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Breadfruit (Artocarpus altilis) is a tropical fruit tree that grows abundantly in many Pacific Islands and is an important starch source. Breadfruit is a fruit fly host and, therefore, requires high temperature forced air (HTFA) treatment before entering New Zealand, whereby the centre of the fruit is raised to 47.2°C and held for 20 min. Anecdotal evidence suggests that breadfruit can be damaged after HTFA treatment, particularly in the 'hot-spot' of an HTFA chamber, where the centre of breadfruit can experience higher temperatures for a longer time, while waiting for fruit in the 'cold-spot' to reach the target temperature/time conditions. Recent research suggests less severe hot air treatments were sufficient to eliminate fruit fly risk, but no data are available about whether these treatments improved fruit quality. This study assessed the fruit quality of two breadfruit cultivars following four hot air treatments, i.e. the current approved treatment compared with three less severe treatments. Breadfruit exposed to the less severe treatments had better fruit quality, but this was not statistically significant from the approved treatment. A less severe treatment would ensure that breadfruit can then tolerate temperature conditions in the 'hot-spots' of a commercial HTFA chamber. [ABSTRACT FROM AUTHOR]

In psychological networks, one limitation of the most used community detection algorithms is that they can only assign each node (symptom) to a unique community, without being able to identify overlapping symptoms. The clique percolation (CP) is an algorithm that identifies overlapping symptoms but its performance has not been evaluated in psychological networks. In this study, we compare the CP with model parameters chosen based on fuzzy modularity (CPMod) with two other alternatives, the ratio of the two largest communities (CPRat), and entropy (CPEnt). We evaluate their performance to: (1) identify the correct number of latent factors (i.e., communities); and (2) identify the observed variables with substantive (and equally sized) cross-loadings (i.e., overlapping symptoms). We carried out simulations under 972 conditions (3x2x2x3x3x3x3): (1) data categories (continuous, polytomous and dichotomous); (2) number of factors (two and four); (3) number of observed variables per factor (four and eight); (4) factor correlations (0.0, 0.5, and 0.7); (5) size of primary factor loadings (0.40, 0.55, and 0.70); (6) proportion of observed variables with substantive cross-loadings (0.0%, 12.5%, and 25.0%); and (7) sample size (300, 500, and 1000). Performance was evaluated through the Omega index, Mean Bias Error (MBE), Mean Absolute Error (MAE), sensitivity, specificity, and mean number of isolated nodes. We also evaluated two other methods, Exploratory Factor Analysis and the Walktrap algorithm modified to consider overlap (EFA-Ov and Walk-Ov, respectively). The Walk-Ov displayed the best performance across most conditions and is the recommended option to identify communities with overlapping symptoms in psychological networks. [ABSTRACT FROM AUTHOR]

Tissue imaging is crucial in oral cancer diagnostics. Imaging techniques such as X-ray imaging, magnetic resonance imaging, optical coherence tomography (OCT) and computed tomography (CT) enable the visualization and analysis of tissues, aiding in the detection and diagnosis of cancers. A significant amount of research has been conducted on designing OCT probes for tissue imaging, but most probes are either heavy, bulky and require external mounting or are lightweight but straight. This study addresses these challenges, resulting in a curved lightweight, low-voltage and compact handheld imaging probe for oral soft tissue examination. To the best of our knowledge, this is the first curved handheld OCT probe with its shape optimized for oral applications. This probe features highly compact all-fiber optics with a diameter of 125 μm and utilizes innovative central deflection magnetic actuation for controlled beam scanning. To ensure vertical stability while scanning oral soft tissues, the fiber was secured through multiple narrow slits at the probe's distal end. This apparatus was encased in a 3D-printed angular cylinder tube (15 mm outer diameter, 12 mm inner diameter and 160 mm in length, weighing < 20 g). An angle of 115° makes the probe easy to hold and suitable for scanning in space-limited locations. To validate the feasibility of this probe, we conducted assessments on a multi-layered imaging phantom and human tissues, visualizing microstructural features with high contrast. [ABSTRACT FROM AUTHOR]

Phosphine (PH3) is a methyl bromide alternative with the potential to control surface pests of New Zealand avocados as a pre-export disinfestation treatment. 'Hass' avocado fruit were treated with PH3 (as ECO2FUME® (2% PH3, 98% CO2 (w/w); Cytec Industries Inc.)). at 500, 750 and 1,500 ppm for 24, 48 and 72 h at 5–6 °C, along with vials containing mould mites (Tyrophagus communis) and greenhouse thrips (Heliothrips haemorrhoidalis). Fruit were then stored at 5 °C for three weeks, external quality assessed, and internal fruit quality assessed after ripening at 20 °C. PH3 treatments had no impact on external fruit quality, nor on skin colouration, and only minor increase in softening compared to control at 24 h, but not 48 or 72 h. Complete (100%) mortality was achieved for thrips at all PH3 concentrations for 48 h. However, only ∼50% mould mite mortality was achieved at the highest PH3 concentration of 1,500 ppm for 72 h; although this treatment did provide a significant reduction in rots and internal disorders. This initial study demonstrates that longer-duration treatments and higher PH3 concentrations improves fruit quality compared with controls, mainly by reducing rots. These treatments fully controlled thrips but provided only partial control of mould mites. [ABSTRACT FROM AUTHOR]

The phylogeography of invasive pests is fundamentally important for the reconstruction of invasion pathways. Infection patterns with maternally inherited endosymbionts such as Cardinium and Wolbachia may provide additional resolution power. Kelly's citrus thrips, Pezothrips kellyanus, a significant Australian-native pest of citrus, has independently colonised New Zealand and the Mediterranean region. However, the Australian source populations for these two invasive ranges are unknown. Furthermore, Australian populations have previously been found with Cardinium and Wolbachia coinfections. Surprisingly, invasive-range populations only had Cardinium but not Wolbachia, although both endosymbionts independently cause cytoplasmic incompatibility that facilitates the endosymbionts' spread in host populations. To resolve this puzzle, we examined mitochondrial diversity and endosymbiont prevalence in 59 P. kellyanus populations across the native and invasive ranges. We found that populations from Victoria in Australia were Wolbachia-free and shared mitochondrial haplotypes with invasive-range populations, suggesting they were the likely source of the founder populations in both invasive ranges. However, we also detected a linkage pattern between Wolbachia and particular haplotypes in Australia. Furthermore, populations with a high Wolbachia prevalence in eastern Australia had a substantially lower haplotype diversity than populations with low Wolbachia prevalence in other parts of Australia. This indicates a Wolbachia-driven selective sweep of mitochondria in the native range of this haplodiploid host due to maternal coinheritance. In contrast, Cardinium was associated with all haplotypes, demonstrating an older association with Cardinium than Wolbachia. Overall, while endosymbionts are informative for tracing pest invasions, the selective sweeps they cause can potentially confound phylogeographic patterns and invasion pathways. [ABSTRACT FROM AUTHOR]

The article examines the quality and accuracy of information on websites of marketed orthodontic products, revealing poor standards and a prevalence of inaccurate statements. It highlights the importance of using assessment tools like DISCERN and accuracy instruments to ensure the reliability of online orthodontic information and advises clinicians to verify the quality of content before sharing links on their own websites.

