37-0.75). There was an association between dental pain and low income (OR = 1.58; 95%CI = 1.07-2.33), prevalence of untreated dental caries (OR = 1.25; 95%CI = 1.11-1.40), periodontal health (OR = 1.80; 95%CI = 1.04-3.09), and dental treatment needs (OR = 6.93; 95%CI = 3.96-12.14). Sociodemographic and clinical factors at the individual level were associated with the outcome but not with contextual variables. These findings reinforce the need to address these factors for effective community health actions.
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Affiliation(s)
- Thaís de Faria Fonseca Macedo
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Graduate Program in Dentistry, Belo Horizonte, MG, Brazil
| | | | - Renata de Castro Martins
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | | | - Rafaela da Silveira Pinto
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry, Belo Horizonte, MG, Brazil
| | - Lia Silva de Castilho
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Restorative Dentistry, Belo Horizonte, MG, Brazil
| | - Fabiana Vargas-Ferreira
- Universidade Federal de Minas Gerais - UFMG, School of Dentistry, Department of Community and Preventive Dentistry, Belo Horizonte, MG, Brazil
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Santos PS, Barasuol JC, Moccelini BS, Magno MB, Bolan M, Martins-Junior PA, Maia LC, Cardoso M. Prevalence of toothache and associated factors in children and adolescents: a systematic review and meta-analysis. Clin Oral Investig 2021; 26:1105-1119. [PMID: 34791550 DOI: 10.1007/s00784-021-04255-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 10/23/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVES This systematic review aimed to determine the pooled prevalence of toothache in children and adolescents and to verify its association with sociodemographic characteristics and dental caries experience. MATERIAL AND METHODS Six main and three grey literature databases were searched in February 2021. Observational studies that assessed the prevalence of toothache and associated factors were included. The methodological quality of the studies was evaluated following the guidelines by Fowkes and Fulton. Proportion and association meta-analyses were performed in MedCalc and Revman software, respectively. The certainty of the evidence was determined with the GRADE approach. RESULTS Seventy-one studies met the inclusion criteria. Thirty-two presented high methodological quality and a low risk of bias. The overall pooled prevalence of toothache in children and adolescents was 36.2% (95%CI: 33.0-39.42; I2: 99.72%; P < 0.001). Females (OR: 1.17; 95%CI: 1.08-1.26; I2: 91%; P < 0.001) and children and adolescents whose caregivers had ≤ 8 years of schooling (OR: 1.42; 95%CI: 1.30-1.56; I2: 77%; P < 0.001) presented the higher chance of reporting toothache. Dental caries experience increased the chance of reporting toothache in 3.49 times (95%CI: 2.70-4.51; I2: 92%; P < 0.001). The certainty of the evidence was very low. CONCLUSIONS The overall pooled prevalence of toothache was considered high. Sociodemographic characteristics (sex and caregivers' educational level) and previous dental caries experience were significantly associated with toothache reports. CLINICAL RELEVANCE Toothache is still a recurrent issue in many countries. Thus, it is essential to understand its possible associated factors to reduce the occurrence of new episodes.
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Affiliation(s)
- Pablo Silveira Santos
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil.
| | - Jéssica Copetti Barasuol
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Bárbara Suelen Moccelini
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Marcela Baraúna Magno
- Department of Pediatric Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Michele Bolan
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Paulo Antônio Martins-Junior
- Department of Child and Adolescent Oral Health, Federal University of Minas Gerais, Belo Horizonte, Minhas Gerais, Brazil
| | - Lucianne Cople Maia
- Department of Pediatric Dentistry, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariane Cardoso
- Department of Dentistry, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
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Costa FDS, Costa CDS, Chisini LA, Wendt A, Santos IDSD, Matijasevich A, Correa MB, Demarco FF. Socio-economic inequalities in dental pain in children: A birth cohort study. Community Dent Oral Epidemiol 2021; 50:360-366. [PMID: 34137065 DOI: 10.1111/cdoe.12660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 04/26/2021] [Accepted: 04/27/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe socio-economic inequalities in dental pain and dental caries in 5 and 12-year-old children enrolled in a birth cohort. METHODS This prospective study was carried out with children enrolled in a birth cohort in Pelotas, Brazil. The main outcome was history of dental pain in the last six months, collected at 5 and 12 years of age. Dental caries was evaluated as a secondary outcome. Inequalities dimensions were investigated using maternal education and family income. The inequalities indicators used were the slope index of inequality (SII) and the concentration index (CIX). RESULTS Some 1,114 and 990 children were included in the analyses at the 5- and 12-year follow-ups, respectively. The prevalence of dental pain was 16.5% (95% CI 14.4-18.8) at 5 years and 31.6% (95% CI 28.7-34.6) at 12 years. Regarding SII, the difference in the prevalence of dental pain was 14 and 11 percentage points at 5 and 12 years, respectively, when comparing the less to the more maternal schooled strata. Relative inequalities (CIX) were found for dental pain only at age 12, considering family income (-5.8 CI95% -11.0; -0.6). Absolute socio-economic inequalities were also observed for dental caries in both ages. CONCLUSION Dental pain in the last six months and dental caries was unequally distributed. Economically disadvantaged groups had the highest prevalence of dental pain and dental caries in both dentitions. Actions to tackle socio-economic inequalities must be designed throughout life.
