Background: Based on the hypothesis that a vicious cycle of dental fear exists, whereby the consequences of fear tend to maintain that fear, the relationship between dental fear, self-reported oral health status and the use of dental services was explored.

Background:The Oral Health Assessment Tool (OHAT) was a component of the Best Practice Oral Health Model for Australian Residential Care study. The OHAT provided institutional carers with a simple, eight category screening tool to assess residents' oral health, including those with dementia. This analysis presents OHAT reliability and validity results. Methods: A convenience sample of 21 residential care facilities (RCFs) in urban and rural Victoria, NSW and South Australia used the OHAT at baseline, three-months and six-months to assess intra-and inter-carer reliability and concurrent validity. Results: Four hundred and fifty five residents completed all study phases. Intra-carer reliability for OHAT categories: percent agreement ranged from 74.4 per cent for oral cleanliness, to 93.9 per cent for dental pain; Kappa statistics were in moderate range (0.51-0.60) for lips, saliva, oral cleanliness, and for all other categories in range of 0.61-0.80 (substantial agreement) (p<0.05). Inter-carer reliability for OHAT categories: percent agreement ranged from 72.6 per cent for oral cleanliness to 92.6 per cent for dental pain; Kappa statistics were in moderate range (0.48-0.60) for lips, tongue, gums, saliva, oral cleanliness, and for all other categories in range of 0.61-0.80 (substantial agreement) (p<0.05). Intraclass correlation coefficients for OHAT total scores were 0.78 for intra-carer and 0.74 for inter-carer reliability. Validity analyses of the OHAT categories and examination findings showed complete agreement for the lips category, with the natural teeth, dentures, and tongue categories having high significant correlations and percent agreements. The gums category had significant moderate correlation and percent agreement. Non-significant and low correlations and percent agreements were evident for the saliva, oral cleanliness and dental pain categories.

Age and loss of teeth can be expected to have a complex relationship with oral health-related quality of life. This study aimed to explain how age and tooth loss affect the impact of oral health on daily living using the short form, 14-item Oral Health Impact Profile (OHIP-14) on national population samples of dentate adults from the UK (1998 UK Adult Dental Health Survey) and Australia (1999 National Dental Telephone Interview Survey). After correcting for key covariables, increasing age was associated with better mean impact scores in both populations. Those aged 30-49 years in Australia showed the worst (highest) scores. In the UK, those aged under 30 showed the highest scores. In both countries, adults aged 70+ showed much better scores than the rest (P < 0.001). When corrected for age, the independent effect of tooth loss was that the worst scores were found where there were fewer than 17 natural teeth in the UK and fewer than 21 teeth in Australia. People with 25 or more teeth averaged much better scores than all other groups (P < 0.001), although there were differences in pattern between countries. When Australians were analysed by region of birth, the pattern of scores by tooth loss for British/Irish immigrants was strikingly similar to that for the UK sample. First-generation immigrants from elsewhere showed much worse overall scores and a profoundly different pattern to the Australian- and British-born groups. Age, number of teeth and cultural background are important variables influencing oral health-related quality of life.

Background: This study aimed to describe both the prevalence of dental fear in Australia and to explore the relationship between dental fear and a number of demographic, socio‐economic, oral health, insurance and service usage variables. Methods: A telephone interview survey of a random sample of 7312 Australian residents, aged five years and over, from all states and territories. Results: The prevalence of high dental fear in the entire sample was 16.1 per cent. A higher percentage of females than males reported high fear (HF). Adults aged 40–64 years old had the highest prevalence of high dental fear with those adults aged 80+ years old having the least. There were also differences between low fear (LF) and HF groups in relation to socio‐economic status (SES), with people from higher SES groups generally having less fear. People with HF were more likely to be dentate, have more missing teeth, be covered by dental insurance and have a longer time since their last visit to a dentist. Conclusions: This study found a high prevalence of dental fear within a contemporary Australian population with numerous differences between individuals with HF and LF in terms of socio‐economic, socio‐demographic and self‐reported oral health status characteristics.

An oral health promotion programme based on repeated rounds of anticipatory guidance initiated during the mother's pregnancy was successful in reducing the incidence of S-ECC in these very young children.

The socioeconomic characteristics of neighborhoods are important for oral health over and above the socioeconomic characteristics of the people living in those neighborhoods. Policies and interventions to improve population oral health should be directed at the social, physical and infrastructural characteristics of places as well as individuals (i.e. the traditional target of intervention efforts).

–  Objective:  The aim of this study was to describe differences in dental attendance and dental self‐care behaviour between socioeconomic groups and to investigate the extent to which the socioeconomic gradient in oral health was explained by these behaviours. Methods:  We used data from a representative sample of adults in Australia, surveyed by telephone interview and by self‐complete questionnaire. The dependent variables were self‐reported missing teeth and the social impact of oral conditions evaluated with the 14‐item Oral Health Impact Profile (OHIP‐14). Socioeconomic position was measured at the small‐area level. We conducted bivariate analysis using one‐way analysis of variance and 95% confidence intervals (95% CI) and adjusted for the effect of age. After adjusting for age, dental behavioural variables were entered individually into multivariate linear regression models. Results:  Data were obtained for 3678 dentate adults aged 18–91 years. Missing teeth and OHIP‐14 scores followed a social gradient with poorer adults experiencing poorer outcomes. Routine dental attendance and diligent dental self‐care were associated with inverse monotonic gradients in missing teeth (P < 0.05) and OHIP‐14 scores (P < 0.05). Although adults living in areas with the least disadvantage had a preventive dental attendance orientation, no socioeconomic pattern was found for dental self‐care. In multivariate analysis, the slope of the socioeconomic gradient [β estimate for Index of Relative Socioeconomic Disadvantage (IRSD)] in missing teeth was not significantly attenuated by either dental attendance or dental self‐care. For OHIP‐14 scores, the slope of the socioeconomic gradient was significantly attenuated by dental visiting, but not by dental self‐care and not by the combined effect of both behaviours. Conclusion:  The commonly held view that the poor oral health of poor people is explained by personal neglect was not supported in this study.

The nature of the relationship between social status and oral conditions differed according to the measure used to index social status. Perception of relative social standing followed an approximately straight-line relationship. In contrast, there was a discrete threshold of income below which oral health deteriorated, suggesting that the benefit to oral health of material resources occurs mostly at the lower end of the across the full socioeconomic distribution.