Australian Research Centre for Population Oral Health publications

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Browsing Australian Research Centre for Population Oral Health publications by Author "Brennan, D."

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    Atraumatic Restorative Treatments in Australian Aboriginal Communities: A Cluster-randomized Trial
    (SAGE Publications, 2020) Arrow, P.; Piggott, S.; Carter, S.; McPhee, R.; Atkinson, D.; Mackean, T.; Kularatna, S.; Tonmukayakul, U.; Brennan, D.; Nanda, S.; Palmer, D.; Jamieson, L.
    INTRODUCTION: The management of early childhood caries (ECC) is challenging. OBJECTIVES: A model of care based on Atraumatic Restorative Treatment and the Hall Technique (ART-HT) to manage ECC was evaluated among remote Aboriginal communities in Australia. METHODS: Aboriginal communities in the North-West of Western Australia were invited to participate and consenting communities were randomized into early or delayed intervention for the management of ECC. Children were examined at baseline and at the 11-mo follow-up. The early intervention group (test) was provided with the ART-based dental care at baseline while the delayed intervention group (control) was advised to seek care through the usual care options available within the community. At follow-up, both groups were examined by calibrated examiners, and were offered care using the ART-HT approach. Changes from baseline to follow-up in caries experience were tested using paired tests. Multivariate analysis after multiple imputation of missing data used generalised estimating equation (GEE) controlling for clustering within communities. RESULTS: A total of 25 communities and 338 children (mean age = 3.6 y, SD 1.7) participated in the study (test = 177). At follow-up, 231 children were examined (68% retention, test = 125). At follow-up, children in the test group had more filled teeth (test filled teeth = 1.2, control filled teeth = 0.2, P < 0.001) and decreased levels of decayed teeth (mean test = 0.7 fewer teeth with decay, mean control = 1.0 more tooth with decay, P < 0.001). GEE analysis controlled for baseline caries experience, age, sex, and community water fluoride levels found increased rates of untreated decayed teeth (RR = 1.4, P = 0.02) and decreased rates of filled teeth (RR = 0.2, P < 0.001) at follow-up among the control group. CONCLUSION: A model of care relying on the principles of minimally invasive atraumatic approaches enabled the delivery of effective dental services to young children (<6 y) in remote Aboriginal Australian communities resulting in increased levels of care and improved oral health. KNOWLEDGE TRANSFER STATEMENT: This cluster-randomized trial tested a multi-component model of dental care to young children with ECC in remote Aboriginal communities in Australia. The intervention, based on the atraumatic approaches using minimally invasive techniques encompassing preventive care, Atraumatic Restorative Treatment and the Hall Technique (ART-HT), delivered more restorative care and reduced the incidence of caries. This model of care was more effective than available standard care and should be incorporated into mainstream service delivery programs.
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    Longitudinal comparison of factors influencing choice of dental treatment by private general practitioners
    (Australian Dental Assn Inc, 2006) Brennan, D.; Spencer, A.; Australian Research Centre for Population Oral Health
    Background: Service rate variations and appropriateness of care issues have focused attention on factors that influence treatment decisions. The aims of this study were to examine what factors dentists consider in choosing alternative treatments, the stability of these factors over time and whether stability of treatment choice was related to age of dentist. Methods: Baseline data were collected by mailed self-complete questionnaires from a random sample of Australian dentists (response rate=60.3 per cent, n=345 private general practitioners provided service data from a typical day) in 1997–1998 and followup data were collected in 2004 (response rate=76.8 per cent, n=177 matched longitudinal cases). Results: The most frequent factors considered important across six alternative treatment pair choice scenarios were caries rate for ‘exam v. x-ray’, age of patient for ‘preventive v. restorative intervention’, cost of treatment for ‘crown v. buildup’, ‘root canal v. extraction’ and ‘bridge v. denture’, and calculus for ‘prophylaxis v. scaling’. The only differences over time were (t-test, P<0.05): higher proportions of responses in the mouth status group at follow-up for ‘exam v. x-ray’; higher proportions of responses in the visit history group at follow-up for ‘preventive v. restorative intervention’; a lower proportion of responses in the caries group at follow-up for ‘crown v. build-up’; and a higher proportion of responses in the treatment constraints group at follow-up for ‘prophylaxis v. scaling’. Conclusions: While a wide range of responses were offered as factors influencing the choice of alternative treatments, cost of treatment was a major consideration in situations where significantly cheaper alternatives existed, while patient preference was commonly included as a secondary consideration across a wide range of treatment choice scenarios. The treatment choice responses showed a high degree of stability over time across all age groups of dentists, suggesting that if routines are developed these are established before or soon after graduation as a dentist.
