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Crocombe LA, Chrisopoulos S, Kapellas K, Brennan D, Luzzi L, Khan S. Access to dental care barriers and poor clinical oral health in Australian regional populations. Aust Dent J 2022; 67:344-351. [PMID: 35765724 PMCID: PMC10084231 DOI: 10.1111/adj.12930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND This paper investigated the associations between oral health with behavioural, demographic, periodontitis risk, financial and access to dental care barriers and compared the results in three Australian regional areas. METHODS Data were obtained from the Australian National Study of Adult Oral Health (2017-18). Oral health status was measured using DMFT-score, and mean numbers of decayed, missing or filled teeth and periodontitis prevalence using the Center for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) Periodontal Classification. Analysis included these dependent variables by three regional areas, seven socio-demographic variables, two periodontal disease risk-factors, two preventive dental behaviours, two barriers to dental care and three access to dental care variables. RESULTS Of the 15,731 people interviewed, 5,022 were examined. There was no significant difference in periodontitis prevalence between the regions. All the socio-demographic characteristics, periodontal disease risk-factors, preventive dental behaviours were significantly associated with at least one of the dental caries indicators. In multivariable analysis, there was no significant association between regional location with any of the four clinical dental caries variables. CONCLUSION Poorer oral health outside major cities was associated with household income, education level, higher smoking, usual reason for and frequency of dental visiting. © 2022 Australian Dental Association.
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Affiliation(s)
- Leonard A Crocombe
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia.,University Department of Rural Health, La Trobe University, Bendigo, Victoria, Australia
| | - Sergio Chrisopoulos
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Kostas Kapellas
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - David Brennan
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Liana Luzzi
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia
| | - Shahrukh Khan
- Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, South Australia, Australia.,University Department of Rural Health, La Trobe University, Bendigo, Victoria, Australia.,Melbourne Dental School, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Victoria, Australia.,Tasmanian School of Medicine, College of Health and Medicine, University of Tasmania, Hobart, Australia
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Ha DH, Crocombe LA, Khan S, Do LG. The impact of different determinants on the dental caries experience of children living in Australia rural and urban areas. Community Dent Oral Epidemiol 2020; 49:337-345. [PMID: 33289154 DOI: 10.1111/cdoe.12606] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 10/14/2020] [Accepted: 11/15/2020] [Indexed: 11/27/2022]
Abstract
AIMS Evidence suggests there are geographical variations in child oral health and this has prompted research into determinants of that variation. This study aimed to investigate factors attributable to the difference in child oral health between urban and rural areas in Australia. METHOD Data were from the National Child Oral Health Study 2012-14, a population-based study of 5- to 14-year-old children, who underwent oral epidemiological examinations by trained examiners. Caries prevalence (dmfs/DMFS > 0) and experience (dmfs/DMFS count) in the primary dentition (5- to 8-year-old) and permanent dentition (9- to 14-year-old) were calculated. Children were grouped by residential location (urban or rural areas). A parental questionnaire collected information on family socio-economic factors, and individual health behaviours (dental access, sugar consumption and toothbrushing). Residential history was used to calculate lifetime exposure to water fluoridation (WF). Analyses were weighted to produce population-representative estimates. The primary outcomes were assessed separately for the two groups in regression models with robust standard error estimation to estimate prevalence ratios and mean ratios and their 95% confidence intervals. Population Attributable Fractions were calculated using the population distribution of the exposures and their adjusted estimates. RESULTS 10 581 5- to 8-year-old and 14 041 9- to 14-year-old children were included. Caries prevalence was higher in rural than in urban areas. In multivariable models, exposure to fluoridation, reason for dental visit and consumption of sugary beverages were consistently associated with caries prevalence and experience. WF coverage attributed to differences in caries prevalence (10% vs 21%) and experience (14% vs 35%) in the permanent dentition. High consumption of sugary beverages attributed to a higher primary and permanent dental caries experience in rural than in urban areas. Dental access was also attributed to the differences between the two areas. CONCLUSION Factors at both community and individual levels attributed to the observed differences in child caries prevalence and experience between urban and rural areas.
