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Tartaglia J, Giglia R, Darby J. Developing culturally appropriate food literacy resources for Aboriginal children with Foodbank WA's Superhero Foods ®. Health Promot J Austr 2022; 33 Suppl 1:150-162. [PMID: 35194892 PMCID: PMC9790422 DOI: 10.1002/hpja.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 02/20/2022] [Indexed: 12/30/2022] Open
Abstract
ISSUE ADDRESSED In Australia, food sovereignty of traditional landowners has been marginalised by the globalisation of food systems and resulted in limited opportunities for children to experience familiar bush tucker foods as healthy choices, particularly in a school environment. Superhero Foods® themed teaching resources focus on the development of nutrition education materials that included traditional Aboriginal foods together with contemporary foods readily available in regional/remote communities. METHODS Consultation with an Aboriginal expert and Aboriginal artist; local, regional/remote teachers and stakeholders informed the development of tailored resources including food cartoon characters, school lesson plans and a storybook. The latter was guided by a resource development model. Users of the resources were surveyed to ascertain the useability, alignment with the Australian Dietary Guidelines, cross-curricular learnings and cultural relevance. RESULTS Respondents across regional/remote and urban locations completed a lesson plan and food character (clipart) survey (N = 51) and storybook survey (N = 14). Respondents advised the resources were relevant, enjoyable, engaging and culturally appropriate for all students regardless of Aboriginality. The resources provided learning opportunities for all children to enhance knowledge about Aboriginal culture and bush foods. Independent evaluation has further indicated the translation of messaging into student's knowledge and learning. CONCLUSIONS Key enablers to the success of the resource included; free online access, the highly engaging nature of the resources and adaptability to be implemented across a number of Aboriginal language groups in WA. Ensuring visual representation of healthy choices was fundamental to reinforcing nutrition messaging. Superhero Foods resources are a positive and important inclusion in the health promotion toolbox for Aboriginal children. SO WHAT?: Superhero Foods are novel nutrition education resources depicting Aboriginal foods and Aboriginal children. These food literacy resources will engage children's understanding of Aboriginal culture, improve food literacy and strengthen equitable access for regional and remote communities.
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Affiliation(s)
| | | | - Jill Darby
- School of Medical and Health ScienceEdith Cowan UniversityJoondalupAustralia
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Orr N, Gwynne K, Sohn W, Skinner J. Inequalities in the utilisation of the Child Dental Benefits Schedule between Aboriginal and non-Aboriginal children. AUST HEALTH REV 2021; 45:274-280. [PMID: 34078533 DOI: 10.1071/ah20028] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Accepted: 10/16/2020] [Indexed: 11/23/2022]
Abstract
Objectives The Child Dental Benefits Schedule (CDBS) is an Australian Government initiative providing basic dental care to children from low-income households. We sought to investigate levels of utilisation of the CDBS among Aboriginal and non-Aboriginal children to determine whether there is equal access to dental services provided through the schedule. Methods CDBS data were obtained for four financial (July-June) years (from 2013-14 to 2016-17). The data captured all claims made during this period. The data included estimates of usage by Aboriginal status, age group and Dental Benefits groups (administrative categories of related dental procedures). Results The utilisation of CDBS services was lower for Aboriginal children. However, in 2013-14, although the odds of using the schedule were higher for non-Aboriginal children (odds ratio (OR) 0.89; P<0.0001) this was reversed in 2015-16 and 2016-17 (OR 1.11 and 1.21 respectively; P<0.0001 in both years). The odds of Aboriginal children using preventive services was below that of non-Aboriginal children in 2013-14 (OR 0.82), 2014-15 (OR 0.76), 2015-16 (OR 0.83) and 2016-17 (OR 0.90; P<0.0001) in all years. Conclusions The data are encouraging with regard to equity because they show that for services overall, Australian Aboriginal and non-Aboriginal children have similar levels of utilisation. However, lower levels of the use of preventive services may indicate future inequalities in oral health among Aboriginal children. What is known about the topic? The CDBS is an Australian Government initiative aimed at improving access to dental care for children from low-income households, including for Aboriginal people. By facilitating greater access to dental care, the schedule has the potential to help address inequalities in oral health for both Aboriginal and non-Aboriginal children. What does this paper add? There are no analyses available comparing the utilisation of the CDBS by Aboriginal and non-Aboriginal children. This study compared levels of utilisation of the schedule overall and specifically for preventive services. What are the implications for practitioners? Greater efforts should be made to address inequalities in the utilisation of the CDBS between Aboriginal and non-Aboriginal children. Although there are some hopeful signs, inequalities remain that may affect the oral health of Aboriginal children. There is also potential to encourage utilisation of the CDBS for greater provision of preventive services, including targeted population oral health initiatives.
