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.
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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.
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    Study aims and methods
    (The University of Adelaide, 2019) Chrisopoulos, S.; Ellershaw, A.; Do, L.; Luzzi, L.; Australian Research Centre for Population Oral Health,
    This chapter describes the study's aims and provides details of the major methodological steps undertaken to collect data: sampling, interviews and examinations.
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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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    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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    Study participation and weighting
    (The University of Adelaide, 2019) Ellershaw, A.; Chrisopoulos, S.; Luzzi, L.; Australian Research Centre for Population Oral Health,
    This chapter provides a summary of the recruitment and classification of study participants and describes participation rates for the Interview and Examination. The potential for biased population estimates due to variation in participation rates is explored and the weighting procedure implemented to ensure the sample is representative of the target population is described. This chapter finishes with a description of population estimates derived from the weighted sample for key socioeconomic and oral health characteristics of the target population.
  • ItemOpen 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.
  • ItemOpen 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.
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    Diasporas, development and engagement in Australia’s Asian century
    (Springer, 2016) Hugo, G.; Chickanda, A.; Crush, J.; Walton-Roberts, M.
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    Internal and International Migration in East and Southeast Asia: Exploring the Linkages
    (Wiley, 2016) Hugo, G.
    Copyright status unknown
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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.
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    The moderating role of dental expectancies on the relationship between cognitive vulnerability and dental fear in children and adolescents
    (Blackwell Munksgaard, 2013) Carrillo-Diaz, M.; Crego, A.; Armfield, J.; Romero, M.; Australian Research Centre for Population Oral Health (ARCPOH)

    Objective

    Recently, cognitive approaches have been successfully applied to the understanding of child dental anxiety. Our study aimed to analyze the interplay between cognitive variables and their associations with dental fear. In particular, we proposed that the observed relationship between dental treatment-related cognitive vulnerability (i.e., uncontrollability, unpredictability, dangerousness, and disgustingness appraisals) and dental fear is moderated by the expectancies of the probability and aversiveness of negative events during dental treatments.

    Methods

    A questionnaire survey was conducted with data obtained from 179 participants (8-18 years, 55.9% female) who attended 12 randomly selected educational establishments in Madrid (Spain).

    Results

    Dental fear was associated with an irregular pattern of dental visits. As expected, cognitive vulnerability was strongly linked to dental anxiety. For those children who expected a lower likelihood of negative dental events or appraised them in a less aversive way, the relationship between cognitive vulnerability and fear was attenuated.

    Conclusions

    As dental fear and oral health are connected, the prevention and reduction of dental fear among children and adolescents might be a worthwhile target for public health interventions. Our study sheds some light on how this could be achieved, that is, by modifying the children's vulnerability appraisals as well as their fearful dental expectancies.
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    Predicting dental avoidance among dentally fearful Australian adults
    (Munksgaard Int Publ Ltd, 2013) Armfield, J.; Australian Research Centre for Population Oral Health (ARCPOH)
    Dental fear is related to poorer oral health outcomes, and this might be explained by the less frequent dental visiting of many fearful people. The objectives of this study were to investigate differences between dentally fearful people who regularly attend the dentist and fearful people who infrequently visit the dentist. A random sample of 1,082 Australians ≥ 15 yr of age completed a mailed questionnaire (response rate = 71.6%), and 191 dentate, high-fear adults (≥ 18 yr of age) were selected for further analysis. Dental avoidance was recorded if a person was currently avoiding or delaying dental care and if he/she had not been to a dentist in the previous 2 yr. Among the selected dentally fearful adults, dental avoidance was predicted by smoking status, toothbrushing frequency, coping strategy use, perceptions of dental visits as uncontrollable and unpredictable, and by anxiety relating to numbness, not knowing what the dentist is going to do, and cost. In a multivariate logistic regression model, smoking, toothbrushing, coping, and anxiety about numbness and cost remained as statistically significant predictors, with the model accounting for 30% of the variance. While several variables were associated with dental avoidance among fearful adults, the nature and causal directions of these associations remain to be established.
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    Dental caries experience among young Australian adults
    (Australian Dental Assn Inc, 2010) Mejia, G.
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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.
  • ItemOpen 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.
  • ItemOpen 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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    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.