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Affiliation(s)
- Diep H Ha
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, Australia
| | - Leonard A Crocombe
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, Australia
- Centre for Rural Health, University of Tasmania, Hobart, Tas., Australia
| | - Shahrukh Khan
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, Australia
- School of Medicine, University of Tasmania, Hobart, Tas., Australia
| | - Loc G Do
- Australian Research Centre for Population Oral Health, University of Adelaide, Adelaide, SA, Australia
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Peres KG, Ha DH, Christofis S. Trend and distribution of coronal dental caries in Australians adults. Aust Dent J 2020; 65 Suppl 1:S32-S39. [PMID: 32583588 DOI: 10.1111/adj.12762] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS To report the experience of coronal dental caries in the Australian adult population. METHODS Dentate people aged 15 years and over were online or telephone interviewed, and dental examined (n = 5022). The number of decay, missing and filled surfaces (DMFS) were recorded. Independent variables were demographic, socioeconomic conditions and dental care characteristics. Proportions of DMFS >0, average DMFS and its components were calculated. RESULTS Overall, 32.1% had decayed surfaces, with a higher proportion found in males (34.7%) and 40% higher in those living in remote areas than in those living in major city and regional areas. The prevalence of decayed surfaces varied from 37.4% (lowest income group) to 25.0% (highest income group). The mean number of decayed surfaces was three times higher in the lowest income group compared to the highest one. Uninsured people had a higher prevalence of decayed surfaces and lower mean of filling surfaces than insured group. Participants with an unfavourable pattern of dental visiting had two times higher prevalence of decay than their counterparts. Overall, three quarters (77.4%) had at least one filling in their permanent dentition. This percentage increased from 61.6% among 15-34 year olds, to 88.0% among those aged 55-74 years. CONCLUSION Socioeconomic inequalities in caries experience persist in Australia.
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Affiliation(s)
- Karen G Peres
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia.,School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - Diep H Ha
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
| | - Sofia Christofis
- Australian Research Centre for Population Oral Health (ARCPOH), Adelaide Dental School, The University of Adelaide, Adelaide, Australia
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Brennan DS, Luzzi L, Chrisopoulos S, Haag DG. Oral health impacts among Australian adults in the National Study of Adult Oral Health (NSAOH) 2017-18. Aust Dent J 2020; 65 Suppl 1:S59-S66. [PMID: 32583589 DOI: 10.1111/adj.12766] [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] [Indexed: 01/29/2023]
Abstract
BACKGROUND This paper examines oral health impacts of toothache experience, self-rated oral health (SROH), being uncomfortable with dental appearance, and avoiding foods in the Australian adult population. METHODS The explanatory variables include age, sex, region, income, area-based SES, dental insurance and visiting pattern. The data were collected in the interview in NSAOH 2017-18. RESULTS There were lower percentages with: toothache in the highest (14.8%) than middle (21.2%) and lower income tertiles (25.2%); fair/poor SROH in the highest (15.8%) than middle (24.1%) and lower tertiles (34.8%); uncomfortable with appearance in the highest (29.1%) than middle (35.3%) and lower tertiles (42.2%); and food avoidance in the higher (15.3%) than middle (22.9%) and lower tertiles (34.4%). There were higher percentages with: toothache in the unfavourable (32.2%) than intermediate (23.1%) and favourable (11.7%) visiting groups; fair/poor SROH in the unfavourable (44.0%) than intermediate (27.4%) or favourable (10.2%) groups; being uncomfortable about appearance in the unfavourable (47.6%) than intermediate (39.5%) or favourable (25.8%) groups; and avoiding foods in the unfavourable (34.8%) than intermediate (26.0%) or favourable (14.5%) groups. CONCLUSIONS Socioeconomic status and dental visiting were associated with oral health impacts. Oral health impacts were worse for those with lower income and unfavourable visiting patterns.
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Affiliation(s)
- David S Brennan
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Liana Luzzi
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Sergio Chrisopoulos
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Dandara G Haag
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, South Australia, Australia
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McNeil DW, Hayes SE, Randall CL, Polk DE, Neiswanger K, Shaffer JR, Weyant RJ, Foxman B, Kao E, Crout RJ, Chapman S, Brown LJ, Maurer JL, Marazita ML. Depression and Rural Environment are Associated With Poor Oral Health Among Pregnant Women in Northern Appalachia. Behav Modif 2015; 40:325-40. [PMID: 26643277 DOI: 10.1177/0145445515615353] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Both oral health problems and depression among pregnant women contribute to maternal-infant health outcomes. Little is known, however, about the potential effects of clinically significant depression on the oral health status of pregnant women. The purpose of the present study was to determine the influence of clinically significant depression and rural- or urban-dwelling status on oral health outcomes among pregnant women. Pregnant women (N = 685) in rural (i.e., West Virginia) and urban (i.e., Pittsburgh, PA) areas of northern Appalachia were assessed by calibrated examiners regarding gingivitis, oral hygiene, and DMFT (decayed, missing, and filled teeth), completed the Center for Epidemiologic Studies-Depression Scale (CES-D) and provided demographics. Participants were categorized based on clinically significant depressive symptoms (CES-D ≥ 16) and rural/urban domicile. Women with depression and those living in rural areas had worse oral health on all three indices than their non-depressed and urban counterparts. Depression, particularly among women in rural areas, affects certain oral health indices and represents a modifiable target for intervention. Moreover, treatments designed specifically for rural populations may be of particular utility. Women who are pregnant or planning to become pregnant may benefit from regular depression screenings from their dental and medical health care providers.