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Affiliation(s)
- Neil Orr
- Poche Centre for Indigenous Health, Edward Ford Building (A27), The University of Sydney, 2006. ; ; and The Faculty of Medicine, Health and Human Sciences, Level 3, 75 Talavera Rd, Macquarie University, NSW 2109, Australia; and Corresponding author.
| | - Kylie Gwynne
- Poche Centre for Indigenous Health, Edward Ford Building (A27), The University of Sydney, 2006. ; ; and The Faculty of Medicine, Health and Human Sciences, Level 3, 75 Talavera Rd, Macquarie University, NSW 2109, Australia
| | - Woosung Sohn
- Sydney Dental School, Westmead Centre for Oral Health, Darcy Road, Westmead, NSW 2145, Australia.
| | - John Skinner
- Poche Centre for Indigenous Health, Edward Ford Building (A27), The University of Sydney, 2006. ;
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Handsley-Davis M, Skelly E, Johnson NW, Kapellas K, Lalloo R, Kroon J, Weyrich LS. Biocultural Drivers of Salivary Microbiota in Australian Aboriginal and Torres Strait Islander Children. FRONTIERS IN ORAL HEALTH 2021; 2:641328. [PMID: 35047996 PMCID: PMC8757737 DOI: 10.3389/froh.2021.641328] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 02/15/2021] [Indexed: 11/13/2022] Open
Abstract
Australian Aboriginal and Torres Strait Islander children experience unacceptably high rates of dental caries compared to their non-Indigenous Australian counterparts. Dental caries significantly impacts the quality of life of children and their families, particularly in remote communities. While many socioeconomic and lifestyle factors impact caries risk, the central role of the oral microbiota in mediating dental caries has not been extensively investigated in these communities. Here, we examine factors that shape diversity and composition of the salivary microbiota in Aboriginal and Torres Strait Islander children and adolescents living in the remote Northern Peninsula Area (NPA) of Far North Queensland. We employed 16S ribosomal RNA amplicon sequencing to profile bacteria present in saliva collected from 205 individuals aged 4–17 years from the NPA. Higher average microbial diversity was generally linked to increased age and salivary pH, less frequent toothbrushing, and proxies for lower socioeconomic status (SES). Differences in microbial composition were significantly related to age, salivary pH, SES proxies, and active dental caries. Notably, a feature classified as Streptococcus sobrinus increased in abundance in children who reported less frequent tooth brushing. A specific Veillonella feature was associated with caries presence, while features classified as Actinobacillus/Haemophilus and Leptotrichia were associated with absence of caries; a Lactobacillus gasseri feature increased in abundance in severe caries. Finally, we statistically assessed the interplay between dental caries and caries risk factors in shaping the oral microbiota. These data provide a detailed understanding of biological, behavioral, and socioeconomic factors that shape the oral microbiota and may underpin caries development in this group. This information can be used in the future to improve tailored caries prevention and management options for Australian Aboriginal and Torres Strait Islander children and communities.
