Caries burden and efficacy of a referral pathway in a cohort of preschool refugee children

Abstract

Background: This study aimed to assess the early caries experience and the efficacy of a community based dental referral pathway in preschool refugees in Western Australia. Methods: Preschool refugee children referred to the Western Australian paediatric hospital Refugee Health Clinic were prospectively screened for caries by a paediatric dentist before being referred to community dental clinics. Dental forms and medical records were audited to assess decayed, missing and filled teeth (dmft), medical data and dental services engagement. Poisson regression analysis determined the contribution of count variables to the final model. Results: Among the 105 screened children (54% male, median age 3.2 years, 41% Burmese), community dental clinic engagement was low (46%, n = 48). Of the 62% with caries (n = 65/105, mean dmft 5.2, SD 4.1), 45% were recommended for specialist dental services and 48% were treated. After adjustment for age, gender and total number of teeth, caries incidence was significantly associated with BMI-for-age Z score (p = 0.02). Conclusions: Preschool refugee caries burden was high. The community dental referral pathway was ineffective compared to co-located intersectorial dental screening. Specialist dental service needs are high in this cohort and require a targeted approach.

Refugee child oral health

“…Oral health status of refugee children Three studies included a clinical oral health examination undertaken by an oral healthcare professional (Vered et al, 2008;Gibbs et al, 2015;Nicol et al, 2015). The remaining four quantitative studies reported only retrospective clinical data recorded as part of a refugee general health assessment (Melvin, 2006;Johnston et al, 2012;Mutch et al, 2012;Shah et al, 2014).…”

“…Disappointingly, but consistent with much of the wider dental literature, there was a lack of consistency and quality of both the screening protocols and the instruments used to diagnose dental caries. Most of the studies use data from either retrospective review of medical records (Johnston et al , ; Mutch et al , ; Shah et al , ) or ‘dental screenings’ that are not comprehensive; hence, caries experience may be under reported (Melvin, ; Nicol et al , ). International standards for epidemiological oral health studies encourage consistency through the use of the International Caries Detection and Assessment System (ICDAS II) (Ismail et al , ).…”

Midwives’ and women's views on accessing dental care during pregnancy: an Australian qualitative study

“…Poor maternal oral health during pregnancy has been linked to an increased risk of poor obstetric outcomes, such as preterm birth and low birthweight . Further, disparity in maternal and child oral health outcomes is experienced in people of lower socioeconomic positions, Indigenous and migrant backgrounds, as well as other vulnerable and disadvantaged populations . Hence, taking preventative measures to improve maternal oral health and educate pregnant women about their own and subsequently their child's oral hygiene, can decrease susceptibility to dental caries.…”

Quality of life changes in children following emergency dental extractions under general anaesthesia

“…Subsequently, these children are then referred to a community clinic for the management of the remaining restorable teeth. Nevertheless, a recent Western Australian study reported that these community dental services and the referral pathways were ineffective, especially among the preschool children. The consequences of not treating the carious lesions include repeated acute infections and emergency DEGA.…”