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

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

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

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

Background/aim: The association between ear problems and traumatic dental injuries (TDIs) has not been examined in longitudinal cohort studies. The study aimed to estimate the effect of ear problems on TDIs in primary and permanent teeth among Australian Indigenous children., Methods: The Longitudinal Study of Indigenous Children is a study of two representative cohorts of Indigenous Australian children, aged from 6 months to 2 years (baby cohort) or from 3.5 to 5 years (child cohort) at baseline (2008). The children's mother/primary carer undertook a face-to-face interview in 2008, repeated annually for the next 9 years. Ear problems included runny ears, perforated eardrum, total deafness, deaf in one ear, hearing loss/partially deaf, and other ear problems. TDIs were teeth and oral soft and hard tissue injuries. Multivariate survival analysis using Cox proportional regression models estimated hazards ratio (HR) were used in the analysis., Results: A total of 870 from baby cohort and 668 from child cohort Indigenous children, who had no TDIs at baseline were included in the analysis. The prevalence of TDIs was 9.2%, 11.1%, and 6.6% in the total, baby, and child cohorts, respectively. Multivariable models for TDIs indicate children with ear problems had nearly four times (total: HR = 3.72, 95% CI: 1.82-6.77), five times (baby cohort: HR = 4.76, 95% CI: 1.59-11.63), and more than 15 times (child cohort: HR = 16.2, 95% CI: 4.78-49.28) the average hazard over time, than those without ear problems. After adjusting for all covariates, children with ear problems had more than 22 times (HR = 22.03, 95% CI: 4.50-87.07) TDIs than those without ear problems in the child cohort. Mothers/primary carers with lower educational level was positively associated with the incidence of TDIs., Conclusion: Ear problems were a risk indicator for the increased incidence of TDIs in two large cohorts of Indigenous Australian children. Mothers/primary carers' educational level was a significant risk factor for TDIs., (© 2024 The Author(s). Dental Traumatology published by John Wiley & Sons Ltd.)