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Affiliation(s)
- Matilda Handsley-Davis
- Australian Centre for Ancient DNA, School of Biological Sciences, University of Adelaide, Adelaide, SA, Australia
- Australian Research Council Centre of Excellence in Australian Biodiversity and Heritage, University of Wollongong, Wollongong, NSW, Australia
| | - Emily Skelly
- Australian Centre for Ancient DNA, School of Biological Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Newell W. Johnson
- Menzies Health Institute Queensland, Griffith University, Gold Coast, QLD, Australia
- School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London, London, United Kingdom
- Newell W. Johnson
| | - Kostas Kapellas
- Indigenous Oral Health Unit, Australian Research Centre for Population Oral Health, Adelaide Dental School, University of Adelaide, Adelaide, SA, Australia
| | - Ratilal Lalloo
- School of Dentistry, University of Queensland, Brisbane, QLD, Australia
| | - Jeroen Kroon
- School of Dentistry and Oral Health, Griffith University, Gold Coast, QLD, Australia
| | - Laura S. Weyrich
- Australian Centre for Ancient DNA, School of Biological Sciences, University of Adelaide, Adelaide, SA, Australia
- Australian Research Council Centre of Excellence in Australian Biodiversity and Heritage, University of Wollongong, Wollongong, NSW, Australia
- microARCH Laboratory, Department of Anthropology and Huck Institutes of Life Sciences, The Pennsylvania State University, University Park, PA, United States
- *Correspondence: Laura S. Weyrich
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Martin-Kerry JM, Whelan M, Rogers J, Raichur A, Cole D, de Silva AM. Addressing disparities in oral disease in Aboriginal people in Victoria: where to focus preventive programs. Aust J Prim Health 2020; 25:317-324. [PMID: 31578164 DOI: 10.1071/py18100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 06/14/2019] [Indexed: 11/23/2022]
Abstract
The aim of this study is to determine where Aboriginal people living in Victoria attend public oral health services; whether they access Aboriginal-specific or mainstream services; and the gap between dental caries (tooth decay) experience in Aboriginal and non-Aboriginal people. Analysis was undertaken on routinely collected clinical data for Aboriginal patients attending Victorian public oral health services and the distribution of Aboriginal population across Victoria. Approximately 27% of Aboriginal people attended public oral health services in Victoria across a 2-year period, with approximately one in five of those accessing care at Aboriginal-specific clinics. In regional Victoria, 6-year-old Aboriginal children had significantly higher levels of dental caries than 6-year-old non-Aboriginal children. There was no significant difference in other age groups. This study is the first to report where Aboriginal people access public oral health care in Victoria and the disparity in disease between Aboriginal and non-Aboriginal users of the Victorian public oral healthcare system. Aboriginal people largely accessed mainstream public oral healthcare clinics highlighting the importance for culturally appropriate services and prevention programs to be provided across the entire public oral healthcare system. The findings will guide development of policy and models of care aimed at improving the oral health of Aboriginal people living in Victoria.
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Affiliation(s)
- Jacqueline M Martin-Kerry
- Department of Health Sciences, University of York, Heslington, York, YO10 5DD, UK; and Corresponding author.
