Child use of dental services and receipt of dental care in New Zealand

Food insecurity and the dental team: a pilot study to explore opinions

PURPOSE

In total, 17% of UK households with children experience food insecurity, with evidence to suggest a direct correlation with the prevalence of oral disease. This study explores current perceptions of the dental team, when recognising and supporting families who may experience food insecurity.

MATERIALS AND METHODS

An online, anonymous cross-sectional survey was designed and sent to members of the British Society of Paediatric Dentistry (BSPD) in June 2023, examining confidence and understanding surrounding food insecurity and dental health. Quantitative data is presented descriptively and qualitative data using a thematic analysis.

RESULTS

The response rate was 9.6% (n = 76). A significant number recognise the link between poor oral health and food insecurity, 80.3% (n = 61). Although practitioners are confident in oral health counselling, 80.3% (n = 61) a smaller proportion are not as confident when approaching food insecurity 32.9% (n = 25). Dental team members recognise the need to improve identification of affected patients and that they have a professional duty to support. Intervention strategies, such as additional training to support team development and signposting of patients are indicated.

CONCLUSION

This study suggests that whilst dental professionals understand the link between food insecurity and oral health, and their responsibilities to those affected; they lack confidence in identifying such patients and providing support. Additional conversations and training are fundamental to better understand their role, which must reflect the needs of the population that they serve.

Food insecurity is associated with self-reported oral health in school-age Ecuadorian children and is mediated by dietary and non-dietary factors

OBJECTIVE

The main objective was to investigate the association of household food insecurity (HFI) with child oral health. A secondary objective was to explore potential dietary and non-dietary mediators of the HFI-child oral health relationship.

DESIGN

Cross-sectional data from the nationally representative Ecuadorian National Health and Nutrition Survey (2018) were analysed. The data included self-reported child oral health, HFI (Food Insecurity Experience Scale), diet (FFQ) and oral care behaviours (toothbrushing frequency, toothpaste use). The association of HFI with the reported number of oral health problems was examined with stereotype logistic regression. Parallel mediation analysis was used to explore potential dietary (highly fermentable carbohydrate foods, plain water) and non-dietary (toothbrushing) mediators of the HFI-oral health relationship. Bias-corrected standard errors and 95 % CI were obtained using non-parametric bootstrapping (10 000 repetitions). Effect size was measured by percent mediation (PM).

SETTING

Ecuador.

PARTICIPANTS

5-17-year-old children (n 23 261).

RESULTS

HFI affected 23 % of child households. 38·5 % of children have at least one oral health problem. HFI was associated with a greater number of oral health problems: 1-2 problems (adjusted odds ratio (AOR) = 1·37; 95 % CI (1·15, 1·58); P = 0·0001), 3-4 problems (AOR = 2·21; 95 % CI (1·98, 2·44); P = 0·0001), 5-6 problems (AOR = 2·57; 95 % CI (2·27, 2·88); P = 0·0001). The HFI-oral health relationship was partially mediated by highly fermentable carbohydrate foods (PM = 4·3 %), plain water (PM = 1·8 %) and toothbrushing frequency (PM = 3·3 %).

CONCLUSIONS

HFI was associated with poorer child oral health. The HFI-oral health relationship was partially mediated by dietary and non-dietary factors. Longitudinal studies are needed to replicate our findings and investigate the role of other potential mediators.

The association between food insecurity, diet quality, and untreated caries among US children

BACKGROUND

The aim of this study was to examine the association between food insecurity and untreated caries among US children and the potential role of diet quality as a mediator in this relationship.

METHODS

The authors analyzed data for 4,822 children aged 5 through 17 years from the National Health and Nutrition Examination Survey cycles from 2011 through 2014. The authors measured food security as household-level food security status (full, marginal, low, very low) and overall food security status (full food secure, food insecure). They measured diet quality using the Healthy Eating Index. The primary outcome measure was untreated caries (none, ≥ 1). The authors used multiple logistic regression analysis to evaluate the relationships among food insecurity, diet quality, and untreated caries. They conducted mediation analysis using the Baron and Kenny approach.

RESULTS

Food-insecure children were more likely to have untreated caries compared with their fully food-secure counterparts, after controlling for confounding variables (odds ratio [OR], 1.38; 95% [CI, 1.11 to 1.72). Specifically, children from marginal and very low food-secure households had significantly higher odds of untreated caries (OR, 1.48; 95% CI, 1.10 to 2.01) compared with children from fully food-secure households (OR, 1.59; 95% CI, 1.12 to 2.26). Diet quality was not significantly associated with untreated caries.

CONCLUSIONS

Food insecurity was negatively associated with untreated caries among US children. Diet quality was not associated with untreated caries.

PRACTICAL IMPLICATIONS

Social factors such as food insecurity should be taken into consideration when dental clinicians perform caries risk assessment because caries risk is shown to be associated with overall health and dental health.

A rapid review of variation in the use of dental general anaesthetics in children

Introduction The use of dental general anaesthetics (DGAs) remains a cause for concern due to additional strains placed on health services. There are numerous factors influencing the prevalence and use of DGAs, and understanding these is an important first step in addressing the issue.Aim Conduct a rapid review of current peer-reviewed and grey literature on the variation in the use of DGAs in children.Methods Electronic searching using Medline via Ovid covering DGA articles from 1998 onwards, written in English. Publication types included primary and secondary sources from peer-reviewed journals and reports, as well as grey literature.Results From 935 results, 171 articles were included in the final review. Themes emerging from the literature included discussions of DGA variation, variations in standards of service provision by health services, and the socio-demographic and geographical characteristics of children. Prominent socio-demographic and geographical characteristics included age, other health conditions, ethnic and cultural background, socioeconomic status and deprivation, and geographical location.Conclusions This review identified numerous variations in the patterns associated with DGA provision and uptake at both a health service and individual level. The findings demonstrate the complicated and multifaceted nature of DGA practices worldwide.

