Trends in caries experience and associated contextual factors among indigenous children

Water fluoridation in Australia: A systematic review

Water fluoridation is considered a safe and effective public health strategy to improve oral health. This review aimed to systematically summarize the available evidence of water fluoridation in Australia, focusing on the history, health impacts, cost effectiveness, challenges, and limitations. A systematic search was conducted on the Ovid Medline, Web of Science, Scopus, ProQuest Central, Cinahl, and Informit databases to identify literature on water fluoridation in Australia. A grey literature search and backward snowballing were used to capture additional literature. Primary studies, reviews, letters, and opinion papers were included in the quantitative analysis and summarized based on the year of publication and geographical location. The data were extracted from primary studies and summarized under three subheadings: history, community health impacts and the limitations and challenges. Water fluoridation in Australia was first implemented in 1953 in Tasmania. Most states and territories in Australia embraced water fluoridation by 1977 and currently, 89% of the Australian population has access to fluoridated drinking water. Studies report that water fluoridation has reduced dental caries by 26-44% in children, teenagers, and adults, benefiting everyone regardless of age, income, or access to dental care. It has been recognized as a cost-effective intervention to prevent dental caries, especially in rural and low-income areas. Water fluoridation as a public health measure has faced challenges, including political and public opposition, implementation and maintenance costs, access and equity, communication and education, and ethical concerns. Variations in research activities on water fluoridation across Australian states and territories over the last seven decades can be due to several factors, including the time of implementation, funding, and support. Ongoing monitoring and research to review and update optimal fluoride levels in drinking water in Australia is warranted to ensure sustainable benefits on oral health while preventing any adverse impacts.

Oral health status, behaviours, food and beverage consumption of aboriginal children in Australia

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.

Prevalence of Caries among Schoolchildren in the Interior of Suriname

The aim of this study was to determine the prevalence of caries among children living in the interior of Suriname and to investigate the influence of the reachability of their habitats and different ethnicities on the prevalence of caries. As part of children's regular dental check-ups, data on the prevalence of caries were registered for schoolchildren (n = 1,309) living in four different regions. Prevalence of caries was expressed by the number of decayed, missing, and filled teeth (DMFT index). Consequences of severe caries were recorded by counting the number of teeth with pulp involvement, ulcerations, fistulas, and abscesses. Depending on the habitat, the number of children with caries in their primary dentition varied between 68% and 100%, in the mixed dentition between 79% and 98%, and in their permanent dentition between 54% and 94%. After the World Health Organization criteria, the average scores of dmft were high in children with primary teeth (except for Brokopondo), moderate to high in children with mixed dentition and low to moderate in children with permanent teeth. Children in more remote areas had a greater prevalence of caries than children in less remote regions. Severe consequences of caries were seen in 14-75% of the children. Treatments were rarely performed. Children in the interior of Suriname are in great need of preventive and curative dental treatments.

Root surface caries among older Australians

OBJECTIVES

Root caries has increased as a clinical problem in recent decades. However, the use of multiple waves of longitudinal follow-up data in estimating root caries increment has not been previously attempted. The aims of this study were to quantify root caries increment from a longitudinal study of older adults with 4 oral examinations over 11 years and to examine behavioural factors associated with root caries.

METHODS

A secondary analysis was undertaken using data collected in 4 waves (baseline, 2-year, 5-year and 11-year) of the South Australian Dental Longitudinal Study which began in 1991/92. The study group consisted of a stratified random sample of people aged 60+ years at baseline. A total of 358 participants with complete oral examinations in all 4 waves were included. The examinations were performed by trained and calibrated dentists. Baseline behavioural risk factors (toothbrushing frequency, flossing frequency, dental visiting pattern, reason for dental visiting and tobacco smoking status) and time in years across the 4 waves were the main exposures. Baseline clinical oral conditions (gingival condition and gingival recession), demographic and socio-economic risk factors served as covariates. Root caries was measured as mean number of untreated root surfaces (root DS) and decayed/filled root surfaces (root DFS) at each wave of examinations. Multivariable multilevel growth model using linear regression analysis was used to get an estimate for root caries increment and associated oral health-related behaviours adjusting for all the covariates.

RESULTS

Findings from the multivariable models indicated that the annual increment of root DS and root DFS were 0.07 (SE = 0.01) and 0.11 (SE = 0.02) surfaces, respectively. Irregular brushing (E [SE] = 0.25 [0.12]), visiting the dentist only for problems (E [SE] = 0.30 [0.13]) and smoking (E [SE] = 0.33 [0.12]) were risk factors for the increase in root DS. Irregular flossing and more frequent dental visit were associated with the increase in root DFS.

CONCLUSIONS

Root caries increased slowly across time among relatively healthier Australian older adults. Irregular brushing, unfavourable dental visiting and tobacco smoking were risk factors for the increase in untreated root caries, while irregular flossing and more frequent dental visiting were associated with the increase in root DFS.