| | - Martin Whelan
- Dental Health Services Victoria, 720 Swanston Street, Carlton, Vic. 3053, Australia
| | - John Rogers
- Department of Health & Human Services, 50 Lonsdale Street, Melbourne, Vic. 3000, Australia
| | - Anil Raichur
- Dental Health Services Victoria, 720 Swanston Street, Carlton, Vic. 3053, Australia; and Department of Health & Human Services, 50 Lonsdale Street, Melbourne, Vic. 3000, Australia
| | - Deborah Cole
- Dental Health Services Victoria, 720 Swanston Street, Carlton, Vic. 3053, Australia
| | - Andrea M de Silva
- Worksafe Victoria, 1 Malop Street, Geelong, Vic. 3220, Australia; and School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, Vic. 3004, Australia
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George A, Villarosa AR, Ingram S, Fatema K, Elliott K, Grace R, Kemp L, Scharkie S, Anderson C, Bucknall N, Wright DC, Comino E. Oral health status, behaviours, food and beverage consumption of aboriginal children in Australia. Health Promot J Austr 2020; 32:208-215. [PMID: 32338802 DOI: 10.1002/hpja.354] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 04/15/2020] [Accepted: 04/22/2020] [Indexed: 11/10/2022] Open
Abstract
ISSUE ADDRESSED Dental decay is prevalent among Australian Aboriginal children, yet little is known about their oral health-related behaviours. This study explored the oral health status, behaviours, food and beverage consumption of Aboriginal school children aged 7-9 years in Sydney, Australia. METHODS Parents who were part of an existing longitudinal birth cohort ("Gudaga") were surveyed when their child was between 7 and 9 years. Children (n = 110) also received oral health screening by a trained nurse. RESULTS A number of children (62%-91%) had at least one visible oral health problem across the 2 years. Around two thirds (62%-67%) of parents rated their child's oral health as excellent/very good and less than half the children (32%-45%) had received dental check-ups. Most children (79%-90%) brushed their teeth and drank water (97%) but more than half (57%-70%) also drank sugar sweetened beverages daily. CONCLUSIONS Parents are instilling good oral health behaviours, however, the oral health screening suggests children are experiencing oral health issues of which parents may be unaware. Parents also seem to be unaware of beverage consumption practices that can increase the risk of childhood decay. SO WHAT?: The findings highlight the need for greater oral health awareness among Aboriginal families on how to recognise early symptoms dental decay and risk factors like sugar sweetened beverages among school going children. This suggests that existing health promotion strategies may not be reaching many Aboriginal families in the urban areas and more culturally appropriate programs may be needed.
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Affiliation(s)
- Ajesh George
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University, South Western Sydney Local Health District, University of Sydney, Ingham Institute Applied Medical Research, Translational Health Research Institute, Liverpool, NSW, Australia
| | - Amy R Villarosa
- COHORT, Western Sydney University, South Western Sydney Local Health District, Ingham Institute Applied Medical Research, Liverpool, NSW, Australia
| | - Suzanne Ingram
- Centre for Health Equity Training, Research and Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care and Equity A Unit of Population Health, South Western Sydney Local Health District, NSW Health, A member of the Ingham Institute, Liverpool, NSW, Australia
| | - Kaniz Fatema
- Centre for Health Equity Training, Research and Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care and Equity A Unit of Population Health, South Western Sydney Local Health District, NSW Health, A member of the Ingham Institute, Liverpool, NSW, Australia
| | - Koby Elliott
- Centre for Health Equity Training, Research and Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care and Equity A Unit of Population Health, South Western Sydney Local Health District, NSW Health, A member of the Ingham Institute, Liverpool, NSW, Australia
| | - Rebekah Grace
- Translation Research and Social Innovation Group, Western Sydney University/Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Lynn Kemp
- Translation Research and Social Innovation Group, Western Sydney University/Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | - Sheryl Scharkie
- Translation Research and Social Innovation Group, Western Sydney University/Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | | | - Natasha Bucknall
- Translation Research and Social Innovation Group, Western Sydney University/Ingham Institute for Applied Medical Research, Liverpool, NSW, Australia
| | | | - Elizabeth Comino
- Centre for Health Equity Training, Research and Evaluation (CHETRE), Part of the UNSW Australia Research Centre for Primary Health Care and Equity A Unit of Population Health, South Western Sydney Local Health District, NSW Health, A member of the Ingham Institute, Liverpool, NSW, Australia
