Australian Research Centre for Population Oral Health publications

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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.
Open Access
Australian dentist labour force 2003
(Australian Dental Assn Inc, 2006) Teusner, D.
This report presents results from the 2003 dentist labour force data collection and makes comparisons with data from previously published collections, 1994 and 2000. This report aims to identify labour force trends between 2000 and 2003, and examines the impact of those trends on the supply of dentist visits in Australia.
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Dental care
(The University of Adelaide, 2019) Chrisopoulos, S.; Luzzi, L.; Ellershaw, A.; Australian Research Centre for Population Oral Health,
Several approaches are used to describe access to dental care among populations. While the most common approaches are focussed on the last dental visit, how long ago it occurred, and the place of the visit, there is also a strong interest in capturing a longer-term view of people’s access to dental care. Another approach asks people about their usual pattern of visits to a dentist. This section uses both approaches, and additionally describes people's experience of financial barriers in obtaining dental care.
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Dental caries experience among young Australian adults
(Australian Dental Assn Inc, 2010) Mejia, G.
Open Access
Dental fear in Australia: who's afraid of the dentist?
(Australian Dental Assn Inc, 2006) Armfield, J.; Spencer, A.; Stewart, J.; Australian Research Centre for Population Oral Health
Background: This study aimed to describe both the prevalence of dental fear in Australia and to explore the relationship between dental fear and a number of demographic, socio-economic, oral health, insurance and service usage variables. Methods: A telephone interview survey of a random sample of 7312 Australian residents, aged five years and over, from all states and territories. Results: The prevalence of high dental fear in the entire sample was 16.1 per cent. A higher percentage of females than males reported high fear (HF). Adults aged 40–64 years old had the highest prevalence of high dental fear with those adults aged 80+ years old having the least. There were also differences between low fear (LF) and HF groups in relation to socioeconomic status (SES), with people from higher SES groups generally having less fear. People with HF were more likely to be dentate, have more missing teeth, be covered by dental insurance and have a longer time since their last visit to a dentist. Conclusions: This study found a high prevalence of dental fear within a contemporary Australian population with numerous differences between individuals with HF and LF in terms of socioeconomic, socio-demographic and self-reported oral health status characteristics.
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Diasporas, development and engagement in Australia’s Asian century
(Springer, 2016) Hugo, G.; Chickanda, A.; Crush, J.; Walton-Roberts, M.
Open Access
Hospitalized head injuries among older people in Australia, 1998/1999 to 2004/2005
(B M J Publishing Group, 2007) Jamieson, L.; Roberts-Thomson, K.; Australian Research Centre for Population Oral Health
Objective: To explore rates of hospitalized head injury among older Australians by a range of risk indicators. Design: Head injury data for 60+-year-olds were obtained from the Australian Institute of Health and Welfare Hospital Morbidity Database from 1998/1999 to 2004/2005. Poisson regression modeling was used to examine head injury rates in relation to age, sex, Indigenous status, location, and injury type. Results: Rates of hospitalized head injury among the older population increased 1.4-fold between 1998/1999 (582.8 per 100 000) and 2004/2005 (844.3 per 100 000) (p<0.001). Those aged 85+ years had 10.8 times the rate of their 60–64-year-old counterparts (95% CI 10.6 to 11.0) after adjustment for other covariates. Men had 1.1 times the rate of women (95% CI 1.1 to 1.2), and those living in rural/remote areas had 3.1 times the rate of their metropolitan-dwelling counterparts (95% CI 3.0 to 3.1). Those identifying themselves as Indigenous had 1.7 times the rate of non-Indigenous persons (95% CI 1.6 to 1.8). The most prevalent injuries were open wounds of the head (38.0%), followed by superficial injuries (24.7%) and intracranial trauma (18.3%). Falls accounted for 81.4% of all head injury admissions. Conclusions: The oldest old were disproportionately represented among those sustaining hospitalized head injuries, along with men, those living in rural/remote areas, and Indigenous persons. Given the increasing proportion of older people in Western societies and the costs of treating hospitalized head injuries, the ability to reduce risk of such trauma in this age group is of critical public health importance.