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Affiliation(s)
- Daniel W McNeil
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Sarah E Hayes
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Cameron L Randall
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Deborah E Polk
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - Kathy Neiswanger
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - John R Shaffer
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - Robert J Weyant
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - Betsy Foxman
- Center for Oral Health Research in Appalachia University of Michigan, Ann Arbor, USA
| | - Elizabeth Kao
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Richard J Crout
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Stella Chapman
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Linda J Brown
- West Virginia University, Morgantown, USA Center for Oral Health Research in Appalachia
| | - Jennifer L Maurer
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
| | - Mary L Marazita
- Center for Oral Health Research in Appalachia University of Pittsburgh, PA, USA
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Rosing K, Hede B, Christensen LB. A register-based study of variations in services received among dental care attenders. Acta Odontol Scand 2015; 74:14-35. [PMID: 25924843 DOI: 10.3109/00016357.2015.1034771] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVES To investigate whether receipt of dental services, among attenders, reflects variations in dental health or whether and to what degree it is associated with socioeconomic status, with irregular or regular dental attendance and with the availability of dentists in residential areas. MATERIALS AND METHODS This retrospective register-based study followed two Danish cohorts, aged 25 and 40, with a dental examination in 2009 (n = 32,351). The dental service data were registered during 2005-2009. The number of dental examinations, individual preventive services (IPS), tooth extractions, root fillings and composite fillings were analyzed in relation to socioeconomic status, irregular/regular dental attendance, inhabitant/dentist ratio and to DMFT at age 15 (DMFT15) and change in DMFT (ΔDMFT) from age 15 to age 25 and age 40, respectively. Poisson regression and negative binomial regression analyses were used. RESULTS The variations in number of services received in the study population were small (SD = 0.2-2.7). However, with a few exceptions, high levels of DMFT15 and ΔDMFT were associated with receipt of more dental services. Socioeconomically-privileged individuals received more dental examinations but fewer tooth extractions, root fillings and composite fillings compared to disadvantaged persons, when controlled for dental health levels. Irregular attenders received fewer IPS and composite fillings but had more extractions compared to regular attenders. CONCLUSIONS Variations in dental care services were found to reflect variations in dental health, but the variations were also related to individual socioeconomic status, residential area and dental attendance patterns.
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Affiliation(s)
- Kasper Rosing
- a 1 Section for Periodontology and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
| | - Børge Hede
- a 1 Section for Periodontology and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
- b 2 Department for Special Care Dentistry , City of Copenhagen, Denmark
| | - Lisa Bøge Christensen
- a 1 Section for Periodontology and Community Dentistry, Department of Odontology, Faculty of Health and Medical Sciences, University of Copenhagen , Copenhagen, Denmark
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Ha DH, Crocombe LA, Mejia GC. Clinical oral health of Australia's rural children in a sample attending school dental services. Aust J Rural Health 2014; 22:316-22. [PMID: 25495626 DOI: 10.1111/ajr.12107] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2014] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To examine the association between children's clinical oral health status and their residential location using the latest available data (2009) and to ascertain whether poor oral health among rural children is related to being Indigenous, having less access to fluoridated water or being of lower socioeconomic status (SES), than children from urban areas. DESIGN Cross-sectional survey. SETTING AND PARTICIPANT Data were collected on 74, 467 children aged 5-12 years attending school dental services in Australia (data were not available for Victoria or New South Wales). MAIN OUTCOME MEASURES Clinical oral health was determined by the mean number of permanent teeth with untreated caries, missing and filled permanent teeth, and the mean decayed, missing and filled permanent teeth index (DMFT) of 8 to 12-year-old-children and the mean number deciduous teeth with untreated caries, missing and filled deciduous teeth, and the mean decayed, missing and filled deciduous teeth index (dmft) of 5-10-year-olds. RESULTS The multivariable models that included coefficients on whether the child was Indigenous, from an area with fluoridated water and SES, were controlled for age and sex. The mean DMFT of 8-12-year-old children and the mean dmft of 5-10-year-old-children were significantly higher in rural areas compared with urban centres after accounting for Indigenous status, fluoridated water and SES. CONCLUSION Children's oral health was poorer in rural areas than in major city areas.
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Affiliation(s)
- Diep Hong Ha
- Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, South Australia, Australia
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