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Butten K, Johnson NW, Hall KK, Toombs M, King N, O’Grady KAF. Yarning about oral health: perceptions of urban Australian Aboriginal and Torres Strait Islander women. BMC Oral Health 2020; 20:35. [PMID: 32013981 PMCID: PMC6998210 DOI: 10.1186/s12903-020-1024-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 01/28/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Many factors influence how a person experiences oral health and how such experiences may facilitate supportive oral health behaviours. Women in particular face different challenges due to their environment, responsibilities and physiological differences to men. Within Australia, Aboriginal and Torres Strait Islander women are reported to have poorer oral health and are faced with additional barriers to supporting their oral health compared with non-Indigenous women. The objective of this paper is to report the experiences and perceptions of oral health from the perspective of urban, Aboriginal and Torres Strait Islander women. METHODS The present data derive from a descriptive study that used yarning circles and face-to-face interviews with women who were mothers/carers of urban, Aboriginal and/or Torres Strait Islander children. This was a qualitative study to investigate the impact of child oral health on families. Participants used the opportunity to share their own personal experiences of oral health as women, thus providing data for the present analyses. Information collected was transcribed and analysed thematically. RESULTS Twenty women shared their personal narratives on the topic of oral health which were reflective of different time points in their life: growing up, as an adult and as a mother/carer. Although women are trying to support their oral health across their life-course, they face a number of barriers, including a lack of information and the costs of accessing dental care. The teenage years and pregnancy were reported as important time periods for oral health support. CONCLUSIONS To improve the oral health of Indigenous Australian women, policymakers must consider the barriers reported by women and critically review current oral health information and services. Current oral health services are financially out of reach for Indigenous Australian women and there is not sufficient or appropriate, oral information across the life-course.
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Affiliation(s)
- Kaley Butten
- Queensland University of Technology, Institute of Health & Biomedical Innovation, Centre for Children’s Health Research, 62 Graham Street, South Brisbane, Qld, Brisbane, 4101 Australia
| | - Newell W. Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Gold Coast Campus, Griffith University, Qld, Gold Coast, 4222 Australia
- King’s College Dental Institute, London, UK
| | - Kerry K. Hall
- Griffith University, 170 Kessels Road, Nathan Campus, Qld, Brisbane, 4111 Australia
| | - Maree Toombs
- Rural Clinical School, The University of Queensland, 152 West St, South Toowoomba, Qld, Toowoomba, 4350 Australia
| | - Neil King
- Faculty of Health, Queensland University of Technology, Victoria Park Road, Kelvin Grove, Qld, Brisbane, 4509 Australia
| | - Kerry-Ann F. O’Grady
- Queensland University of Technology, Institute of Health & Biomedical Innovation, Centre for Children’s Health Research, 62 Graham Street, South Brisbane, Qld, Brisbane, 4101 Australia
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Butten K, Johnson NW, Hall KK, Toombs M, King N, O’Grady KAF. Impact of oral health on Australian urban Aboriginal and Torres Strait Islander families: a qualitative study. Int J Equity Health 2019; 18:34. [PMID: 30777079 PMCID: PMC6378750 DOI: 10.1186/s12939-019-0937-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Accepted: 02/11/2019] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The oral health of a child not only impacts the physical well-being of the child, but can have quality of life implications for parents and families as they endeavour to provide care and support their child's oral health needs. Within Australia, Aboriginal and Torres Strait Islander children are thought to experience a disproportionate burden of poor oral heath compared to non-Indigenous children. Despite the prevalence of oral health challenges, there are limited qualitative studies investigating the oral health experiences of families. The objective of the study was to explore 'from the perspective of urban, Aboriginal and Torres Strait Islander parents and carers' the impact child oral health has on families. METHODS Yarning circles and face-to-face interviews were used to document the experiences of (N = 20) parents of urban, Aboriginal and Torres Strait Islander children. Participants were recruited from an Aboriginal-owned and operated primary health clinic in northern Brisbane, Australia and through word of mouth. Information collected was transcribed and analysed thematically. Codes and themes were confirmed by the researcher and two participants. RESULTS The findings indicate that oral health is an important issue for urban Indigenous families and maintaining oral health to a desired standard is having emotional, physical and financial impacts. Themes identified were financial concerns, worry about the future and juggling multiple priorities, all of which were inter-related and cyclical. CONCLUSIONS Families in this study have demonstrated that with the current policy arrangements, oral health is impacting their quality of life, contributing to stress, financial challenges and at times affecting their physical health. To address these challenges, oral health education and promotion needs a multidisciplinary approach that reaches families before children are school-aged.