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Indigenous child oral health at a regional and state level
(Blackwell Publishing Asia, 2007) Jamieson, L.; Parker, E.; Armfield, J.; Australian Research Centre for Population Oral Health
Aim: To compare the dental disease experience of Indigenous and non-Indigenous children in South Australia’s mid-north region (regional area) and to assess Indigenous oral health differences at a regional- and state-level. Methods: Data were collected from a School Dental Service based in an Aboriginal-owned medical health service and standard school dental clinics in the regional area from March 2001 to March 2006. State-level data were obtained over a 12-month period in 2003. Caries prevalence (per cent dmft or DMFT >0) and severity (mean dmft or DMFT, SiC and SiC10) measures were used to assess dental disease experience. Results: In the regional area, Indigenous children aged <10 years had 1.6, 1.9, 1.6 and 1.4 times the percent dmft >0, mean dmft, SiC primary and SiC10 primary, respectively, of their non-Indigenous counterparts, while Indigenous children aged 6+ years had 1.3, 1.7, 1.7 and 1.6 times the percent DMFT > 0, mean DMFT, SiC permanent and SiC10 permanent, respectively, of non-Indigenous children. Indigenous children in the regional area had significantly higher caries prevalence and severity than Indigenous children at a state-level. Conclusion: Indigenous children in South Australia’s mid-north region are dentally disadvantaged in comparison with their non-Indigenous counterparts and with the general South Australian Indigenous child population.
Open Access
Influence of fear of pain and coping strategies on health-related quality of life and patient-anticipated outcomes in patients with chronic pain: cross-sectional study protocol
(JMIR Publications, 2017) Mittinty, M.M.; Brennan D,; Randall, C.L.; McNeil, D.W.; Mittinty, N.M.; Jamieson, L.M.
Background: Fear of pain and coping strategies are emotional-behavioral responses to pain and are known to play an important role in the development and maintenance of pain. It is highly likely that fear of pain and coping strategies influence each other, potentially affecting the course of chronic pain. To our knowledge, the relationship between pain, fear of pain and coping strategies, and how they influence patient-anticipated outcomes and health-related quality of life, have not been investigated. Objective: The aims of this study are to test (1) if both fear of pain and/or coping strategies are sufficient causes for maintaining pain; and (2) whether fear of pain influences coping strategies and pain intensity. The study will also examine the impact of fear of pain and coping strategies on health-related quality of life and patient-anticipated outcomes. Methods: The cross-sectional study will be conducted using an online survey. The Fear of Pain Questionnaire-III (FPQ-III), the Brief Coping Inventory (COPE), and EuroQoL-5d (EQ-5D) validated questionnaires will be used to collect data. Information pertaining to demographic factors, pain-related factors, and patient-anticipated outcomes will also be collected. The study has ethics approval from the Human Research Ethics Committee of the University of Adelaide. Study participants will be individuals aged 18 years and above who are experiencing chronic pain (ie, pain lasting more than 6 months). Effect measure modification technique (EMMM) will be used to examine if fear of pain acts as a moderator or mediator between coping strategies and pain. Simple and multinomial logistic regression analysis will be used to examine the effect of fear of pain and coping strategies on health-related quality of life and patient-anticipated outcomes. Results: Recruitment began July 2017 and it is anticipated that data collection will be completed by October 2017. Findings from this study will help to extend our understanding of fear of pain and coping strategies, their interaction, and their impact on health-related quality of life and patient-anticipated outcomes. Conclusions: Fear of pain and coping strategies have significant influence on the experience of chronic pain and its course. This study will help enhance our understanding of the relationship between fear of pain and coping strategies, which may help in developing patient-centered care practices.
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Internal and International Migration in East and Southeast Asia: Exploring the Linkages
(Wiley, 2016) Hugo, G.
Copyright status unknown
Open Access
Intra-oral distribution of caries in South Australian children
(Australian Dental Assn Inc, 2006) Armfield, J.; Spencer, A.
The Child Dental Health Survey (CDHS), a national surveillance survey of child oral health, is one of the longest running national health data collections in Australia. Commencing in 1977 under the auspices of the then Commonwealth Department of Health, the annual survey has documented an appreciable improvement in Australian children’s caries experience.
Open Access
Job satisfaction of registered dental practitioners
(Australian Dental Assn Inc, 2005) Luzzi, L.; Spencer, A.; Jones, K.; Teusner, D.