Objective: Accurate assessment of child oral health is important for guiding economic evaluations and informing healthcare decision‐making. Early Childhood Oral Health Impact Scale (ECOHIS‐4D) is a preference‐based instrument that measures the oral health‐related quality of life of young children. The aim of this study was to compare the utility scores of ECOHIS‐4D and Child Health Utility Index (CHU‐9D), against an oral health indicator to evaluate which utility score corresponds better with the oral health indicator. Method: The ECOHIS‐4D and CHU‐9D were applied to 314 parent/child dyads from preschools in a primary healthcare setting in Perth, Western Australia. Four parameters were used to assess which instrument corresponds better with the oral health indicator (decayed, missing and filled teeth score‐dmft score): (i) discrimination, the ability to discriminate between different clinical severity groups, (ii) external responsiveness, how much the utility values relate to the changes in dmft scores, (iii) correlation, the association between the two instruments and the related dimensions and (iv) differences in the utility values across the two instruments. Results: Most participants (81%) were 2–6 years old, and nearly 50% had a dmft score <3. ECOHIS‐4D demonstrated a superior ability to differentiate between dmft severity groups and respond to changes in dmft scores. A significant weak correlation was observed between dmft and ECOHIS‐4D (−0.26, 95%, CI −0.36 to −0.15) compared to a non‐significant very poor correlation between dmft and CHU‐9D (0.01, 95% CI −0.12 to 0.10). The utility scores of the two instruments had relatively good agreement towards good health and weak agreement towards poor health. Conclusions: ECOHIS‐4D, the oral health‐specific instrument, is more sensitive in assessing children's oral health‐related quality of life than the generic CHU‐9D. Thus, ECOHIS‐4D is more appropriate for utility estimates in economic evaluations of oral health‐related interventions and resource allocation decision‐making. [ABSTRACT FROM AUTHOR]

Objectives: In celebration of the journal's 50th anniversary, the aim of the study was to review the whole collection of Community Dentistry and Oral Epidemiology (CDOE) publications from 1973 to 2022 and provide a complete overview of the main publication characteristics. Methods: The study used bibliometric techniques such as performance and science mapping analysis of 3428 articles extracted from the Scopus database. The data were analysed using the 'Bibliometrix' package in R. The journal's scientific production was examined, along with the yearly citation count, the distribution of publications based on authors, the corresponding author's country and affiliation and citation count, citing source and keywords. Bibliometric network maps were constructed to determine the conceptual, intellectual and social collaborative structure over the past 50 years. The trending research topics and themes were identified. Results: The total number of articles and average citations has increased over the years. D Locker, AJ Spencer, A Sheiham and WM Thomson were the most frequently published authors, and PE Petersen, GD Slade and AI Ismail published papers with the highest citations. The most published countries were the United States, United Kingdom, Brazil and Canada, frequently engaging in collaborative efforts. The most common keywords used were 'dental caries', 'oral epidemiology' and 'oral health'. The trending topics were healthcare and health disparities, social determinants of health, systematic review and health inequalities. Epidemiology, oral health and disparities were highly researched areas. Conclusion: This bibliometric study reviews CDOE's significant contribution to dental public health by identifying key research trends, themes, influential authors and collaborations. The findings provide insights into the need to increase publications from developing countries, improve gender diversity in authorship and broaden the scope of research themes. [ABSTRACT FROM AUTHOR]

A series of experiments were carried out to develop a phytosanitary disinfestation protocol to kill Ceratitis capitata (Weidemann) (Mediterranean fruit fly, Diptera: Tephritidae) in 'Hayward' kiwifruit (Actinidia deliciosa (A. Chev.) C.F. Liang and A.R. Ferguson) and 'Zesy002' kiwifruit (Actinidia chinensis Planch.). Experiments on 4 immature life stages (eggs and 3 larval instars) with treatment durations of between 5 and 18 days showed that third instars were the most tolerant to temperatures around 3 °C, with the lethal time to 99.9968% (probit 9) mortality (LT99.9968) estimated to be 17.3 days (95% confidence interval (CI) 16.4–18.2). Larvae reared and treated in 'Zesy002' were significantly more susceptible to cold treatment than those reared in 'Hayward'. A large-scale trial testing a disinfestation protocol of 3 ± 0.5 °C for 18 days treated over 500,000 third-instar C. capitata with no survivors. These results demonstrate that a cold treatment of 3.5 °C or below for 18 days induces C. capitata mortality in kiwifruit at a rate that exceeds 99.9968% with a degree of confidence greater than 99%. [ABSTRACT FROM AUTHOR]

Objective: Invasive colonial influences and continuing neoliberal policies have a detrimental impact on Land, health, food and culture for Indigenous Communities. Food security and sovereignty have significant impacts on Indigenous well-being and, specifically, oral health. Aspects relating to food security, such as availability of nutritious foods, are a common risk factor of oral diseases. This scoping review aimed to collate existing evidence regarding the relationship between food sovereignty and/or food security and oral health for Indigenous Communities, globally. Design: Four databases were searched using keywords related to 'Food security' or 'Food sovereignty,' 'Indigenous Peoples' and 'Oral health.' Duplicates were removed, and two independent reviewers screened the titles and abstracts to identify articles for full-text review. Extracted data were summarised narratively, presenting a conceptual model which illustrates the findings and relationships between food security and/or food sovereignty and oral health. Results: The search identified 369 articles, with forty-one suitable for full-text review and a final nine that met inclusion criteria. The impact of food security and food sovereignty on oral health was discussed across different populations and sample sizes, ranging from eighteen Kichwa families in Brazil to 533 First Nations and Metis households in Canada. Pathways of influence between food sovereignty and/or food security are explored clinically, quantitatively and qualitatively across oral health outcomes, including early childhood caries, dental caries and oral health-related quality of life for Indigenous Communities. Conclusions: Innovative strategies underpinned by concepts of Indigenous food sovereignty are needed to promote oral health equity for Indigenous Communities. The nexus between oral health and Indigenous food sovereignty remains largely unexplored, but has immense potential for empowering Indigenous rights to self-determination of health that honour Indigenous ways of knowing, being and doing. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to investigate how education level affects dental service utilization patterns in the Australian adult population. This study tested how education level mediated these service patterns through behavioural mediators such as smoking, tooth brushing and oral health status and investigated these mediation effects in different dental service providers. Method: Following the flexible mediation approach, the direct and indirect effects of education through behavioural mediators on dental service utilization patterns (time of last dental visit, reason for last dental visit and frequency of seeking dental care) were calculated for the South Australian population from the Dental Care and Oral Health Study. Results: Participants with lower educational attainment were 33% (Odds Ratio: 0.67, 95% CI 0.56–0.78) and 38% (Odds Ratio: 0.62, 95% CI 0.53–0.74), less likely than their counterparts with higher education to visit a dentist or to receive dental care in the last 12 months, respectively. Low education was associated with a 23% increase in odds of receiving emergency and treatment services (Odds Ratio: 1.23, 95% CI 1.05–1.43) compared to routine dental check‐ups or examinations. Conclusion: Low education, regardless of oral health behaviours and status, reduces the odds of dental service utilization in terms of frequency of seeking dental care and time of last dental visit. There is more tendency towards receiving emergency and treatment services compared to routine dental check‐ups or examinations in participants with lower educational attainment. [ABSTRACT FROM AUTHOR]

Objectives: Arguably, the deficit narrative of oral health inequities, perpetuated by colonial re‐search agendas, media and sociopolitical discourse, contributes to oral disease burden and fatalism among Aboriginal and Torres Strait Islander Peoples. There remains a need to evolve the way oral health is understood, in a manner that reflects the lived experiences of Aboriginal and Torres Strait Islander Peoples. Methods: This paper proposes decolonising methodologies as a strategy to ensure oral health re‐search creates more equitable oral health outcomes and realities for Aboriginal and Torres Strait Islander Communities. Anchored by a critical reflection of the failure of dominant oral health inequity re‐search practices to address Indigenous oral health, both in Australia and internationally, we propose five explicit pathways for decolonising Aboriginal and Torres Strait Islander oral health re‐search. Results: We argue the need for (1) positionality statements in all re‐search endeavours, (2) studies that honour reciprocal relationships through the development of proposals that ask questions and follow models based on Traditional Knowledges, (3) the development of culturally secure and strengths‐based data capturing tools, (4) frameworks that address the intersection of multiple axes of oppression in creating inequitable conditions and (5) decolonising knowledge translation techniques. Conclusion: Importantly, we recognize that re‐search will never be entirely 'decolonised' due to the colonial foundations upheld by academic institutions and society more broadly; however, as oral health re‐searchers, we ascertain that there is an ethical compulsion to drive decolonising re‐search pursuits that produce equitable oral health outcomes for Aboriginal and Torres Strait Islander Communities. [ABSTRACT FROM AUTHOR]