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Affiliation(s)
- Kaley Butten
- Queensland University of Technology, Institute of Health & Biomedical Innovation, Centre for Children’s Health Research, 62 Graham Street, South Brisbane, Qld, 4101 Australia
| | - Newell W. Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Gold Coast Campus, Griffith University, Gold Coast, Qld, 4222 Australia
- Dental Institute, King’s College London, London, UK
| | - Kerry K. Hall
- Griffith University, 170 Kessels Road, Nathan Campus, Qld, 4111 Australia
| | - Maree Toombs
- Rural Clinical School, The University of Queensland, 152 West St, South Toowoomba, Qld, Toowoomba, 4350 Australia
| | - Neil King
- Faculty of Health, Queensland University of Technology, Queensland, Victoria Park Road Kelvin Grove, Qld 4509 Australia
| | - Kerry-Ann F. O’Grady
- Queensland University of Technology, Institute of Health & Biomedical Innovation, Centre for Children’s Health Research, 62 Graham Street, South Brisbane, Qld, 4101 Australia
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Butten K, Johnson NW, Hall KK, Anderson J, Toombs M, King N, O'Grady KF. Risk factors for oral health in young, urban, Aboriginal and Torres Strait Islander children. Aust Dent J 2018; 64:72-81. [PMID: 30375649 PMCID: PMC6392135 DOI: 10.1111/adj.12662] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2018] [Indexed: 11/26/2022]
Abstract
Background The caries process follows a strong social gradient which can commence in the first years of life. Yet data on young children remain limited. This study reports the potential risk factors and indicators in urban, Aboriginal and Torres Strait Islander children aged less than 5 and estimates the prevalence of caries. Methods Demographic and risk factor and risk indicator data were collected at baseline in a cohort study of children attending a health clinic in north Brisbane. Dentulous children received a basic oral examination to explore the presence of decayed, missing and filled teeth (dmft). Descriptive analyses were performed. A backwards stepwise logistic regression model was performed to identify potential associations with dmft status. Results In this study, 180 children enrolled: 111 children received the oral examination, of whom 14 (12.6%) (mean age 35 months) were estimated to have dmft >0. There was a high prevalence of socio‐economic, dietary and behavioural risk factors/indicators present for children. Due to the small sample size, planned regression was not performed. Conclusions Overall, the prevalence of risk factors and risk indicators for caries in the study population is high. More culturally appropriate resources that support preventive care need to be invested before children are school aged.
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Affiliation(s)
- K Butten
- Queensland University of Technology, Institute of Health & Biomedical Innovation, Centre for Children's Health Research, South Brisbane, Queensland, Australia
| | - N W Johnson
- Menzies Health Institute Queensland and School of Dentistry and Oral Health, Griffith University, Gold Coast, Queensland, Australia.,Dental Institute, King's College London, London, UK
| | - K K Hall
- Caboolture Community Medical, Caboolture, Queensland, Australia
| | - J Anderson
- Caboolture Community Medical, Caboolture, Queensland, Australia
| | - M Toombs
- Rural Clinical School, The University of Queensland, South Toowoomba, Queensland, Australia
| | - N King
- Faculty of Health, Queensland University of Technology, Kelvin Grove, Queensland, Australia
| | - K F O'Grady
- Queensland University of Technology, Institute of Health & Biomedical Innovation, Centre for Children's Health Research, South Brisbane, