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Background: In Australia, Aboriginal adults experience higher levels of poor oral and general health than the non‐Aboriginal population. This study compared self‐rated oral and general health among Aboriginal adults in regional South Australia with participants in the National Survey of Adult Oral Health (NSAOH). Methods: Data were obtained from the Indigenous Oral Health Literacy Project (IOHLP) based in South Australia. Three sub‐populations from the NSAOH were utilised for comparison: National Aboriginal, National non‐Aboriginal and South Australian Regional Non‐Aboriginal adults. All data were standardised by age group and sex, utilising Census data. Results: Just over 70% of South Australian Regional Aboriginal participants gave a rating of 'excellent, very good or good' for general health, more than 17% lower than each of the other groups. Just over 50% rated their oral health highly, 20% fewer than the proportion for each other group. Stratifying by key socio‐demographic factors did not account for all differences. Conclusions: Proportionally fewer South Australian Regional Aboriginal adults had high ratings of oral and general health than the Aboriginal and non‐Aboriginal adults from the national survey, indicating that national‐level data might underestimate the proportion of regional Aboriginal Australians with poor oral health. [ABSTRACT FROM AUTHOR]

Objectives Diabetes mellitus and periodontal disease are highly prevalent among Indigenous Australian adults. Untreated periodontitis impacts glycaemic control in people with diabetes. The aim of this study was to report on the effect of periodontal therapy on glycaemic control among people with obesity. Methods This subgroup analysis is limited to 62 participants with diabetes from the original 273 Aboriginal Australian adults enrolled into the PerioCardio study. Intervention participants received full-mouth non-surgical periodontal scaling during a single, untimed session while controls were untreated. Endpoints of interest included change in glycated haemoglobin (HbA1c), C-reactive protein ( CRP) and periodontal status at 3 months post-intervention. Results There were more females randomized to the treatment group ( n = 17) than control ( n = 10) while the control group had a higher overall body mass index ( BMI) [mean ( SD)] 33.1 (9.7 kg m−2) versus 29.9 (6.0 kg m−2). A greater proportion of males were followed up at 3 months compared to females, P = 0.05. Periodontal therapy did not significantly reduce HbA1c: ancova difference in means 0.22 mmol mol−1 (95% CI −6.25 to 6.69), CRP: ancova difference in means 0.64 (95% CI −1.08, 2.37) or periodontal status at 3 months. Conclusions Non-surgical periodontal therapy did not significantly reduce glycated haemoglobin in participants with type 2 diabetes. Reasons are likely to be multifactorial and may be influenced by persistent periodontal inflammation at the follow-up appointments. Alternatively, the BMI of study participants may impact glycaemic control via alternative mechanisms involving the interplay between inflammation and adiposity meaning HbA1c may not be amenable to periodontal therapy in these individuals. [ABSTRACT FROM AUTHOR]

Background: Few studies have examined dental caries experience in Aboriginal adults. The objectives of this study were to describe the dental caries experience of some Aboriginal Australian adults residing in the Northern Territory, and to determine associations with dental caries experience.Methods: A convenience sample of Aboriginal adults from Australia's Northern Territory was dentally examined. Self-reported oral health information was collected through a questionnaire.Results: Data were available for 312 participants. The per cent of untreated decayed teeth (per cent DT >0) was 77.9 (95% CI 73.0 to 82.1), the mean DT was 3.0 (95% CI 2.6 to 3.4), the prevalence of any caries experience (the per cent DMFT >0) was 95.5 (95% CI 92.6 to 97.3) and the mean DMFT was 9.7 (95% CI 8.9 to 10.5). In multivariable analyses, unemployment and not brushing teeth the previous day were associated with the per cent DT >0. Problem-based dental attendance was associated with both the mean DT and the per cent DMFT >0. Older age, residing in the capital city, being non-incarcerated, last visiting a dentist <1 year ago and problem-based dental attendance were associated with the mean DMFT.Conclusions: Dental caries experience among this convenience sample of Aboriginal Australian adults was very high. Most factors associated with dental caries were social determinants or dental service access-related. [ABSTRACT FROM AUTHOR]