Purpose: Preference-based quality of life measures (PBMs) are used to generate quality-adjusted life years (QALYs) in economic evaluations. A PBM consists of (1) a health state classification system and (2) a utility value set that allows the instrument responses to be converted to QALYs. A new, oral health-specific classification system, the Early Childhood Oral Health Impact Scale-4D (ECOHIS-4D) has recently been developed. The aim of this study was to generate an Australian utility value set for the ECOHIS-4D. Methods: A discrete choice experiment with duration (DCETTO) was used as the preference elicitation technique. An online survey was administered to a representative sample of Australian adults over 18 years. Respondents were given 14 choice tasks (10 tasks from the DCE design of 50 choice sets blocked into five blocks, 2 practice tasks, a repeated and a dominant task). Data were analyzed using the conditional logit model. Results: A total of 1201 respondents from the Australian general population completed the survey. Of them, 69% (n = 829) perceived their oral health status to be good, very good, or excellent. The estimated coefficients from the conditional logit models were in the expected directions and were statistically significant (p < 0.001). The utility values for health states defined by the ECOHIS-4D ranged from 0.0376 to 1.0000. Conclusions: This newly developed utility value set will enable the calculation of utility values for economic evaluations of interventions related to oral diseases such as dental caries among young children. This will facilitate more effective resource allocation for oral health services. [ABSTRACT FROM AUTHOR]

Background: The first steps towards gender equity in science are measuring the magnitude of inequity and increasing awareness of the problem. Objectives: To describe trends in gender disparities in first and last authorship in the most cited dental publications and general dental literature over a 20‐year period. Methods: Articles and bibliometric data were retrieved from the Scopus database for the period 1996 to 2015. Two groups of 1000 articles each were retrieved: a random sample and another sample of top‐cited articles for each year. The gender of the first and last author of each publication was manually identified. When this was not possible, we used an online software platform (https://genderize.io/). Descriptive analyses identified the proportion of women first and last authors in both samples, stratifying by dental discipline and geographic region. Trends were ascertained by frequency metrics across years. Gender disparity was observed in both first and last authorship, with a larger gap being observed in the top‐cited sample. Results: Women led 28.4% and 20.3% of articles in the random and top‐cited samples, respectively. A similar pattern was observed for the last authorship group (22.1% and 16.1%, respectively). An increasing trend in the proportion of articles led by women over time was observed in both samples. This increase was larger in the top‐cited sample (from 15.0% in 1996–2000 to 25.1% in 2015) than in the random sample (from 26.3% in 1996–2000 to 33.2% in 2011). Conclusions: Clear gender disparities in dental research publications in the last 20 years were identified in both general and top‐cited manuscripts, across dental disciplines, across countries, across first and last authorship, and over time. It is paramount that actions are taken to attract, retain and promote women in science, as well as to monitor and ensure progress towards gender equity. [ABSTRACT FROM AUTHOR]

Objectives: With elimination of the financial burden of dental services, one can expect an increase in utilization of dental services. This study aimed to investigate the effective mechanisms of financial barriers to the utilization of dental services in an Australian adult population. Methods: South Australian survey data from the Dental Care and Oral Health Study (2015) were analysed. Following the flexible mediation approach, the direct effect of income and indirect effect of income through mediators (insurance, concession card and service sector) on the outcomes (visit avoidance and treatment prevention due to the cost) were calculated. Results: Findings showed that around half of the low‐income people and one‐third of the high‐income South Australians experienced a financial burden on receiving a dental visit or service. The indirect effect of income on both outcomes of financial burden was negligible, while the direct effect was significant. By changing the potential outcome distribution to their counterfactual exposure distribution and if the mediators are drawn from their counterfactual exposure (lower/higher income) distribution, the odds of visit avoidance and treatment prevention due to the cost were almost twice (Odds Ratio: 2.13, 95% CI 1.72–2.60) and 98% (Odds Ratio: 1.98, 95% CI 1.67–2.35) than in the lower‐income individuals, respectively. Conclusions: It can be concluded that the level of household income, directly and regardless of insurance status, concession card ownership and whether the service sector was public or private, affected the financial burden on utilization of dental services. [ABSTRACT FROM AUTHOR]

Objectives: To investigate whether a strong sense of coherence (SOC) modifies the association between low-income and oral and general health-related quality of life (OHRQoL and HRQoL, respectively) among a South Australian population sample; and to explore the main and interaction effects of income and SOC on OHRQoL and HRQoL. Methods: Baseline data from the Dental Care and Oral Health Study (DCOHS, a South Australian representative study, 2015–2016) were used for cross-sectional analysis (n = 3,786). Four multivariable factorial ANOVA models were applied to assess the effect measure modification, main effects, and interaction of income and SOC on OHRQoL (measured using the OHIP-14) and HRQoL (measured using the EQ-5D-3L). Results: Income and SOC had small main effects on OHRQoL. Income had a small effect and SOC had an intermediate effect on HRQoL, meaning that individuals with strong SOC had better OHRQoL and HRQoL in all income categories. Also, high-income participants had better OHRQoL and HRQoL. The interaction between income and SOC was statistically significant on HRQoL. Among participants from low-income group, those with strong SOC had better OHRQoL (mean = 8.8, 95% CI[7.9, 9.7]) and HRQoL (mean = 1.1, 95% CI[1.0, 1.3]) than others with weak SOC (OHIP-14 mean = 12.7, 95% CI[11.7, 13.6]) and (EQ-5D-3L mean = 2.0, 95% CI[1.9, 2.2]). Conclusion: The findings showed the main effects and interaction between SOC and income on OHRQoL and HRQoL. Income had different effects on OHRQoL and HRQoL depending on whether SOC was strong or weak. Findings suggested that strong SOC modified the association between low-income and OHRQoL and HRQoL. [ABSTRACT FROM AUTHOR]

Chronic kidney disease (CKD) and poor oral health are inter‐related and their significant impact on each other is well established in the literature. Many systematic reviews and meta‐analyses have demonstrated a strong relationship between CKD and periodontitis, where periodontal treatment has shown potential in improving CKD outcomes. However, the quality of the studies and heterogeneity of the results show variation. The aim of this umbrella review was to review the quality of the current systematic reviews on the relationship between CKD and oral health with an emphasis on periodontal disease and to generate clinically relevant guidelines to maintain periodontal health in patients with CKD. This umbrella review was conducted and reported in alignment with the Joanna Briggs Institute and the PRISMA 2020 guidelines. The review protocol was established prior to commencing the review and registered on JBI and PROSPERO (CRD42022335209). Search strings were established for PubMed, Embase, Web of Science, Cochrane Database of Systematic Reviews, and Dentistry & Oral Science Source up to April 2022. All systematic reviews and meta‐analyses that considered the relationship between CKD and periodontitis or periodontal treatment were included. Of 371 studies identified through the systematic search, 18 systematic reviews met the inclusion criteria. Ten studies assessed the relationship between oral health status and CKD with a focus on periodontitis and CKD, five reviewed the impact of periodontal treatment on CKD outcomes, two included both relationship and effectiveness of periodontal treatment and one qualitatively reviewed oral health‐related quality of life in patients with kidney failure. Findings indicate there is a bidirectional relationship between CKD and periodontal disease. In view of the heterogeneity of the existing literature on CKD and periodontal disease, specific recommendations for the management of periodontitis among patients with CKD are proposed for medical professionals, dental professionals, and aged care workers based on the evidence collated in this review. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic significantly impacted and continues to impact the health and well-being of Australian adults. However, there has been no instrument validated to comprehensively measure how the COVID-19 pandemic impacted adults in Australia across several domains (e.g. fear of COVID-19, attitudes towards vaccination, psychosocial impact of lockdowns). The current study conducted a rigorous psychometric process to develop and validate an instrument to measure the impact of the COVID-19 pandemic in Australia, the COVID-19 Impact Scale (CIS). Data was obtained from the Australian population. Participants (N = 563) aged between 19 and 91 years (M = 54.50, SD = 16.16) provided online responses between June, 2021 and May, 2022. The majority of participants were female (60.9%), employed either full-time (37.7%) or part-time (22.0%), and had completed an undergraduate degree or higher (70.1%). An initial pool of 30 items was developed based on a review of the literature and input from a panel of experts including psychologists, epidemiologists, and public health experts, among others. The study used network psychometrics to examine the psychometric properties of: (1) item score distributions; (2) item redundancy; (3) dimensionality; (4) model fit; (5) measurement invariance; (6) reliability; and (7) criterion validity. Following an evaluation of items for ceiling/floor effects and redundancy, the final CIS network model included eighteen nodes and displayed a three-dimensional structure. The three communities of "Fear" (consisting of three nodes; ω = 0.82), "Attitudes" (consisting of ten nodes; ω = 0.89), and "Ill-being" (consisting of five nodes; ω = 0.79) displayed adequate reliability. The evaluation of model fit indicated a good fit of the network model (RMSEA = 0.047; CFI =0.98). The instrument is available to be used by Australian researchers and implemented to evaluate public policies, adapted for future pandemics, or used internationally. [ABSTRACT FROM AUTHOR]