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Affiliation(s)
| | | | - Luiz Alexandre Chisini
- Center of Biological Sciences and Health, Taquari Valley University, Lajeado, RS, Brazil
| | - Andrea Wendt
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Iná da Silva Dos Santos
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Department of Preventive Medicine, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil
| | - Marcos Britto Correa
- Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Flávio Fernando Demarco
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil.,Postgraduate Program in Dentistry, Federal University of Pelotas, Pelotas, RS, Brazil
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Pentapati KC, Yeturu SK, Siddiq H. Global and regional estimates of dental pain among children and adolescents-systematic review and meta-analysis. Eur Arch Paediatr Dent 2021; 22:1-12. [PMID: 32557184 PMCID: PMC7943429 DOI: 10.1007/s40368-020-00545-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 06/07/2020] [Indexed: 01/13/2023]
Abstract
AIM We aimed to evaluate the pooled prevalence of dental pain amongst children and adolescents. METHODS Studies conducted in children and adolescents up to18 years of age and where prevalence of dental is reported or calculated were included. Search was performed in four major databases from inception to June 1st, 2019. Prevalence estimate at the maximal recall for the dental pain for the individual study was used to calculate the overall pooled estimate. RESULTS The prevalence of dental pain ranged from 1.33 to 87.8% in the included publications for quantitative synthesis (n = 97). More than half of the publications reported the lifetime prevalence of dental pain (n = 51) while few studies reported the current prevalence of dental pain (n = 3) and only one study evaluated the dental pain in the past one week. Heterogeneity was high among the included publications (Q = 49,063.12; P < 0.001; df = 96 and I2 = 99.8; P < 0.001). Overall pooled prevalence of dental pain was 32.7 (CI = 29.6-35.9). No difference was seen with respect to the trends in prevalence of dental pain (Coefficient: 0.005; 95% CI - 0.001-0.011; P-value: 0.101). CONCLUSION Two out of ten children below five years, four out of ten children between 6 and 12 years and three out of ten adolescents between 13 and 18 years would have experienced pain in the past. Overall, three out of ten children or adolescents might have experienced dental pain in the past. There was no difference in the pain prevalence between male and females. Studies from Africa reported highest pooled prevalence (50.1%) with least being from Australia (20.7%). Studies from India (40.4%), China (41.3%) and Iran (42.6%) reported high pooled prevalence estimates of dental pain.
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Affiliation(s)
- Kalyana Chakravarthy Pentapati
- Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India.
| | - Sravan Kumar Yeturu
- grid.411370.00000 0000 9081 2061Department of Public Health Dentistry, Amrita School of Dentistry, Amrita Viswavidya Peetham, Kochi, India
| | - Hanan Siddiq
- grid.411639.80000 0001 0571 5193Department of Public Health Dentistry, Manipal College of Dental Sciences, Manipal, Manipal Academy of Higher Education, Manipal, 576104 Karnataka India
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Jean G, Kruger E, Tennant M. Universal access to oral health care for Australian children: comparison of travel times to public dental services at consecutive census dates as an indicator of progressive realisation. Aust J Prim Health 2020; 26:109-116. [PMID: 32252888 DOI: 10.1071/py19148] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Accepted: 12/04/2019] [Indexed: 11/23/2022]
Abstract
Progressive realisation of equitable access to health services is a fundamental measure of a state's resolve to achieve universal health coverage. The World Health Organization has reprioritised the importance of oral health services as an integral element of the roadmap towards health equity. This study sought to determine whether there is an indication of progressive realisation of equitable spatial access to public dental services for Australians <18 years of age through a comparison of travel times to the nearest public dental clinic at successive census dates. The distribution of children classified by rural remoteness and level of socioeconomic disadvantage, as well as the location of public dental clinics at the 2011 and 2016 Australian Bureau of Statistics censuses, was mapped using geographic imaging software. OpenRouteService software was used to calculate the travel time by car between each statistical census district and the nearest public dental clinic. There has been an improvement in the percentage of the population <18 years of age living within a reasonable travel time of a public dental clinic. The most socioeconomically disadvantaged groups in more densely populated areas have better spatial access to publicly funded dental services than less disadvantaged groups. Children living in very remote areas continue to experience lengthy travel times to access fixed oral health services.
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Affiliation(s)
- Gillian Jean
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia; and Corresponding author.
| | - Estie Kruger
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
| | - Marc Tennant
- International Research Collaborative - Oral Health and Equity, School of Human Sciences, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009, Australia
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