Background Indigenous children experience significantly more dental caries than non-Indigenous children. This study assessed if access to fluoride in the water closed the gap in dental caries between Indigenous and non-Indigenous children. Methods Data from four states and two territories were sourced from the Child Dental Health Survey (CDHS) conducted in 2010. The outcomes were dental caries in the deciduous and permanent dentitions, and the explanatory variables were Indigenous status and access to fluoridated water (≥0.5 mg/L) prior to 2008. Results Dental caries prevalence and severity for Indigenous and non-Indigenous children, in both dentitions, was lower in fluoridated areas compared to non-fluoridated areas. Among non-Indigenous children, there was a 50.9% difference in mean dmft scores in fluoridated (1.70) compared to non-fluoridated (2.86) areas. The difference between Indigenous children in fluoridated (3.29) compared to non-fluoridated (4.16) areas was 23.4%. Among non-Indigenous children there was a 79.7% difference in the mean DMFT scores in fluoridated (0.68) compared to non-fluoridated (1.58) areas. The difference between Indigenous children in fluoridated (1.59) and non-fluoridated (2.23) areas was 33.5%. Conclusions Water fluoridation is effective in reducing dental caries, but does not appear to close the gap between non-Indigenous children and Indigenous children. [ABSTRACT FROM AUTHOR]

Background The reasons why social inequality is associated with oral health outcomes is poorly understood. This study investigated whether stratification by different measures of socio-economic status ( SES) helped elucidate these associations. Methods Cross-sectional survey data were used from Australia's 2004-06 National Survey of Adult Oral Health. The outcome variable was poor self-rated oral health. Explanatory variables comprised five domains: demographic, economic, general health behaviour, oral health-related quality of life and perceived need for dental care. These explanatory variables were each stratified by three measures of SES: education, income and occupation. Results The overall proportion of adults reporting fair or poor oral health was 17.0% (95% CI 16.1, 18.0). Of these, a higher proportion were older, Indigenous, non-Australian born, poorly educated, annual income <$20 000, unemployed, eligible for public dental care, smoked tobacco, avoided food in the last 12 months, experienced discomfort with their dental appearance, experienced toothache or reported a need for dental care. In stratified analyses, a greater number of differences persisted in the oral health impairment and perceived need for dental care domains. Conclusions Irrespective of the SES measure used, more associations between self-rated oral health and dental-specific factors were observed than associations between self-rated oral health and general factors. [ABSTRACT FROM AUTHOR]

Background The aim of this study was to describe the caries experience and severity of periodontal disease in a convenience sample of Indigenous Australians living in the Northern Territory. Methods Data were gathered via self-reported questionnaire and dental examination by calibrated examiners. Socio-demographic characteristics were compared with data from the 2011 Australian census while prevalence of periodontal disease and dental caries was compared against weighted estimates from the National Survey of Adult Oral Health 2004-2006. In each comparison, non-overlapping 95% confidence intervals inferred a significant difference. Within-study comparisons were assessed via chi-square, t-tests and analysis of variance for differences among study participants. Results A total of 312 Indigenous Australian participants provided completed data (average age 39.5 ± 10.5 years, 174 males). Of these, 87.5% were confirmed periodontitis cases; 3.5 times that of national-level estimates. The experience of untreated caries was five times that of national estimates (mean decayed 3.0 versus 0.6). Periodontitis case status was positively associated with older age, male gender and presence of diabetes. Conclusions Periodontal disease and untreated caries were significantly more prevalent in this sample of Indigenous Australians compared to the general Australian population. The prevalence of periodontal disease was markedly higher than that previously described for Indigenous Australians. [ABSTRACT FROM AUTHOR]