It is known that parental experiences of perceived racism are associated with poorer mental health in children. However, little is known about the mechanism of transmission of intergenerational racism among Aboriginal Australians. This study aims to explore the causal effect of Aboriginal mothers' experience of perceived racism on children's social and emotional well-being mediated by parenting sense of competence. Pregnant Aboriginal women (N = 159) reported their experiences of perceived racism using the Measure of Indigenous Racism Experiences instrument, and completed a five year follow-up survey, reporting their sense of parenting competence using the Parenting Sense of Competence Scale and their child's social and emotional well-being using the Strengths and Difficulties Questionnaire. A single causal mediation analysis was used to examine the causal effects while accounting for confounding variables (mother's age, education, and socioeconomic status). Mothers who experienced perceived racism in at least one setting were at an increased odds of their child experiencing social and emotional difficulties (OR = 1.28, 95% CI [0.55, 2.98]). This effect was not mediated by parenting sense of competence, despite an effect between parenting competence and children's social and emotional well-being (OR = 0.44, 95% CI [0.19, 1.06]). The findings suggest that maternal experiences of perceived racism has a longitudinal effect on their children's social and emotional well-being, which is not mediated through the mothers' parenting sense of competence. These findings highlight the importance of reducing racism as these may have far-reaching effects across generations on socio-social and emotional well-being. What is already known about this topic: Racism is a significant public health issue in Australia as experiences of racism are highly prevalent among Aboriginal Australians, and associated with adverse health and wellbeing. The effects of racism are known to have pervasive intergenerational impacts, with parental experiences of racism affecting children's social and emotional wellbeing. To date, little is known about the mechanism by which parental perceptions of racism lead to adverse social-emotional wellbeing for children. What this topic adds: This paper is the first to explore whether parenting sense of competence mediates the effect of maternal experience of perceived racism on children's social and emotional well-being. Children aged five years were at an increased risk of social and emotional difficulties if their mother had experienced perceived racism in at least one setting during pregnancy. The impact of maternal experience of perceived racism on children's social and emotional well-being was not transmitted through the mother's parenting sense of competence. [ABSTRACT FROM AUTHOR]

As part of a (bio)colonial project, the biological information of Indigenous Peoples has historically been under scientific scrutiny, with very limited benefits for communities and donors. Negative past experiences have contributed to further exclude Indigenous communities from novel developments in the field of omics research. Over the past decade, new guidelines, reflections, and projects of genetic research with Indigenous Peoples have flourished in Australia, providing opportunities to move the field into a place of respect and ethical relationships. This review explores the ethical and cultural implications of the use of biological samples from Indigenous communities in biomedical research. A structured framework outlining emerging topics of interest for the development of respectful omics research partnerships with Indigenous Australians is presented. This paper highlights aspects related to Indigenous governance, community and individual consent, respectful handling of biological samples, data management, and communication in order to protect Indigenous interests and rights and to promote communities' autonomy. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To investigate the oral health literacy (OHL) of nurses and explore the factors affecting their OHL. Background: OHL is important for improving the oral health outcomes. Nurses' OHL may affect the oral health of themselves, families, and patients. Few studies have examined the OHL and its related factors among nurses. Design: A cross‐sectional design following the STROBE guideline. Methods: A total of 449 nurses were recruited from tertiary hospitals in the minority areas of southwest China. The participants completed an online questionnaire, which contained questions related to the OHL, sociodemographic factors, general health, oral health and related behaviours, oral health knowledge, attitudes, and oral health‐related quality of life. OHL was measured using the validated Chinese version of the short‐form Health Literacy of Dentistry (HeLD‐14) scale. Descriptive statistics, the Mann–Whitney U test, Spearman's correlation, and multiple linear regression analysis were used to analyse the data. Results: The median HeLD‐14 score (p25–p75) was 50.0 (44.0–54.0). The regression model for OHL was found to be significant. The factors that influenced OHL included oral health knowledge, oral health attitudes, self‐reported oral health, annual household income, and dental flossing; these factors accounted for 13.9% of the variance in OHL. Conclusions: The nurse' OHL has room for improvement. Nurses' OHL could be improved by enriching their oral health knowledge, promoting their positive oral health attitudes, increasing their household income, and helping them build correct oral health behaviours. Relevance to clinical practice: The findings of the study could be used to make a case for changing nursing curricula. Oral health knowledge curriculum or programmes targeted towards nurses should be developed to improve their OHL. Patient or public contribution: No Patient or Public Contribution. [ABSTRACT FROM AUTHOR]

Objectives: Methamphetamine use impacts oral health, but little is known about its impacts on oral health related quality of life (OHRQoL). In this study we examined OHRQoL in a cohort of people who use methamphetamine and assessed associations with sociodemographic, behavioural, psychosocial and dental service utilisation correlates. A secondary aim was to examine the relationship between methamphetamine route of administration and OHRQoL, to test whether smoking the drug is associated with reduced OHRQoL. Methods: Cross-sectional analysis was performed, using data from VMAX, a cohort of people who use methamphetamine at least monthly in Victoria, Australia (n = 194). Utilising the oral health impact profile (OHIP-14), we assessed three OHRQoL outcomes: OHIP-14 prevalence, OHIP-14 extent and OHIP-14 severity. Regression analyses examined associations between independent variables and the three OHIP-14 outcome measures. Results: A significant segment of the cohort (35%) reported poor OHRQoL. Overall, no statistically significant association was detected between methamphetamine route of administration and the three OHIP-14 outcomes. Participants living in rural areas, with moderate-to-severe self-reported depression and with methamphetamine dependence had significantly worse OHRQoL levels, which persisted after adjusting for other covariates. Conclusion: Overall, VMAX cohort participants reported reduced OHRQoL levels. Our findings highlight the need for upstream interventions to improve the OHRQoL of people who use methamphetamine, with specific focus on those living in rural locations. Further research on the links between OHRQoL and mental health among people who use methamphetamine is required. [ABSTRACT FROM AUTHOR]

Racially minoritized children often bear a greater burden of dental caries, but the overall magnitude of racial gaps in oral health and their underlying factors are unknown. A systematic review and meta-analysis were conducted to fill these knowledge gaps. We compared racially minoritized (E) children aged 5–11 years (P) with same-age privileged groups (C) to determine the magnitude and correlates of racial inequities in dental caries (O) in observational studies (S). Using the PICOS selection criteria, a targeted search was performed from inception to December 1, 2021, in nine major electronic databases and an online web search for additional grey literature. The primary outcome measures were caries severity, as assessed by mean decayed, missing, and filled teeth (dmft) among children and untreated dental caries prevalence (d > 0%). The meta-analysis used the random-effects model to calculate standardized mean differences (SMD) and 95% confidence intervals (95% CI). Subgroup analysis, tests for heterogeneity (I2, Galbraith plot), leave-one-out sensitivity analysis, cumulative analysis, and publication bias (Egger's test and funnel plots) tests were carried out. The New Castle Ottawa scale was used to assess risk of bias. This review was registered with PROSPERO, CRD42021282771. A total of 75 publications were included in the descriptive analysis. The SMD of dmft score was higher by 2.30 (95% CI: 0.45, 4.15), and the prevalence of untreated dental caries was 23% (95% CI: 16, 31) higher among racially minoritized children, compared to privileged groups. Cumulative analysis showed worsening caries outcomes for racially marginalized children over time and larger inequities in dmft among high-income countries. Our study highlights the high caries burden among minoritized children globally by estimating overall trends and comparing against factors including time, country, and world income. The large magnitude of these inequities, combined with empirical evidence on the oral health impacts of racism and other forms of oppression, reinforce that oral health equity can only be achieved with social and political changes at a global level. [ABSTRACT FROM AUTHOR]

This study aims to describe the natural history of and identify the risk factors associated with oral human papillomavirus (HPV) infections in an Australian Indigenous cohort. A longitudinal cohort study design, with baseline (2018), 12-month, and 24-month data obtained from Indigenous Australians aged 18+ years in South Australia, was performed. Face-to-face interviews were conducted, and saliva samples for HPV testing were collected at each time point. Basic descriptive analyses were conducted to calculate prevalence, incidence, persistence, clearance, and incidence proportions of any HPV infection. Multivariable logistic regression analyses with adjusted prevalence ratios (PRs) were conducted to identify risk factors associated with oral HPV infection. Among 993 participants with valid saliva samples, 44 HPV types were identified. The prevalence of infection with any oral HPV infection was 51.3%, high-risk HPV was 11%, and types implicated in Heck's disease (HPV 13 or 32) was 37.4%. The incidence, persistence, and clearance of any and high-risk HPV infections were 30.7%, 11.8% and 33.3% vs. 9.3%, 2.8%, and 9%, respectively. Our findings indicate that the prevalence, incidence, and persistence of oral HPV infection in a large sample of Indigenous Australians were high, and clearance was low. Oral sex behaviours and recreational drug use were risk factors associated with incident high-risk HPV infection. [ABSTRACT FROM AUTHOR]

Objective: Children and adolescents with orofacial clefts may experience ongoing psychosocial impacts due to the continuous nature of cleft treatments, facial and dental differences, and speech and hearing difficulties. The aim of this qualitative systematic review was to better understand the experiences of children and adolescents with orofacial clefts. Design: A systematic search strategy using PubMed, Embase, Emcare, Scopus, and Web of Science databases was performed to identify relevant qualitative studies evaluating the lived experience of children and adolescents with orofacial clefts from inception through to June 2021. Eligible studies were critically appraised using the Joanna Briggs methodology and a meta-aggregative approach. Results: The search identified 2466 studies, with 13 found to meet the inclusion criteria. Extraction of 155 findings resulted in 27 categories, which were meta-aggregated into 7 overarching synthesized findings. These 7 core findings included aspects of child experience and findings that enhanced or impeded child experience at the individual, family, and community levels. Conclusions: Factors that impeded child experience at the individual, family, and community levels were more pronounced than factors that enhanced their experience among children and adolescents with orofacial clefts. Further initiatives are needed to provide support to individuals, families, and school communities to enhance children's experience of orofacial cleft during the formative childhood and adolescent years. [ABSTRACT FROM AUTHOR]

Objective: Although the prevalence of poor self-rated oral health and experience of negative life events among Indigenous adults is high, the contribution of modifiable risk factors is unknown. We aimed to estimate the contribution of modifiable risk factors in poor self-rated oral health among Indigenous Australian adults with high and low experience of negative life events using decomposition analysis. Methods: The study utilised a cross-sectional design, with data from a large convenience study of Indigenous adults in South Australia. Participants were stratified based on a median split of negative life events in the last 12 months. The outcome was the proportion of fair/poor self-rated oral health (SROH). Independent variables included experience of racism, sex, age, geographic location, car ownership, and time since last dental visit. Results: Of the 1011 participants, the proportion with fair poor self-rated oral health was 33.5% (95% CI 30.5 to 36.4) and the proportion who had experienced 3+ negative life events in the past 12 months was 47.3% (95% CI 43.7 to 50.9). More than half the contribution in fair/poor self-rated oral health among Indigenous adults with a higher magnitude of negative life events was from experience of racism (55.3%, p<0.001), followed by residential location (19.9%), sex (9.7%) and car ownership (9.8%). Conclusions: The contributions of modifiable risk factors in poor self-rated oral health among Indigenous adults with different exposures to negative life events differed substantially. Targets to reduce racism will decrease oral health inequities for both groups, however Indigenous adults who have experienced substantial negative life events require additional focus on provision of culturally safe dental care. [ABSTRACT FROM AUTHOR]

Objectives: Indigenous health workers (IHW) play an integral role in the provision of culturally safe care for Indigenous communities. Despite this, IHW involvement in oral health has been limited. Therefore, this qualitative systematic review aimed to build an understanding of IHW insights on oral health. Methods: Two independent reviewers searched PubMed, EMBASE, Web of Science and Scopus using a pre‐established search strategy. Qualitative studies that included IHW illustrations about oral health were considered. The search was not limited by geographic setting. Included articles were critically appraised with the Joanna Briggs Institute appraisal tool for qualitative studies. Results: The search identified 1856 articles eligible for inclusion; a total of 10 articles were included. Four synthesized findings were identified during the meta‐aggregation: oral health challenges in community, systemic barriers limiting IHW ability to support oral health, benefits of IHW involvement in oral health and avenues to increase IHW involvement in oral health. Conclusion: The prioritization of Indigenous leadership in oral health has the potential to address many of the current challenges Indigenous communities face. Future works need to determine the capacity of IHW to provide oral health care and explore opportunities to create specific oral health roles for IHW. [ABSTRACT FROM AUTHOR]

There is a need for a theoretically informed, contextualized approach to measuring oral health from a multidisciplinary perspective that goes beyond the commonly used clinical indices and sociodental measures. This commentary aims to discuss the potential for the WHO's International Classification of Functioning, Disability and Health (ICF) to provide a model for the development of indicators for oral health. It is suggested that the ICF might provide both a theoretical model and an operational classification for indicators of oral health. The ICF model states that human experience of physical, cognitive and social functioning is universal and, thus, can be described and qualified. Human function is given social and environmental context within the model at both an individual and population level. The ICF can not only capture data regarding oral health and function at the physiological level (e.g. chewing) but also at the social level (e.g. sharing meals). It is able not only to capture aspects of preventive behaviour (e.g. caring for teeth) but also aspects of social facilitation (e.g. economic self‐sufficiency) or ability to fulfil a social role (e.g. remunerative employment). It also includes aspects of social environment, such as healthcare services or political, economic and legal systems. Case studies are given as examples of the potential use of the ICF in the oral health domain. Examples are also given of the first steps that have been made towards operationalization of the ICF in data collection and oral health research. The challenges of encompassing such a comprehensive model into a practical oral health measure are discussed. [ABSTRACT FROM AUTHOR]

Knowledge of and practice around health inequities have been limited by scarce investigations on intersecting forms of structural oppression, including the extent to which their effects are more severe among multiply marginalized groups. We addressed these insufficiencies by adopting a structural intersectionality approach to the study of edentulism (i.e. complete tooth loss), the dental equivalent of mortality. While individual information was gathered from approximately 200,000 adult (ages 18–64 years) respondents to the 2010 US Behavioral Risk Factor Surveillance System survey, state-level data for 2000 and 2010 were obtained from a 2021 study by Homan et al. (J Health Soc Behav. 2021;62(3):350–370) and the US Census. These 3 sources provided information on edentulism, race, sex, structural racism, structural sexism, and income inequality, in addition to multiple covariates. Analyses showed that the intersections between structural sexism and state-level income inequality and structural racism were associated with 1.4 (95% confidence interval: 1.1, 1.9) and 1.5 (95% confidence interval: 1.1, 2.2) times' increased odds of complete tooth loss, respectively. The frequency of edentulism was highest among non-Hispanic Black men residing in states with high structural racism, high structural sexism, and high economic inequality. Based on these and other findings, we highlight the importance of a structural intersectionality approach to research and policy related to health inequities in the United States and elsewhere. [ABSTRACT FROM AUTHOR]

