Oral health of schoolchildren in Western Australia

Arrow, Peter

doi:10.1111/adj.12368

Cited by 11 publications

(19 citation statements)

References 16 publications

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“…Dental conditions were also a common cause of avoidable hospitalization for Aboriginal children. Previous studies have also documented poor dental health in Aboriginal communities [ 57 – 59 ], as well as higher rates of hospitalization for dental conditions among Aboriginal children in Western Australia [ 60 , 61 ].…”

Section: Discussionmentioning

confidence: 99%

Inequalities in pediatric avoidable hospitalizations between Aboriginal and non-Aboriginal children in Australia: a population data linkage study

et al. 2016

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BackgroundAustralian Aboriginal children experience a disproportionate burden of social and health disadvantage. Avoidable hospitalizations present a potentially modifiable health gap that can be targeted and monitored using population data. This study quantifies inequalities in pediatric avoidable hospitalizations between Australian Aboriginal and non-Aboriginal children.MethodsThis statewide population-based cohort study included 1 121 440 children born in New South Wales, Australia, between 1 July 2000 and 31 December 2012, including 35 609 Aboriginal children. Using linked hospital data from 1 July 2000 to 31 December 2013, we identified pediatric avoidable, ambulatory care sensitive and non-avoidable hospitalization rates for Aboriginal and non-Aboriginal children. Absolute and relative inequalities between Aboriginal and non-Aboriginal children were measured as rate differences and rate ratios, respectively. Individual-level covariates included age, sex, low birth weight and/or prematurity, and private health insurance/patient status. Area-level covariates included remoteness of residence and area socioeconomic disadvantage.ResultsThere were 365 386 potentially avoidable hospitalizations observed over the study period, most commonly for respiratory and infectious conditions; Aboriginal children were admitted more frequently for all conditions. Avoidable hospitalization rates were 90.1/1000 person-years (95 % CI, 88.9–91.4) in Aboriginal children and 44.9/1000 person-years (44.8–45.1) in non-Aboriginal children (age and sex adjusted rate ratio = 1.7 (1.7–1.7)). Rate differences and rate ratios declined with age from 94/1000 person-years and 1.9, respectively, for children aged <2 years to 5/1000 person-years and 1.8, respectively, for ages 12- < 14 years. Findings were similar for the subset of ambulatory care sensitive hospitalizations, but in contrast, non-avoidable hospitalization rates were almost identical in Aboriginal (10.1/1000 person-years, (9.6–10.5)) and non-Aboriginal children (9.6/1000 person-years (9.6–9.7)).ConclusionsWe observed substantial inequalities in avoidable hospitalizations between Aboriginal and non-Aboriginal children regardless of where they lived, particularly among young children. Policy measures that reduce inequities in the circumstances in which children grow and develop, and improved access to early intervention in primary care, have potential to narrow this gap.Electronic supplementary materialThe online version of this article (doi:10.1186/s12887-016-0706-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Inequalities in pediatric avoidable hospitalizations between Aboriginal and non-Aboriginal children in Australia: a population data linkage study

et al. 2016

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“…No studies were excluded based solely on the assessment of methodological quality. Only 13 [Hallett and O'Rourke, 2002;Endean et al, 2004;Australian Institute of Health and Welfare, 2007;Brennan et al, 2007;Lawrence et al, 2008;Kapellas et al, 2014;Arrow, 2016;Jamieson et al, 2016a;Miranda et al, 2018;Shi et al, 2018;Simangwa et al, 2018;Haag et al, 2020;Arantes et al, 2021] studies of 43 answered "yes" for each critical appraisal question, achieving a score of 9 out of 9. The lowest score was 5, observed in studies by Jamieson et al [2007b] and Gowda et al [2009] as these studies failed to mention the sampling frame, methods for sampling participants, and sample size calculation.…”

Section: Methodological Qualitymentioning

confidence: 99%

“…Another reason for exclusion was variations in measurement of den-tal caries prevalence for both the case and control groups. Therefore, a total of 43 articles [Schamschula et al, 1980;de Muñiz, 1985;del Rio Gomez, 1991;Jones et al, 1992;Rao and Bharambe, 1993;Grim et al, 1994;Davies et al, 1997;Hallett and O'Rourke, 2002;Endean et al, 2004;Schroth et al, 2005;Zeng et al, 2005;Jamieson et al, 2006a, b;Australian Institute of Health and Welfare, 2007;Jamieson et al, 2007a, b;Brennan et al, 2007;Lawrence et al, 2008;Medina et al, 2008;Gowda et al, 2009;Lawrence et al, 2009;Phelan et al, 2009;Jamieson et al, 2010a, b;Dogar et al, 2011;Foster Page and Murray Thomson, 2011;Page and Thomson, 2011;Singh et al, 2011;Kumar et al, 2013;Kapellas et al, 2014;Drummond et al, 2015;John et al, 2015 2015; Shen et al, 2015;Arrow, 2016;Jamieson et al, 2016a;Schuch et al, 2017;Miranda et al, 2018;Shi et al, 2018;Simangwa et al, 2018;Haag et al, 2020;Arantes et al, 2021] met the inclusion criteria and were included in this review for descriptive analysis. A total of 34 articles were included for meta-analysis...…”

Section: Study Selectionmentioning

confidence: 99%

Dental Health Inequalities among Indigenous Populations: A Systematic Review and Meta-Analysis

Nath¹,

Poirier²,

Ju³

et al. 2021

Caries Res

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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.

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“…A recent report of the oral health of school children examined within the School Dental Service (SDS) in WA showed that Aboriginal children had nearly twice the decay experience of nonAboriginal children in both deciduous and permanent teeth, and 1.8 times and 2.4 times the number of carious deciduous and permanent teeth, respectively, after controlling for exposure to community water fluoridation and socio-economic level 17 . Also, although the rate of admission for hospitalbased care has increased for Aboriginal children, and is now approaching the rate of non-Indigenous children, it is lower for Aboriginal children in rural and remote areas.…”

Section: Aboriginal Oral Healthmentioning

confidence: 99%

Minimally Invasive Dentistry Based on Atraumatic Restorative Treatment to Manage Early Childhood Caries in Rural and Remote Aboriginal Communities: Protocol for a Randomized Controlled Trial (Preprint)

Arrow¹,

McPhee²,

Atkinson³

et al. 2018

Preprint

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BACKGROUND The caries experience of Aboriginal children in Western Australia (WA) and elsewhere in Australia is more than twice that of non-Aboriginal children. Early childhood caries (caries among children <6 years) has a significant impact on the quality of life of children and their caregivers, and its management is demanding and commonly undertaken under general anesthesia. A randomized controlled trial using a minimally invasive dentistry approach based on Atraumatic Restorative Treatment (ART) in metropolitan Perth, WA, has demonstrated a significant reduction in the rate of referral to a dental specialist for dental care among children with early childhood caries, potentially reducing the need for treatment under general anesthesia. The tested approach was clinically successful and was without adverse effects on child dental anxiety. The model of ART-based primary care requires further testing and development if similar outcomes for Aboriginal children in remote and rural settings are to be achieved. OBJECTIVE The study aims to develop, implement, and evaluate a remote primary care model to deliver effective primary dental services, encompassing treatment and preventive services, to Aboriginal preschool children (based on minimally invasive approaches including ART). METHODS This is a two-arm parallel cluster randomized controlled study in which a test group will be provided with the intervention treatment at the start of the study and a control group will be provided with the intervention treatment 12 months after study commencement (delayed intervention). Participating communities, stratified by size of community (ie, number of children in the sample frame) and baseline caries experience, will be randomly assigned using a computer-generated block randomized list into immediate (test group) or delayed intervention (control group; provided with standard care). Informed consent will be obtained from all participants. Aboriginal research assistants will explain the study to the parents and assist the parents in completing the questionnaires. Participants in the randomized study will be examined at baseline and at 12 months follow-up by a calibrated examiner. Test group participants will subsequently be contacted and appropriate appointments coordinated for treatment. Control group participants will be provided with standard preventive care by the Aboriginal Health Workers and managed for treatment as per standard procedures. RESULTS Community consultations have been undertaken and 26 communities have agreed to participate. Fieldwork is in progress to recruit study participants. CONCLUSIONS The significance of the study lies in its holistic approach to testing the model of care. Clinical evaluations as well as oral health‒related quality of life evaluations will be undertaken. Cost-effectiveness and cost-utility evaluations will assist in the development of policy options for oral health services for rural and remote communities. The elicitation of caregiver perspectives through focus group interviews will supplement the clinical, psychosocial, and cost-utility evaluations and provide a richer evaluation of the intervention. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12616001537448; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371735 (Archived by WebCite at http://www.webcitation.org/70UMxndFZ) REGISTERED REPORT IDENTIFIER RR1-10.2196/10322

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Oral health of schoolchildren in Western Australia

Cited by 11 publications

References 16 publications

Inequalities in pediatric avoidable hospitalizations between Aboriginal and non-Aboriginal children in Australia: a population data linkage study

Inequalities in pediatric avoidable hospitalizations between Aboriginal and non-Aboriginal children in Australia: a population data linkage study

Dental Health Inequalities among Indigenous Populations: A Systematic Review and Meta-Analysis

Minimally Invasive Dentistry Based on Atraumatic Restorative Treatment to Manage Early Childhood Caries in Rural and Remote Aboriginal Communities: Protocol for a Randomized Controlled Trial (Preprint)

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