Background Individual-level factors influence DMFT, but little is known about the influence of community environment. This study examined associations between community-level influences and DMFT among a birth cohort of Indigenous Australians aged 16-20 years. Methods Data were collected as part of Wave 3 of the Aboriginal Birth Cohort study. Fifteen community areas were established and the sample comprised 442 individuals. The outcome variable was mean DMFT with explanatory variables including diet and community disadvantage (access to services, infrastructure and communications). Data were analysed using multilevel regression modelling. Results In a null model, 13.8% of the total variance in mean DMFT was between community areas, which increased to 14.3% after adjusting for gender, age and diet. Addition of the community disadvantage variable decreased the variance between areas by 4.8%, indicating that community disadvantage explained one-third of the area-level variance. Residents of under-resourced communities had significantly higher mean DMFT (β = 3.86, 95% CI 0.02, 7.70) after adjusting for gender, age and diet. Conclusions Living in under-resourced communities was associated with greater DMFT among this disadvantaged population, indicating that policies aiming to reduce oral health-related inequalities among vulnerable groups may benefit from taking into account factors external to individual-level influences. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To describe the rates of hospitalisation for head and traumatic brain injury among Australian children aged 0-14 years. DESIGN: Descriptive analysis of the Australian Institute of Health and Welfare National Hospital Morbidity Database, using data for the period 1 July 2000 to 30 June 2006. RESULTS: The rate of hospitalisation for head injury was 395.9 per 100,000 (95% CI 393.4 to 398.4), with 47.6 per 100,000 (95% CI 46.7 to 48.5) being high-threat-to-life injuries. In multivariate analysis, those aged 0-4 years had 1.8 times the rate of head injury of 10-14-year-olds, while boys had 1.7 times the rate of girls. Children living in very remote and remote areas had a 1.3-1.5-fold greater rate of head injury, and a 1.6-1.8-fold greater rate of injuries that were high threat to life, than city-dwelling children. The rate of traumatic brain injury (TBI) was 91.1 per 100,000 (95% CI 89.9 to 92.3), with 34.7 per 100,000 (95% CI 33.9 to 35.4) being high-threat-to-life injuries. In multivariate analysis, children aged 0-4 years had 0.8 times the rate of 10-14-year-olds, and boys had 1.9 times the rate of girls. Children living in the very remote and remote areas had a 1.9-2.8-fold greater rate of TBI, and a 1.5-1.7-fold greater rate of injuries that were high threat to life, than city-dwelling children. CONCLUSIONS: Children living remotely were disproportionately represented among those sustaining head injuries. Almost a quarter of head injuries were TBI. [ABSTRACT FROM AUTHOR]

Objectives: To determine predictors of untreated dental decay among 15-34-year-olds in Australia. Methods: Data were from Australia's National Survey of Adult Oral Health, a representative survey that utilized a three-stage, stratified clustered sampling design. Models representing demographic, socioeconomic, dental service utilization and oral health perception variables were tested using multivariable logistic regression to produce odds ratios. Results: An estimated 25.8% (95% CI 22.4-29.5) of 15-34-year-old Australians had untreated dental decay. After controlling for other covariates, those who lived in a location other than a capital city had 2.0 times the odds of having untreated dental decay than their capital city-dwelling counterparts (95% CI 1.29-3.06). Similarly, those whose highest level of education was not a university degree had 2.1 times the odds of experiencing untreated dental decay (95% CI 1.35-3.31). Perceived need of extractions or restorations predicted untreated coronal decay, with 2.9 times the odds for those who perceived a treatment need over those with no such treatment need perception (95% CI 1.84-4.53). Participants who experienced dental fear had 2.2 times the odds of having untreated dental decay (95% CI 1.38-3.41), while those who reported experiencing toothache, orofacial pain or food avoidance in the last 12 months had 1.9 times the odds of having untreated dental decay than their counterparts with no such oral health-related quality-of-life impact (95% CI 1.20-2.92). The multivariate model achieved a 'useful' level of accuracy in predicting untreated decay (area under the ROC curve = 0.74; sensitivity = 0.63; specificity = 0.73). Conclusions: In the Australian young adult population, residential location, education level, perceived need for dental care, dental fear, toothache, orofacial pain or food avoidance together were predictors of untreated dental decay. The prediction model had acceptable specificity, indicating that it may be useful as part of a triage system for health departments wishing to screen by means of a questionnaire for apparently-dentally healthy 15-34-year-olds. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To determine the prevalence and severity of dental caries in a sample of urban Fijian school children. DESIGN: Cross-sectional. SAMPLE AND METHODS: Children aged between 6 and 8 years who attended one of four primary schools in different localities of Suva completed self-report questionnaires and were examined for dental caries. RESULTS: A total of 704 children (response rate = 72.4%) returned questionnaires and were examined dentally. The prevalence of dental caries in the primary dentition was 87.6% and in the permanent dentition, 46.7%. The mean dfs and mean DFS were 8.43 (SD 7.82) and 2.38 (SD 1.37), respectively. High caries prevalence and severity were associated with infrequent brushing, snacking on sugar-containing foods, having seen a dentist before, and having last visited a dentist because of pain. CONCLUSIONS: The caries prevalence of the sample was comparable with findings from a national oral health survey conducted in 1985/86, but the caries severity was greater. As in other developing countries, this may be due to an increased availability of refined sugar products without a concurrent rise in oral health awareness. The study findings contribute to the overall picture of Fijian school children's dental health. [ABSTRACT FROM AUTHOR]