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    Oral health perceptions
    (The University of Adelaide, 2019) Brennan, D.; Luzzi, L.; Ellershaw, A.; De Anselmo Peres, M.; Australian Research Centre for Population Oral Health,
    Oral health examination surveys measure visible signs of oral disease and its treatment, providing indicators of impairment. Yet, there are many aspects of oral health that cannot be assessed systematically during a standardised oral epidemiological examination, including pain, function and quality of life (Slade & Sanders 2003). This chapter adds to the examination findings presented in Chapter 4 by describing rates of pain and difficulty eating due to oral problems. In addition, perceived needs for the most common dental treatments are presented to provide an additional indicator of subjective oral health in the Australian adult population.
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    Positive and negative affect and oral health-related quality of life
    (BioMed Central Ltd., 2006) Brennan, D.; Singh, K.; Spencer, A.; Roberts-Thomson, K.; Australian Research Centre for Population Oral Health
    Background: The aims of the study were to assess the impact of both positive (PA) and negative affect (NA) on self-reported oral health-related quality of life and to determine the effect of including affectivity on the relationship between oral health-related quality of life and a set of explanatory variables consisting of oral health status, socio-economic status and dental visiting pattern. Methods: A random sample of 45–54 year-olds from metropolitan Adelaide, South Australia was surveyed by mailed self-complete questionnaire during 2004–05 with up to four follow-up mailings of the questionnaire to non-respondents (n = 986 responded, response rate = 44.4%). Oral health-related quality of life was measured using OHIP-14 and affectivity using the Bradburn scale. Using OHIP-14 and subscales as the dependent variables, regression models were constructed first using oral health status, socio-economic characteristics and dental visit pattern and then adding PA and NA as independent variables, with nested models tested for change in R-squared values. Results: PA and NA exhibited a negative correlation of -0.49 (P < 0.01). NA accounted for a larger percentage of variance in OHIP-14 scores (3.0% to 7.3%) than PA (1.4% to 4.6%). In models that included both PA and NA, PA accounted for 0.2% to 1.1% of variance in OHIP-14 scores compared to 1.8% to 3.9% for NA. Conclusion: PA and NA both accounted for additional variance in quality of life scores, but did not substantially diminish the effect of established explanatory variables such as oral health status, socio-economic status and dental visit patterns.
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    Practice profiles of Australian private general dental practitioners
    (Australian Dental Assn Inc, 2006) Brennan, D.; Spencer, A.; Australian Research Centre for Population Oral Health
    In Australia, the vast majority of dental practitioners are in the private sector (83 per cent). The provision of oral health services is dominated by general practitioners (85 per cent), with a small percentage of practitioners in specialist and restricted practice (12 per cent), and the remainder in areas such as administration, teaching and research. This paper describes the profile of patients and their presenting conditions among private general dental practitioners in 2003–2004.
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    Trends in oral health and use of dental services 1987-2017
    (The University of Adelaide, 2019) Brennan, D.; Luzzi, L.; Chrisopoulos, S.; Australian Research Centre for Population Oral Health,
    This chapter evaluates trends in oral health and use of dental services in the Australian population over a 30-year period. The trends are based on comparisons of data from three Australian surveys of adult oral health. These sources comprise the National Oral Health Survey of Australia 1987–88, the National Survey of Adult Oral Health from 2004–06 and the National Study of Adult Oral Health 2017–18.