Risk factors for dental caries in small rural and regional Australian communities

Abstract

Introduction: Dental decay (caries) can cause pain, infection and tooth loss, negatively affecting eating, speaking and general health. People living in rural and regional Australian communities have more caries, more severe caries and more untreated caries than those in the city. The unique environmental conditions and population groups in these communities may contribute to the higher caries burden. In particular, some towns lack community water fluoridation, and some have a high proportion of Aboriginal people, who have significantly worse oral health than their non-Aboriginal counterparts. Because of these and other unique circumstances, mainstream research on caries risk factors may not apply in these settings. This study aimed to gather contemporary oral health data from small rural or regional Australian communities, and investigate caries risk factors in these communities. Methods: A cross-sectional survey consisting of a standardized dental examination and questionnaire was used to measure the oral health of 434 children (32% Aboriginal) aged 3-12 years in three small rural or regional areas. Oral health was determined as the deciduous and permanent decayed, missing and filled teeth (dmft/DMFT), and the proportion of children without caries. Risk factors were investigated by logistic regression. Results: The dmft/DMFT for children in this study was 1.5 for 5-6 year olds and 1.0 for 11-12 year olds (index groups reported). Independent predictors of having caries (Yes/No) were age group, holding a concession card (OR=2.45, 95%CI=1.58-3.80) and tooth-brushing less than twice per day (OR=2.11, 95% CI=1.34-3.34). Aboriginal status also became a significant variable under © A Zander, S Sivaneswaran, J Skinner, R Byun, B Jalaludin, 2013. A licence to publish this material has been given to James Cook University, http://www.rrh.org.au 2 sensitivity analyses (OR 1.9, CI 1.12-3.24) when the tooth-brushing variable was removed. Gender, water fluoridation and parental education were not significant predictors of caries in these communities.Conclusions: The rural/remote children in this study had worse oral health than either state or national average in both the 5-6 year old and 11-12 year age group. Socioeconomic status, tooth-brushing and Aboriginal status were significantly associated with caries in these communities. To close the substantial gap in oral health outcomes between rural and metropolitan residents, approaches that target rural areas, Aboriginal people and those from low socioeconomic backgrounds are needed.

Oral health status, behaviours, food and beverage consumption of aboriginal children in Australia

“…Although it is hard to know how many of these children brushed twice a day, the figures reported are higher than population data where 56% Aboriginal and Torres Strait Islander children aged 5‐14 years residing in major cities are reported to brush twice or more a day 26 . A recent study involving Aboriginal children in regional NSW also found only half of all children (49%) brushed their teeth more than once a day 31 . Adding to these findings is the fact that nearly all the children owned their own tooth brush which is essential as sharing tooth brushes can increase the risk of developing dental decay due to transmission of bacteria 32 .…”

“…26 A recent study involving Aboriginal children in regional NSW also found only half of all children (49%) brushed their teeth more than once a day. 31 Adding to these findings is the fact that nearly all the children owned their own tooth brush which is essential as sharing tooth brushes can increase the risk of developing dental decay due to transmission of bacteria. 32 In addition, close to two-thirds of children were using standard toothpaste (62%) at nine years compared to children's toothpaste, a jump of 20% from the previous time point.…”

Prevalence and risk factors of oral cavity parasites in pregnant women in Western Iran

“…In consistent with our findings, the studies conducted by Derikvand et al (2018) and Mahmoudvand et al, (2018) have reported a significant correlation between teeth brushing and the prevalence of E. gingivalis and T. tenax ( Derikvand , 2018 ; Mahmoudvand et al, 2018 ) . Previous studies have reported people living in rural regions poor due to lack of attention to oral health, more frequency of tooth loss and gum diseases was observed ( Zander et al, 2013 ; Chen, 2018 ). Similarly, our findings showed that there was a significant correlation between living in rural regions and the frequency of E. gingivalis and T. tenax; this considerable prevalence in rural communities may be due to some factors such as the low compliance with health standards, lower educational level, more contact between people, and lack of access to health services ( Coughlin et al, 2019 ).…”

Missed opportunities for improving oral health in rural Victoria: The role of municipal public health planning in improving oral health

“…38 Despite repeated calls for a focus on social determinants and a common risk factor approach to oral health promotion, 22 , 23 high rates of preventable oral disease remain. 2 , 12 People living in rural and regional Australian communities have more caries, more severe caries and more untreated caries than those in urban areas 4 , 19 , 39 ; they also experience higher rates of potentially preventable hospital admissions due to dental conditions. 6 , 12…”