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Objective: Objective: Dental emergencies are a significant impact on the health system. The resource needs are complex and consume services in the tertiary health sector. It is important that we examine the reasons and types of attendances to look for ways to mitigate this demand. The aim was to identify the rate of dental emergencies according to age groups, genders and Indigenous status. Method: A retrospective analysis of dental emergencies at the Princess Margaret Hospital (PMH; tertiary children hospital in Perth) was performed. Setting: The study included data from hardcopy files of patients admitted to the PMH. Main outcome measures: Main outcome measures: The records of 239 children who attended the PMH in Perth with dental emergency problems during the first 3 months of 2017 were analyzed. Findings: The major reasons for dental emergencies were infection and trauma. The most common age group was children between 3 to 6 years old. In this age group, boys attended more than girls due to dental injury. Although there were equal presentations of dental infection and dental trauma cases, dental infection cases mostly required hospitalization and treatment under general anesthetic. Conclusion: While some dental emergencies are unavoidable, increasing awareness about dental hygiene, regular checkups and early dental treatments in children could decrease emergency visits and prevent conditions such as dental infections. [ABSTRACT FROM AUTHOR]

Objective This study investigated the delivery of paediatric (0-17 years) government dental services in New South Wales (NSW), Australia through public dental clinics and the commissioned payments models of Fee-for- Service and Capped-Fee. Method De-identified patient data from government provided dental care and the commissioned services was sourced from NSW Oral Health Data Warehouse for evaluation and interpretation using descriptive analysis during the period 1 January 2012 to 31 December 2013. Result The breakdown of dental care provided the associated cost analysis for the study's cohort that resulted in both years, more than 50 percent dental services offered to paediatric patients were preventive care in all payment systems. The most common preventive items offered were fluoride treatment, dietary advice, oral health education and fissure sealants. Conclusion There was little difference in the mix of dental care provided between study years and age groups through the three payment systems in NSW. The difference between the government services and those provided via the Fee-for-Service and Capitation payment systems was negligible. This has important implications for the delivery of dental care to public dental care, particularly when patients may not live close to a public dental clinic and also with the interest nationally in giving patients greater choice. [ABSTRACT FROM AUTHOR]

Objectives To evaluate clinical outcomes of supportive peri-implant therapy ( SPIT) following surgical treatment of peri-implantitis. Materials and methods Twenty-four partially dentate patients with 36 dental implants diagnosed with peri-implantitis were treated by an anti-infective surgical protocol followed by regular supportive therapy. SPIT included removal of supra- and submucosal biofilm at the treated implants using titanium or carbon fibre curettes, or ultrasonic devices. In addition, professional prophylaxis (calculus/biofilm removal) at other implants/teeth and oral hygiene reinforcement was provided. Clinical measurements and radiographs were obtained at 1, 3 and 5 years. A successful treatment outcome was defined as implant survival with the absence of peri-implant probing depths ( PD) ≥ 5 mm with concomitant bleeding/suppuration and absence of progression of peri-implant bone loss. Results Twelve months after treatment, there was 100% survival of the treated implants and 79% of patients (19 of 24) had a successful treatment outcome according to the defined success criteria. At 3 years, 75% of the patients (18 of 24) had a successful treatment outcome, two patients (8%) were lost to follow-up ( LTF), while 8% lost an implant, and two patients had recurrence of peri-implantitis. Between 3 and 5 years, an additional two patients were LTF, and an additional two patients each lost one implant. Thus, at 5 years 63% of patients (15 of 24) had a successful treatment outcome. Complete resolution of peri-implantitis, defined as absence of bleeding at all sites, was achieved in 42% of implants ( N = 15) at 5 years. Conclusion Five years following regular supportive therapy, the peri-implant conditions established following peri-implantitis surgery were maintained in the majority of patients and implants. Some patients had recurrence of peri-implantitis and some lost implants over the 5-year period. [ABSTRACT FROM AUTHOR]