Major sociohistorical processes have profound effects on oral health, with impacts experienced through structural oppression manifested in policies and practices across the lifespan. Structural oppression drives oral health inequities and impacts population‐level oral health. In this global perspective paper, we challenge old assumptions about oral health inequities, address misleading conceptualizations in their description and operation and reframe oral health through the lens of intersecting systems of oppression. Furthermore, we emphasize the need for oral health researchers to explore causal pathways through which oppression harms oral health and engage in social science concepts to understand the root causes of oral health inequities fully. Finally, we call on policymakers, dental scholars and decision makers to consider health equity in all policies and to take a systems‐oriented approach to effectively address oral health inequities. [ABSTRACT FROM AUTHOR]

Aim: The study aimed to estimate the incidence/progression and reversal of chronic periodontitis and to identify factors associated with chronic periodontitis in Australian adults over a 12‐year period. Materials and Methods: Data were obtained from the longitudinal component of the National Study of Adult Oral Health (NSAOH) in 2004–2006, and repeated data, among the same adults, in 2017–2018. NSAOH 2004–2006 was a population‐based study of Australian adults aged 15+ years. The American Academy of Periodontology/European Federation of Periodontology case definitions were used, and then compared with two other case definitions. Multivariable Poisson regression models were used to estimate incidence rate ratios (IRRs) and reversal rate ratio (RRRs) of periodontitis. Results: A total of 775 dentate Australian adults had dental examinations at both times. The proportion of incidence/progression and reversal among Australian adults was 56.4% and 11.0%, respectively. Tobacco smokers presented with more than three times higher incidence (IRR: 3.32, 95% CI: 1.50–7.60) and lower reversals (RRR: 0.94, 95% CI: 0.39–0.98) than those who had never smoked. Cessation of smoking was positively associated with periodontitis reversal. The total incidence/progression was 471.7/10,000 person‐years, with reversal being 107.5/10,000 person‐years. The average number of teeth lost due to periodontal disease was 1.9 in 2017–2018. Being male and not having periodontal treatment were significant risk markers for the incidence/progression of periodontitis. Conclusion: Smoking is a risk factor for periodontitis. Cessation of smoking is an effective means of reducing the incidence and progression of chronic periodontitis, to reduce the risk of tooth loss, and to improve overall periodontal health. [ABSTRACT FROM AUTHOR]

Objectives: Indigenous Australians experience cumulative forms of oppression. Using intersectionality as the underlying analytical framework, and with oral health as an outcome, we demonstrate how oppressions are interlinked and cannot be treated in isolation. The study aimed to quantify the cumulative effect of two forms of oppression on Indigenous Australian oral health inequities. Methods: This observational study was conducted Feb 2018—Jan 2020. Recruitment occurred through Aboriginal Community Controlled Health Organisations in South Australia, Australia. Eligibility included identifying as Indigenous, residing in South Australia and aged 18+ years. Socio-demographic factors, health-related characteristics, experience of racism, negative life events and self-reported oral health outcomes were collected. The main outcomes were fair/poor self-rated oral health and oral health related quality of life, measured by OHIP-14. Effect-measure modification was used to verify differences on effect sizes per strata of negative life events and racism. The presence of modification was indicated by Relative Excess Risk due to Interactions (RERIs). Results: Data were obtained for 1,011 participants, median age 37 years, 66% female and 63% residing in non-metropolitan locations. Over half (52%) had experienced racism in the past 12 months and 85% had experienced one or more negative life events. Around one-third (34%) rated their oral health as fair/poor and the mean OHIP-14 score was 17. A higher proportion of participants who had experienced both racism and negative life events (46%) were male (52%), aged 37+ years (47%), resided in metropolitan locations (57%), reported difficulty paying a $100 dental bill (47%), had fair/poor self-rated oral health (54%) and higher mean OHIP-14 scores (20). The RERIs observed were 0.31 for fair/poor self-rated oral health and 0.23 for mean OHIP-14. The positive RERIs indicated a super-additive effect between racism, negative life events (effect modifier) and self-reported oral health outcomes. Conclusion: The more oppressions participants experienced, in the form of racism and negative life events, the greater the burden of poor self-reported oral health. The study is one of the first to use intersectionality as a theory to explain oral health inequities as experienced by Indigenous Australians. [ABSTRACT FROM AUTHOR]

In Australia, despite social support increasingly being reported as playing an important role in influencing health outcomes of Aboriginal and Torres Strait Islanders, measures of social support have not yet been validated for Aboriginal people. The current study aimed to evaluate the validity and reliability of the Social Support Scale in an Aboriginal and/or Torres Strait Islander population. The Social Support Scale (SSS) is a 4-item psychological instrument that was designed to evaluate four social support functions, instrumental, informational, emotional and appraisal support. Data included participants from two different samples: (1) Teeth Talk Study (n = 317), an oral-health randomized controlled trial (RCT) conducted with Aboriginal adults; and (2) the South Australian Aboriginal Birth Cohort Study (n = 367), a prospective longitudinal birth cohort study in which pregnant Aboriginal women were interviewed at baseline. The SSS psychometric properties were examined with Graphical Loglinear Rasch Models (GLLRM). The overall fit to a GLLRM was established (χ2(96)sample1 = 52.7, p = 0.06; χ2(25)sample2 = 22.2, p = 0.62) after accounting for local dependence between items 3 and 4. Item 2 displayed differential item functioning by employment status in Sample 1. Regarding dimensionality, the SSS was unidimensional in both samples (γobs1 = 0.80; γexp1 = 0.78, p = 0.65; γobs2 = 0.75, γexp2 = 0.77, p = 0.16). The instrument also displayed good reliability (Rsample1 = 0.82, Rsample2 = 0.84). Despite a few identified limitations (such as poor targeting), the findings indicated that the SSS is a promising instrument to provide culturally-valid and reliable measurement of social support among Aboriginal and/or Torres Strait Islander adults. Future studies should further investigate the instrument psychometric properties in other Aboriginal samples and the development and inclusion of culturally-sensitive items are also recommended. [ABSTRACT FROM AUTHOR]

It is well-established that social determinants of health contribute to health and well-being. Among the social determinants of health, health-related social needs (HRSNs) are unmet needs that can be identified by the health care system and addressed through referral to community services. Despite the importance of identifying patients with HRSNs, none of the few screening tools for HRSNs available internationally have received a comprehensive psychometric validation. This study aims to conduct a qualitative validation of the Social Determinants of Health Screening Tool (SDoHST). This study took place at Lyell McEwin Hospital, a major tertiary hospital located in Adelaide, South Australia. Patient (n = 5) and stakeholder (n = 9) focus groups were conducted face to face, audio recorded, and transcribed verbatim. Inductive content analysis of focus group transcripts was performed to inform tool modifications (e.g. item rewording). The patient focus group recommended the addition of an explanatory paragraph to improve face validity, and highlighted the importance of reliable transport and internet access. The stakeholder focus group recommended using language that carries less stigma to this particular community and incorporating questions surrounding cultural, linguistic, and spiritual needs. The final version of the SDoHST included 12 items (four original items were removed and seven new items were added during the validation process). The SDoHST is the first validated tool to measure social determinants of health (and specifically HRSNs) in Australia, receiving a comprehensive qualitative validation. The instrument is readily available and future studies will further investigate its psychometric properties with quantitative methods. A brief guide to screening tools for social determinants of health and their validation The importance of social context in contributing to overall health is well-established. Social determinants of health (SDoH) are social and environmental factors such as employment, housing security, financial stability, social isolation, and personal safety, which contribute up to 60% of overall health. In recent years, there has been a paradigm shift in how healthcare systems view health and wellbeing. There is a growing call to intervene in adverse SDoH from within the healthcare system. One such intervention involves screening patients for unmet needs, such as housing or food insecurity, and providing appropriate connections to organizations in the community to assist with their needs. The screening tools implemented in this context are multiple and diverse. Some target only one or two factors while others assess multiple SDoH. However, little is reported about the development of these tools. If a screening tool is not thoroughly developed and validated, it is impossible to know whether the data collected with the tool are appropriate or relevant. This study details the development and validation of a screening tool for unmet social needs by community members and healthcare providers at a major metropolitan hospital in South Australia. [ABSTRACT FROM AUTHOR]

Objective: The history of oral health research and dental care provision for Aboriginal and Torres Strait Islander Peoples has been framed by oppressive colonial values and wrought with maltreatment and unethical behavior. This commentary aims to collate evidence regarding the healthy history of Aboriginal and Torres Strait Islander oral health, the implications of colonization on oral health, and the current portrayal of oral health. Conclusion: We argue the need to reframe deficit focused discussions of Aboriginal and Torres Strait Islander oral health to strengths‐based narratives by critically engaging with the ways in which the future of Aboriginal and Torres Strait Islander oral health lies in the footprints of the past. [ABSTRACT FROM AUTHOR]

Objectives: The management of early childhood caries is challenging and the impacts of its treatment on child oral health‐related quality of life (COHRQoL) and dental anxiety among Australian Aboriginal children is relatively unknown. The aim of the study was to compare the impact on COHRQoL and dental anxiety after approximately 12 months among Aboriginal children treated for early childhood caries (ECC) using the Atraumatic Restorative Treatment and the Hall Technique (ART/HT: test) or standard care (control). Methods: Consenting Aboriginal communities in the North‐West of Western Australia were randomized into early (test) or delayed (control) intervention for the management of ECC. Children and parents/carers completed a questionnaire at baseline and at follow‐up. The questionnaire sought information on COHRQoL using the proxy‐reported Early Childhood Oral Health Impact Scale (ECOHIS) and the self‐reported Caries Impacts and Experiences Questionnaire for Children (CARIES‐QC). The test group was provided with the ART/HT care at baseline while the control group was advised to seek care through the usual care options available within the community. At follow‐up, both groups were offered care using the ART/HT approach. Changes in the mean scores from baseline to follow‐up within groups were evaluated using appropriate paired (t‐test, Wilcoxon paired test), and between groups with unpaired tests (t‐test). Multivariate regression analysis after multiple imputations of missing data used generalized estimating equation (GEE) controlling for clustering within communities. Results: Twenty‐five communities and 338 children (mean age = 3.6 years, sd 1.7) participated in the study (test = 177). One child was excluded from the analysis because of a missing questionnaire and clinical data at baseline and follow‐up. At baseline, test group children were older (test = 3.8 years, 95% CI 3.6–4.1;control = 3.3 years, 95% CI 3.1–3.6) and had higher caries experience (test dmft = 4.4, 95% CI 3.8–5.0;control dmft = 3.1, 95% CI 2.5–3.7), but there was no significant difference in COHRQoL or anxiety levels between the groups. At follow‐up, parents in the delayed intervention reported worsening of COHRQoL (70% worsening of the family impact section of the ECOHIS and 37% worsening of the total ECOHIS scale), and there was an 8% reduction in child dental anxiety among the early treatment group. Conclusions: The application of the ART/HT approaches was feasible, effective, and impacted positively on child oral health‐related quality of life and child dental anxiety among Aboriginal children in remote communities. The model of care as tested in this study should be further developed for inclusion in main‐stream service delivery programmes. [ABSTRACT FROM AUTHOR]

Objective: To investigate whether the association between social support and oral health outcomes is modified by levels of household income. Methods: Data were from the National Study of Adults Oral Health (NSAOH 2004‐06), a nationally representative study comprising n = 3619 adults in Australia. Effect measure modification (EMM) analysis was adopted to verify whether the association between social support and poor/fair self‐rated oral health, lack of a functional dentition (<21 teeth) and low Oral Health Related Quality of Life (OHRQoL; measured using OHIP‐14) varies according to levels of income. Poisson regressions adjusted for age, sex, education, country of birth, main language spoken at home and remoteness were used to estimate prevalence ratios (PR) for oral health outcomes for each stratum of social support (overall, family, friends and significant other) and income (effect modifier). We then computed the Relative Excess Risk due to Interaction (RERI), which represents the risk that is over what would be expected if the combination of low social support and low income was entirely additive. Sensitivity analyses for different cut‐offs of household income were performed. Results: Adults with lower levels of social support had a 2.1, 1.2 and 1.9 times higher prevalence of fair/poor self‐rated oral health, <21 teeth and poor OHRQoL respectively. The RERIs observed were 0.98 (95% CI −0.01; 1.96) for poor/fair self‐rated oral health; 0.52 (95% CI −0.06; 1.10) for lack of a functional dentition and 0.50 (95% CI −0.16; 1.15) for poor OHRQoL. For all outcomes and all individual domains of social support, the positive RERIs indicated that the joint association of low social support and low household income surpassed the sum of their separate associations with objective and subjective oral health indicators. Conclusion: Individuals with lower levels of social support had poorer oral health than those with high levels of social support, although this association was small for the outcome <21 teeth. The association between social support and poor oral health indicators is modified by levels of household income. Hence, the provision of social support had a stronger association with the oral health of low‐income participants, suggesting that socioeconomically disadvantaged individuals would mostly benefit from a social support intervention. [ABSTRACT FROM AUTHOR]

In Australia, the Strengths and Difficulties Questionnaire (SDQ) has been implemented in several national studies, including the Longitudinal Study of Australian Children (LSAC). However, three previous state-level validations indicated problems with instrument dimensionality, warranting further research. To address this gap, the current study employed exploratory graph analysis to investigate dimensionality of the caregiver-completed SDQ version 4 to 10 years in a nationally representative sample of Australian children. Data were from a dual cohort cross-sequential study (LSAC) that included more than 20,000 responses. Gaussian graphical models were estimated in each study wave and exploratory graph analysis applied. Structural consistency, item stability and network loadings were evaluated. The findings provided mixed support for the original SDQ five-factor structure. The Peer Problem scale displayed low structural consistency since items clustered with the Emotional Symptoms and Prosocial behavior, generating four-dimensional structures. Implications for future use of the SDQ version 4 to 10 years in Australia are provided. [ABSTRACT FROM AUTHOR]

Background: Dialysis for end-stage kidney disease (ESKD) is the leading cause of hospitalization among Aboriginal and Torres Strait Islander individuals in Australia. Poor oral health is commonly the only obstacle preventing Aboriginal and Torres Strait Islander people with ESKD in Australia from receiving kidney transplant. Objective: This study aims to improve access, provision, and delivery of culturally secure dental care for Aboriginal and Torres Strait Islander individuals with ESKD in South Australia through the following objectives: investigate the facilitators of and barriers to providing oral health care to Aboriginal and Torres Strait Islander patients with ESKD in South Australia; investigate the facilitators of and barriers to maintaining oral health among Aboriginal and Torres Strait Islander people with ESKD in South Australia; facilitate access to and completion of culturally secure dental care for Aboriginal and Torres Strait Islander individuals with ESKD and their families; provide oral health promotion training for Aboriginal health workers (AHWs) at each of the participating Aboriginal Community Controlled Health Services, with a specific emphasis on oral health needs of patients with ESKD; generate co-designed strategies to better facilitate access to and provision of culturally secure dental services for Aboriginal and Torres Strait Islander people living with ESKD; and evaluate participant progress and AHW oral health training program. Methods: This collaborative study is divided into 3 phases: exploratory phase (baseline), intervention phase (baseline), and evaluation phase (after 6 months). The exploratory phase will involve collaboration with stakeholders in different sectors to identify barriers to providing oral health care; the intervention phase will involve patient yarns, patient oral health journey mapping, clinical examinations, culturally secure dental care provision, and strategy implementation workshops; and the evaluation phase will involve 6-month follow-up clinical examinations, participant evaluations of dental care provision, and AHW evaluation of oral health training. Results: Stakeholder interviews were initiated in November 2021, and participant recruitment commenced in February 2022. The first results are expected to be submitted for publication in December 2022. Conclusions: Expected outcomes will identify the burden of oral disease experienced by Aboriginal and Torres Strait Islander people with ESKD in South Australia. Qualitative outcomes are expected to develop a deeper appreciation of the unique challenges regarding oral health for individuals with ESKD. Through stakeholder engagement, responsive strategies and policies will be co-designed to address participant-identified and stakeholder-identified challenges to ensure accessibility to culturally secure dental services for Aboriginal and Torres Strait Islander individuals with ESKD. [ABSTRACT FROM AUTHOR]