Introduction: Public service provision is one of the keys to reducing inequalities in the utilization of dental services. Given the increase in the aging population, there should be a focus on older adults' oral health. However, this is often overlooked., Objectives: This study investigates the effectiveness of public services in reducing income-related inequalities in dental service utilization among older South Australians., Methods: A multiple counterfactual mediation analysis using the ratio of mediator probability weighting approach was used to explore the proposed mediation mechanism using a South Australian population of older adults (≥65 y). The exposure variable in the analysis was income, and the mediators were concession cards and the last dental sector (public or private). The outcome variable was the time of last dental visit., Results: Half of the older adults with high income (≥$40,000) owned a concession card, and 10% of those who attended public dental services belonged to this group. Interestingly, only 16.3% of the study participants had visited the public dental sector at their last dental appointment. Results showed a negligible indirect effect (odds ratio [OR], 0.99; 95% confidence interval [CI], 0.85-1.05) and a significant direct effect (OR, 3.09; 95% CI, 2.24-4.87). By changing the potential outcome distributions to the counterfactual exposure distributions and taking the mediators' distribution as a counterfactual exposure distribution, the odds of dental visits occurring before the past 12 mo approximately tripled for low-income compared to high-income individuals., Conclusion: Income inequalities were associated with relatively delayed dental visits in older South Australians, and provision of public services could not improve this pattern. This might happen due to inequitable access to concession cards and public services. A review of policies is required, including addressing income inequalities and implementing short-term approaches to improve service utilization patterns in older South Australians., Knowledge Transfer Statement: The findings of this study can enable policymakers for informed decision-making about the provision of public dental services for older Australians. This study emphasizes the importance of reviewing the current public dental services and subsidies and implementing short-term approaches to reduce income inequalities for older Australians., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Social inequities in dental caries are reflected by both inequities in the social structures that contribute to disease severity and inequities in the provision of dental care. This study aimed to describe social differentials in the dental caries experience among Australian adults across a 13-y period and to examine if the highest magnitude of oral health inequities persisted across dental caries prevalence (decayed teeth [DT]) or its management (missing teeth [MT], filled teeth [FT])., Methods: Data were from 2 population-based cross-sectional surveys of Australian adult oral health conducted in 2004-2006 (National Survey of Adult Oral Health-1 [NSAOH-1], n = 5,505) and 2017-2018 (NSAOH-2, n = 5,022). In each survey, representative samples of adults were obtained through a 3-stage, stratified sample design within metropolitan and regional areas in each state/territory. Clinical outcomes included the prevalence and mean of DT, MT, FT, and DMFT. Equivalized household income was grouped into approximately quartiles from low to high., Results: Across all income quartiles, the mean DT and % DT >0 was higher in NSAOH-2 than in NSAOH-1. The increase in prevalence was highest in the third highest income group (prevalence difference [PD] = 8.4, from 24.1 to 32.5). Similarly, % MT >0 was lower in NSAOH-2 than in NSAOH-1 across all income groups, with the decrease most marked for the lowest income group (PD = -6.5, from 74.1 to 67.8). Across all income quartiles, % FT >0 was lower in NSAOH-2 than in NSAOH-1. The decrease was the most marked for the lowest income group (PD = -8.9, from 81.1 to 72.2)., Conclusion: The findings confirm that although oral health inequities decreased for the most extreme management outcome of dental caries (MT), inequities increased for experience of that disease (DT) and the more conservative management of dental caries (FT). For all D, M, and F components (DMFT), inequities between the lowest and highest household income groups increased from 2004-2006 to 2017-2018., Knowledge Transfer Statement: This study found that social inequities in oral health (experience of untreated dental caries and missing teeth) increased between the most socially advantaged and disadvantaged groups between 2004-2006 and 2017-2018. This suggests that models of dental service provision in Australia are increasingly benefitting those who can afford and access the care and who arguably need the services less than their less socially advantaged counterparts do., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Background: Indigenous Australians score worse on both sleep and oral health. This study aimed to evaluate sleep quality and quantity associated with oral health-related quality of life (OHRQoL) among Indigenous Australian adults., Methods: A cross-sectional study involving 728 Indigenous Australian adults aged 18+ years was conducted. Exposure variables were sleep quality and quantity. The primary outcome variable was Oral Health Impact Profile-14 (OHIP14), which has been used to assess OHRQoL. Multivariable log-Poisson regression models were applied to estimate the mean ratios (MRs) for mean OHIP14 scores., Results: The average OHIP14 score was 14.9, and the average amount of sleep was 6.8 h/night. After adjusting for all covariates, self-rated very bad sleep quality was associated with 2.2 times (MR = 2.17, 95% CI: 1.97-2.37) higher OHIP14 scores than those who rated their sleep quality as very good. Participants who self-reported sleeping 7-8 h/night had 0.9 times (MR = 0.89, 95%CI: 0.83-0.95) lower OHIP14 scores than those sleeping more than 8 h., Conclusions: The average number of sleep hours for Indigenous participants were lower than recommended (7-8 h/night). Our findings indicate that poor sleep quality and quantity, and oral health-related behaviours associated with sleep deprivation were positively associated with poor oral health related quality of life among Indigenous Australian adults.

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., (© 2023 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

Chronic oral diseases, such as caries and periodontal disease, may, in future, be treated by oral microbiome transplant (OMT) technology. OMT therapy would involve collecting a donor oral microbiome and transplanting into a recipient to either prevent or treat oral diseases linked to a change (i.e., dysbiosis) in the oral microbiome. Given the great promise of this technology, we must consider the ethical and practical implications of how it is developed to maximise its accessibility and affordability. Here, we examine ways that OMT technology might be commercialized in the context of equity and accessibility in both clinical or do-it-yourself settings. We do this while assuming that the technology can be developed for humans in ways that are safe and effective at the individual and population-levels. We highlight the need for OMT therapy to be 1) cost-effective, 2) understood by end users and clinicians, 3) easy to access even in rural or remote communities, and 4) providing donors equitable compensation for their microbiomes. These key elements will only be achieved through partnerships between scientists, clinicians, investors and stakeholders throughout development. Therefore, proper acknowledgement and equitable evaluation of contributions in this team will also be critical to ensuring that this technology can be globally accessed. While OMT is likely to reshape how we prevent or treat oral disease, consciously guiding its development toward equity and accessibility to all people may significantly aid in improving health for those without access to dental care., (Copyright© 2024 Dennis Barber Ltd.)

Over 700 oral bacterial species have been identified in human populations, with ~200 bacterial species identified in any given individual mouth. The relationship between the oral microbiome and health is evidenced in many studies, with dysbiosis (a shift from a healthy to less healthy state of microbial community) associated with dental caries, periodontitis, halitosis and oral cancer. However, oral microbiome research to date has focused primarily on European populations, particularly those in large urban centres housing academic institutions with access to research funding. Key anthropological perspectives examining the sociocultural, epidemiological, genetic and environmental factors that influence the oral microbiome have also been Euro-centric. Very little is known about how the oral microbiome mediates both oral and general disease risks specifically within Indigenous and other vulnerable populations. Undertaking oral microbiome research in under-served communities requires consideration of many issues often unfamiliar in the broader research community, including being acceptable, relevant and of perceived benefit to the communities being studied. Research materials need to be managed respectfully in a culturally safe way, sharing/translating the knowledge obtained. These approaches will likely provide unique insights into the complex connections between environment and biology, people and place, and culture and science in relation to the oral microbiome. The ongoing development of oral microbiome research must facilitate frameworks that are equitable and inclusive to better enable clinical and scientific expertise within marginalised communities., (Copyright© 2024 Dennis Barber Ltd.)

Advancing oral microbiome research has revealed the association between oral microbiome composition and oral disease. However, much of the research has predominantly focused on comparing health and disease conditions, overlooking the potential dental public health implications. This article examines the evolution of oral microbial research from inception, advancement, and current knowledge of health-associated microbiota. Specifically, we focus on two key aspects: the impact of lifestyle and environmental factors on the oral microbiome and using the oral microbes as a therapeutic modality. The complex interaction of host intrinsic, environmental, and lifestyle factors affects the occurrence and development of the oral microbiota. The article highlights the need for ongoing research that embraces population diversity to promote health equity in oral health research and integrate public health practices into microbiome-based research. The implication of population-level interventions and targeted approaches harnessing the oral microbiome as an intervention, such as oral microbiome transplantation, should be further explored., (Copyright© 2024 Dennis Barber Ltd.)

Microbiome research is currently biased towards populations of European descent, with such populations providing a weak basis upon which to understand microbiome-health relationships in under-studied populations, many of whom carry the highest burdens of disease. Most oral microbiome studies to date have been undertaken in industrialized countries. Research involving marginalised populations should be shaped by a number of guiding principles. In the Indigenous Australian context, one useful framework is the Consolidated Criteria for Strengthening Reporting of Health Research involving Indigenous Peoples (CONSIDER) statement. This paper describes how the microbiome research field is having impacts in the Indigenous Australian health space, and describes a particular project involving Indigenous Australians in which the CONSIDER statement is used as the underlying framework., (Copyright© 2024 Dennis Barber Ltd.)

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., (© 2022 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

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., (© 2022 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

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., (© 2022 The Authors. Community Dentistry and Oral Epidemiology published by John Wiley & Sons Ltd.)

We applied a structural intersectionality approach to cross-sectionally examine the relationships between macro-level systems of oppression, their intersections, and access to oral care in the United States. Whether and the extent to which the provision of government-funded dental services attenuates the emerging patterns of associations was also assessed in the study. To accomplish these objectives, individual-level information from over 300,000 respondents of the 2010 US Behavioral Risk Factor Surveillance System was linked with state-level data for 2000 and 2010 on structural racism, structural sexism, and income inequality, as provided by Homan et al. Using multilevel models, we investigated the relationships between systems of oppression and restricted access to oral health services among respondents at the intersections of race, gender, and poverty. The degree to which extended provision of government-funded dental services weakens the observed associations was determined in models stratified by state-level coverage of oral care. Our analyses bring to the fore intersectional groups (e.g., non-Hispanic Black women and men below the poverty line) with the highest odds of not seeing a dentist in the previous year. We also show that residing in states where high levels of structural sexism and income inequality intersect was associated with 1.3 greater odds (95% confidence interval, 1.1-1.5) of not accessing dental services in the 12 mo preceding the survey. Stratified analyses demonstrated that a more extensive provision of government-funded dental services attenuates associations between structural oppressions and restricted access to oral health care. On the basis of these and other findings, we urge researchers and health care planners to increase access to dental services in more effective and inclusive ways. Most important, we show that counteracting structural drivers of inequities in dental services access entails providing dental care for all.

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.

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.

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., (© The Author(s) 2022. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)