Objective: The objectives of this study were to (i) compare a Capped Payment formula for adults, to the fee-for-service model and the New South Wales Government services payment model; (ii) identify the presenting oral health needs of a 65+ years of age cohort during the period January 2011 to March 2015.Background Data Discussing the Present Status Of the Field: Australia faces an ageing population with the vast majority accessing free market dental care, whilst the poor access Government services. This cohort retains most of their dentition increasing demand on Government services.Materials and Methods: The analysis of New South Wales Government adult de-identified patients' record unit data was from 2011 to 2015, for the three payment models and undertaken in three stages; (i) development of the Capped Payment Model; (ii) evaluation of twenty (20) case studies of adults 65+ years of age; (iii) analyse the cost efficiency of the three payment models.Results: This study found that the Government model was the most cost effective. The Capped-fee model performed less efficiently, particularly in the 75+ age group, with the fee-for-service model generally more costly. It was $2580 (85%) more costly for the 65-74 age cohort, and $4619 (66%) for the 75+ age cohort.Conclusion: Policy makers in partnership with Government and private service providers should seek to develop partnerships with Government, private services and universities, scope opportunities in applying a Capped-fee funding model, and one that helps address the oral needs of the elderly. [ABSTRACT FROM AUTHOR]

The aim of this study was to create an Urban Dental Index (UDI) for Perth, Western Australia, adapting a method utilised by the World Health Organisation. Dental health indicators were derived from the 2011 census, standardised on a (0,1) interval, amalgamated using a geometric mean, and mapped to identify dental health inequity. The validity of the UDI was tested by comparison with oral cellulitis data. Dental health disparities were examined using a ratio of the mean of the highest to lowest decile and slope of the eight middle deciles. The robustness of the UDI was tested using indicator correlation, weighting, and systematic indicator removal. There were a high proportion of low UDI census areas outside the inner city. Adult public dental clinics were unevenly distributed across these low UDI areas. The UDI was significantly correlated with oral cellulitis data and had a moderate disparity ratio (1.69) and slope (0.23). All dental indicators were highly correlated, and UDIs calculated with weighted indicators and indicators removed were significantly correlated with the original UDI. These results indicate that the UDI is a robust tool which can be used by policy makers to target dental health initiatives to high-risk areas. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to examine the service accessibility of Somali Australians suffering Autism Spectrum Disorder (ASD) by using both quantitative and qualitative methods.Design/methodology/approach Using Geographic Information System (GIS) and the 2011 census data a total of 19,178 people reporting Somali ancestry were mapped to SA1 level with most being in the three capital cities of original migration; Sydney, Melbourne and Perth.Findings Access to primary services pertinent to ASD was measured using the GIS software, some 15 per cent of these cities Somali children were within 500 m of a General practice and 89 per cent within 2,000 m. A quarter of children were within 2,000 m of a speech pathology service access point and nearly a third (31 per cent) within 2,000 m of a psychologist. Qualitative analysis found a quite negative perspective on mental illness and ASD within the community with 85 per cent of respondents reporting a “Bad” perception of ASD within the community.Research limitations/implications Clearly, the opportunity these data provide is to develop service models targeting need and changing perspectives of ASD within an at risk community.Originality/value This is the first time in Australia that issues of service access (health) for Autism suffers and their families has been analysed in a detailed geographic manner. [ABSTRACT FROM AUTHOR]