Comparison of dental treatment performed under general anesthesia between healthy children and children with special health care needs in a hospital setting, Saudi Arabia

Background

The aim of this retrospective study was to assess and compare the dental treatments performed under general anesthesia (GA) between healthy children and children with special health care needs (SHCN) according to age group and gender at king Fahd hospital, Dhahran, Saudi Arabia.

Material and Methods

Data was retrieved from the records of 304 healthy and SHCN children 1 18 years of age who received dental rehabilitation under GA in the period 2015-2018. The dental treatment modalities were compared in the two groups and differences according to age group and gender were reported.

Results

Compared to healthy children, children with SHCN received significantly less pulp therapy treated teeth, and restored primary teeth. While, they received significantly more extracted teeth, and restored permanent teeth (P<0.05). In both groups, younger children (≤ 6 years) received significantly more crowns, pulp therapy treated teeth, and restored primary teeth than older children (> 6 years) (P<0.05). While, they received significantly less fissure sealed teeth, extracted primary teeth, and restored permanent teeth (P<0.05). No gender difference was found among children with SHCN; however, healthy boys ≤ 6 years received significantly more extracted primary teeth than girls of same age group, while healthy boys > 6 years received significantly more pulp therapy treated teeth than girls of same age group (P<0.05).

Conclusions

Healthy children had different approaches for treatment under GA than children with SHCN. The use of radical treatment approaches like extraction in children with SHCN and the lessened preference toward pulp therapy coupled with greater need for permanent teeth restorations when compared to healthy children were observed. Greater emphasis on oral health education and preventive strategies for children with SHCN is required. It is important to educate their parents/caregivers on the importance of establishing early dental home.

Key words:Dental treatment, general anesthesia, special health care needs.

Association between untreated dental caries and household food insecurity in schoolchildren

Abstract The aim of the present study was to assess the association between untreated dental caries (UDC) and household food insecurity (HFI) among schoolchildren in different income strata. A population-based study was carried out with a sample of 584 12-y-old schoolchildren. Oral examinations were performed and HFI was determined using a validated scale. Other independent variables were analyzed for being of interest to the stratification of the results (per capita household income) or for acting as potential confounding variables. The prevalence of UDC and HFI was 45% and 39%, respectively. The multivariate models demonstrated that the UDC was significantly more prevalent among children in food-insecure households with per capita income of up to US$ 70.71 than among those in the same income stratum that were free of HFI [PR = 1.52 (95%CI = 1.01-2.29)]. HFI was associated with a greater frequency of UDC among low-income schoolchildren, but had no significant impact on this variable among children from other income strata. Thus, ensuring access to quality food may be a good strategy for minimizing inequities in oral health and reducing dental caries experience among schoolchildren from low-income families.

Indigenous child health: are we making progress?

We identified 244 relevant articles pertinent to indigenous health (4% of the total) with a steady increase in number since 1995. Most Australian publications in the journal (with a small Indigenous population) have focussed on conditions such as malnutrition, diarrhoeal disease, iron deficiency, rheumatic fever, acute glomerulonephritis and respiratory and ear infections, and in settings where nearly all affected children are Indigenous. In contrast, New Zealand publications (with a large Maori and Pacific Islander population) have addressed important health issues affecting all children but emphasised the over-representation of Maori and Pacific Islanders. Publications in the journal are largely descriptive studies with relatively few systematic reviews and randomised trials. Our review attempts to cover the important Indigenous health issues in our region as represented by articles published in the Journal. The studies do document definite improvements in indigenous child health over the last 50 years.

Maternal self-report of oral health in six-year-old Pacific children from South Auckland, New Zealand

OBJECTIVE

To examine maternal and socio-demographic factors associated with oral health practices and experiences in six-year-old Pacific children.

METHODS

The longitudinal Pacific Islands Families (PIF) study is following a cohort of Pacific children born in Auckland, New Zealand in 2000. At approximately six years postpartum maternal reports (n = 1001) on child oral health practices and experiences of fillings and extractions were gathered.

RESULTS

Forty-five per cent of mothers reported that their child had experienced fillings or extractions. After adjusting for confounding factors, we found that Tongan children were almost twice as likely to have their teeth filled or extracted than Samoan children (OR, 1.93; 95%, 1.34-2.77). Differences between Samoan children and children of other ethnic groups were not significant. Children of mothers who had secondary qualifications were significantly less likely to have their teeth filled or extracted compared to children of mothers who had postsecondary qualifications (OR, 0.634; 95%, 0.44-0.90). Prolonged duration of breastfeeding was associated with an increased likelihood of filling or extraction experience. In terms of maternal oral hygiene, maternal tooth brushing frequency of less that once a day was significantly associated with increased odds of fillings and/or extractions in their children (OR, 1.35; 95% CI, 1.02-1.79). Children who were sometimes supervised for tooth brushing were significantly more likely to have fillings or extractions than children who were not provided supervision.

CONCLUSIONS

These findings highlight the role of cultural factors and maternal hygiene in child oral health outcomes and suggest that health promotion efforts should encompass the whole family and embrace a culturally appropriate approach.