The Impact of Policy Modifiable Factors on Inequalities in Rates of Child Dental Caries in Australia

Abstract

Background: Poor oral health in childhood can lead to adverse impacts later in life. We aimed to estimate the prevalence and population distribution of childhood dental caries in Australia and investigate factors that might ameliorate inequalities. Methods: Data from the nationally representative birth cohort Longitudinal Study of Australian Children (N = 5107), using questions assessing: The experience of dental caries during each biennial follow-up period (2–3 years to 10–11 years), socioeconomic position (SEP), and policy modifiable oral health factors. Results: The odds of dental caries were higher for children with lowest vs. highest SEP (adjusted OR (adjOR) 1.92, 95% CI 1.49–2.46), and lower where water was fluoridated to recommended levels (adjOR 0.53, 95% CI 0.43–0.64). There was no evidence of an association between caries experience and either reported sugary diet or tooth brushing. When SEP and fluoridation were considered in conjunction, compared to the highest SEP group with water fluoridation children in the lowest SEP with fluoridation had adjOR 1.54 for caries, (95% CI 1.14–2.07), and children in the lowest SEP without fluoridation had adjOR 4.06 (95% CI 2.88–5.42). For patterns of service use: The highest SEP group reported a greater percentage of service use in the absence of caries. Conclusions: Dental caries appears prevalent and is socially distributed in Australia. Policy efforts should consider how to ensure that children with dental caries receive adequate prevention and early care with equitable uptake.

Knowledge, Attitude and Practice Regarding Caries Risk Assessment and Management in General Dentists- A Cross Sectional Survey

“…Goldfeld et al showed that caries were higher in children with lower socioeconomic status. (14) Factors such as the socioeconomic status represent a few key indicators of the disease, such as the socioeconomic status, and risk factors such as microflora determines that the person is at a low, moderate and high risk of caries, although most of the research has been carried out on children. (15) The CRA is more important in people who have inadequate socioeconomic status and further attention should be paid to this group of people.…”

Guidelines for use of fluorides in Australia: update 2019

“…A secondary analysis of a nation‐wide longitudinal birth cohort study of Australian children also contributed evidence of impact of water fluoridation on socioeconomic inequalities in child oral health …”

“…A secondary analysis of a nation-wide longitudinal birth cohort study of Australian children also contributed evidence of impact of water fluoridation on socioeconomic inequalities in child oral health. 34 The 2019 Guidelines on water fluoridation Therefore, the Workshop supported the continuation of water fluoridation at current Australian levels and recommended:…”

Study of Mothers’ and Infants’ Life Events Affecting Oral Health (SMILE) birth cohort study: cohort profile

“…A number of longitudinal studies used only self-reported oral health outcomes. 10 11 Furthermore, timing of and interaction between these exposures in early childhood are potentially important. We lack crucial longitudinal evidence to comprehensively evaluate the timing and interaction between risk and protective factors influencing caries experience through childhood.…”