Objective This study aimed to evaluate users' acceptance of a teledentistry model utilizing a smartphone camera used for dental caries screening and to identify a number of areas for improvement of the system. Methods A store-and-forward telemedicine platform "Remote-I" was developed to assist in the screening of oral diseases using an image acquisition Android app operated by 17 teledental assistants. A total of 485 images (five images per case) were directly transmitted from the Android app to the server. A panel of five dental practitioners (graders) assessed the images and reported their diagnosis. A user acceptance survey was sent to the graders and smartphone users following completion of the screening program. Results Of the 22 surveys sent out, 20 (91%) were completed. Generally, users showed optimism towards the use of the teledentistry system, and strongly positively assessed items on content and service quality. The majority of graders took less than 15 min to read the images while phone users took 5-10 min to complete the dental photography using the Android app. This study identified a number of factors that are essential for improving the current system, such as optimization of smartphone camera features, the format of the server, and the orientation of images and using oral retractors during photography. Conclusions Users appear to be generally satisfied with the proposed teledentistry model. However, they have specific concerns to address, many of which could be resolved through more effective training, coordination between sites and upgrading the current system. [ABSTRACT FROM AUTHOR]

Objective: This study analysed all hospitalisations of persons over the age of 65 years for oral health-related conditions, over a decade, and projected future hospitalisation rates.Background: The proportion of older Australians is increasing, and their oral health is improving. At the same time, there is concern about the increasing burden that hospitalisations place on government health budgets.Methods: Hospitalisation data of all patients older than 65 years, admitted to hospital for an oral health-related condition in Western Australia over a decade, were analysed.Results: Over a ten-year period, a total of 11608 people over the age of 65 were admitted to hospital, with 10% 85 years and older, 52% were men, and 0.1% were Aboriginal patients. The highest rates of hospitalisation were for those from the most disadvantaged areas. Over ten years, there was a significant annual increase in rates of hospitalisation (4.4%). Overall, most admissions were for 'Malignant neoplasms' (16.6%), 'Dental caries' (15.4%) and 'Other disorders of the teeth and supporting structures' (14.3%). These three conditions accounted for almost half of all admissions (46.4%). Projections indicate high future burdens of hospitalisation.Conclusions: It is of concern that hospitalisations for oral health-related reasons among the oldest patients include high numbers with potentially preventable conditions such as dental caries. Projections indicate that if current trends are set to continue, hospitalisations for oral health-related conditions among Western Australians older than 65 years will place a considerable burden on the health system. [ABSTRACT FROM AUTHOR]

Objective: To test the variability of the volume measurements when different segmentation methods are applied in pulp volume reconstruction. Materials and methods: Osirix® and ITK-SNAP software were used. Different segmentation methods (Part A) and volume approaches (Part B) were tested in a sample of 21 dental CBCT's from upper canines. Different combinations of the data set were also tested on one lower molar and one upper canine (Part C) to determine the variability of the results when automatic segmentation is performed. Results: Although the obtained results show correlation among them(r>0.75), there is no evidence that these methods are sensitive enough to detect small volume changes in structures such as the dental pulp canal (Part A and Part B). Automatic segmentation is highly susceptible to be affected by small variations in the setting parameters (Part C). Conclusions: Although the volumetric reconstruction and pulp/tooth volume ratio has not shown better results than methods based on dental radiographs, it is worth to persevere with the research in this area with new development in imaging techniques. [ABSTRACT FROM AUTHOR]

Different non-invasive methods have been proposed for dental age estimation in adults, with the Kvaal et al. method as one of the more frequently tested in different populations. The purpose of this study was to apply the Kvaal et al. method for dental age estimation on modern volumetric data from 3D digital systems. To this end, 101 CBCT images from a Malaysian population were used. Fifty-five per cent were female (n = 55), and forty-five percent were male (n = 46), with a median age of 31 years for both sexes. As tomographs allow the observer to obtain a sagittal and coronal view of the teeth, the Kvaal pulp/root width measurements and ratios were calculated in the bucco-lingual and mesio-distal aspects of the tooth. From these data different linear regression models and formulae were built. The most accurate models for estimating age were obtained from a diverse combination of measurements (SEE ±10.58 years), and for the mesio-distal measurements of the central incisor at level A (SEE ±12.84 years). This accuracy, however is outside an acceptable range in for forensic application (SEE ±10.00 years), and is also more time consuming than the original approach based on dental radiographs. [ABSTRACT FROM AUTHOR]