Background: This study was designed to measure job satisfaction among registered clinical dentists so as to identify issues which may influence recruitment and retention of dentists in active clinical practice. Methods: A questionnaire measuring dimensions of job satisfaction was mailed to a stratified random sample of 80 private and 80 public sector dentists selected from the 1999 Victorian Dental Register. Results: An adjusted response rate of 60 per cent was achieved (n=87). Analyses showed significant differences (ANOVA; p<0.05) in levels of satisfaction for various dimensions of job satisfaction by gender, age group and practice type. Differences in job satisfaction between male and female dentists related to the personal time dimension. Differences in satisfaction between dentists of different age groups were attributable to six dimensions: relationships with colleagues, relationships with patients, relationships with staff, personal time, community and administrative responsibilities. Differences between levels of satisfaction among private and public dentists related to the autonomy, relationships with patients, pay and resources dimensions. Conclusion: There are various dimensions of job satisfaction that may be pertinent to issues influencing recruitment and retention of dentists. Differences that exist between levels of job satisfaction among private and public sector dentists, between male and female dentists and dentists of different age groups need to be addressed in order to improve recruitment and retention rates of dentists in active clinical practice in different sectors of the dental care system.
Open Access
Limited evidence to measure the impact of chronic pain on health outcomes of indigenous people
(Elsevier, 2018) Mittinty, M.M.; McNEil, D.W.; Jamieson, L.M.
Open Access
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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Manipulating perceptions of spider characteristics and predicted spider fear: Evidence for the cognitive vulnerability model of the etiology of fear
(Pergamon-Elsevier Science Ltd, 2007) Armfield, J.; Australian Research Centre for Population Oral Health
The present study reports on an attempt to experimentally manipulate perceptions of uncontrollability, unpredictability and dangerousness related to an imaginal encounter with a spider in order to determine whether there is an effect on self-rated predicted spider fear. Experimental manipulations involved differing information in relation to both the spider and the imaginal task. The control, predictability and dangerousness manipulations all had significant main effects on task-related spider fear (TRSF). Measures of the perception of the spiders as uncontrollable, unpredictable and dangerous were also significantly associated with TRSF and accounted for 42% of the variance in predicted fear beyond that accounted for by the experimental manipulations. Results are discussed in terms of their implications for better understanding the etiology and maintenance of fear. The overall findings are consistent with the cognitive vulnerability model, with cognitive perceptions of an object or situation seen as causal determinants of the fear associated with the stimulus.
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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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Oral health status
(The University of Adelaide, 2019) Do, L.; Luzzi, L.; Australian Research Centre for Population Oral Health,
This chapter reports prevalence and severity of oral diseases and other conditions that affect the teeth and gums. They are arranged using a common format described in Chapter 2. The tables report findings regarding four sets of oral health conditions: • tooth loss, including denture wearing and replacement of missing teeth • experience of dental decay, including untreated cavities, and teeth that have been filled or extracted to treat past decay • gum diseases, including periodontitis and inflammation of the gums • other oral conditions, including tooth wear, dental fluorosis, xerostomia, lack of occlusal contact and oral mucosal lesions. The tables use information collected primarily during the examination. Interview information is limited to questions about tooth loss, denture wearing and dental implants, in response to questions about objective oral health asked in the interview. Xerostomia is also reported under other oral conditions. Other more subjective questions about experience of oral symptoms and perceived needs for dental treatment were also asked in the interview, but they are reported in Chapter 6.
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Periodontal disease and dental caries among Indigenous Australians living in the Northern Territory, Australia
(Wiley, 2014) Kapellas, K.; Skilton, M.; Maple-Brown, L.; Do, L.; Bartold, P.; O'Dea, K.; Brown, A.; Celermajer, D.; Jamieson, L.
BACKGROUND: The aim of this study was to describe the caries experience and severity of periodontal disease in a convenience sample of Indigenous Australians living in the Northern Territory. METHODS: Data were gathered via self-reported questionnaire and dental examination by calibrated examiners. Socio-demographic characteristics were compared with data from the 2011 Australian census while prevalence of periodontal disease and dental caries was compared against weighted estimates from the National Survey of Adult Oral Health 2004-2006. In each comparison, non-overlapping 95% confidence intervals inferred a significant difference. Within-study comparisons were assessed via chi-square, t-tests and analysis of variance for differences among study participants. RESULTS: A total of 312 Indigenous Australian participants provided completed data (average age 39.5 ± 10.5 years, 174 males). Of these, 87.5% were confirmed periodontitis cases; 3.5 times that of national-level estimates. The experience of untreated caries was five times that of national estimates (mean decayed 3.0 versus 0.6). Periodontitis case status was positively associated with older age, male gender and presence of diabetes. CONCLUSIONS: Periodontal disease and untreated caries were significantly more prevalent in this sample of Indigenous Australians compared to the general Australian population. The prevalence of periodontal disease was markedly higher than that previously described for Indigenous Australians.
Open Access
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.
Open Access
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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