BACKGROUND: This study aimed to investigate the associations of oral health literacy (OHL), sense of coherence (SOC) and other covariates with self‐reported school performance (SRSP) in adolescents enrolled in public schools in Brazil. METHODS: This was a cross‐sectional study conducted with adolescents aged from 14 to 18 years enrolled in 6 public schools in Piracicaba, São Paulo, Brazil. Researchers carried out data collection at schools using a self‐administered structured questionnaire. The dependent variable was SRSP. The explanatory factors included were sociodemographic characteristics, OHL, SOC, self‐rated oral health, health behaviors, and experience of bullying. Analyses included simple and multiple logistic regression models. RESULTS: The final sample consisted of 385 adolescents with a mean age of 16 years. Poor school performance was associated (95%CI) with being male, with more than 1 sibling, individual whose last visit to the dentist was due to dental pain, with a lower level of OHL and SOC. CONCLUSIONS: OHL and SOC were important factors associated with SRSP performance together with other sociodemographic and oral health‐related variables in high school students. Our findings reinforce the importance of intersectoral actions between the health and education sectors to promote better school performance among adolescents, including actions to improve OHL and SOC. [ABSTRACT FROM AUTHOR]

Background: Perceived self-efficacy has been associated with psychological well-being, health behaviours and health outcomes. Little is known about the influence of self-efficacy on oral health outcomes for Aboriginal adults in Australia, a population experiencing high levels of oral health conditions. This study examines associations between oral health-related self-efficacy and oral health outcomes in a regional Aboriginal Australian population and investigates whether the associations persist after adjusting for sociodemographic characteristics and other general and oral health-related psychosocial factors. Methods: Cross-sectional data were obtained from the baseline questionnaire of the Indigenous Oral Heath Literacy Project, South Australia. Oral health-related self-efficacy was measured using a six item scale, with total sum scores dichotomised into high/low self-efficacy. Oral health outcomes included self-rated oral health and oral health impacts, measured using the Oral Health Impact Profile (OHIP-14). Generalized linear models with a log-Poisson link function were used to estimate Prevalence Ratios (PR) of poor self-rated oral health according to levels of oral health-related self-efficacy. Multivariable linear regressions were used to estimate the association between oral health-related self-efficacy and OHIP-14 scores. Blocks of confounders were subsequently added into the models, with the final model including all factors. Results: Complete data were available for 252 participants (63%) aged 18 to 82 years (mean age of 37.6 years). Oral health-related self-efficacy was associated with poor self-rated oral health, with a 43% (PR = 1.43 (95% CI 1.09, 1.88)) greater prevalence of poor self-rated oral health among those with low self-efficacy. Oral health-related self-efficacy was associated with OHIP-14 severity scores, with a score over six points higher for those with low self-efficacy (B = 6.27 95% CI 2.71, 9.83). Although addition of perceived stress into the models attenuated the relationship, associations remained in the final models. Conclusion: Lower levels of oral health-related self-efficacy were associated with a higher prevalence of poor self-rated oral health and greater impacts of oral health among Aboriginal adults in regional South Australia. These associations persisted after controlling for sociodemographic and psychosocial confounders, suggesting that increasing self-efficacy may provide an opportunity for improving oral health outcomes for Aboriginal adults. [ABSTRACT FROM AUTHOR]

Background: Aboriginal Community Controlled Health Organisations (ACCHOs) play a critical role in supporting Aboriginal and Torres Strait Islander health in Australia. This article aims to identify and describe oral health programming and promotion provided by ACCHOs in South Australia. Methods: All ACCHOs in South Australia were identified through the Aboriginal Health Council of South Australia. A targeted search strategy was designed to include the websites and social media pages (Facebook, Twitter, Instagram) for each organisation. Program characteristics were extracted and summarised, and oral health promotion content was analysed utilising content analysis. Results: Twelve programs were identified across the 12 ACCHOs in South Australia. Of these, seven focused on oral health and five focused on nutrition. Oral health and nutrition information shared online by ACCHOs was extracted and aggregated into oral health and nutrition categories, which included reminders about visiting services, advocacy statements, oral hygiene messaging, appointment availability, education resources, and upcoming community‐based activities. Conclusions: The evidence explored highlights the integral role ACCHOs play in oral health promotion and service delivery. It is critically important that ACCHOs are involved in development and implementation of oral health services to ensure programming reflects community knowledges and is effective in improving oral health equity. [ABSTRACT FROM AUTHOR]

Background: This study aims to investigate the mediating pathways of oral health literacy (OHL) and oral health‐related behaviours on the relationship between education and self‐reported tooth loss among Australian adults. Methods: Data used for studying the effects of mediating pathways are from the National Dental Telephone Interview Survey 2013, a random sample survey of Australian adults aged 18+ years. To study the mediating effects, we use counterfactual‐based analysis. To decompose the effect of multiple mediator's alternate, to natural effect, methods such as interventional effects have been proposed. In this paper, we use these approaches to decompose the effect between education, OHL and oral health‐related behaviours on self‐reported tooth loss. Sensitivity analysis was performed for unmeasured confounding with multiple mediators. Results: Data were available for 2936 Australian adults. The prevalence of persons with ≥12 self‐reported tooth loss was approximately 15%. The average total causal effect from the low education group was nearly 150%, and the interventional indirect effect through OHL and the dependence of oral health‐related behaviours on OHL to more than 12 missing teeth were 20% and 120%, respectively, higher than in the high education group. Sensitivity analysis indicated if the difference in the prevalence of unmeasured confounder is as big as 6% the direct effect and the indirect effect remains as observed. Conclusions: An additional two‐fifths reduction on having more than 12 missing teeth for Australian adults with lower education level could be achieved if the proportion of lower OHL was decreased and optimal dental behaviours were increased. [ABSTRACT FROM AUTHOR]

The aim of this systematic review and meta-analysis was to document the disparity in dental caries experiences among indigenous and nonindigenous populations globally by measuring dental caries prevalence and severity. An electronic database (MEDLINE) was initially searched using relevant keywords. This was followed by use of the search string in the following electronic databases: Scopus, EBSCOhost, Cochrane, and Open Grey. Two independent reviewers conducted the study search and screening, quality assessment, and data extraction, which was facilitated using JBI SUMARI software. The primary outcome was the decayed missing filled teeth (DMFT) score and dental caries prevalence. Subgroup analysis was done by country of publication to identify causes of heterogeneity. Forest plots were used with the standardized mean difference (SMD) and publication bias was assessed using the Egger test with funnel plot construction. For the final review, 43 articles were selected and 34 were meta-analyzed. The pooled mean DMFT for both the permanent dentition (SMD = 0.26; 95% CI 0.13-0.39) and deciduous dentition (SMD = 0.67; 95% CI 0.47-0.87) was higher for the Indigenous population than for the general population. Indigenous populations experienced more decayed teeth (SMD = 0.44; 95% CI 0.25-0.62), a slightly higher number of missing teeth (SMD = 0.11< 95% CI -0.05 to 0.26), and lesser filled teeth (SMD = -0.04; 95% CI -0.20 to 0.13) than their nonindigenous counterparts. The prevalence of dental caries (SMD = 0.27; 95% CI 0.13-0.41) was higher among indigenous people. Globally, indigenous populations have a higher caries prevalence and severity than nonindigenous populations. The factors which have led to such inequities need to be examined. [ABSTRACT FROM AUTHOR]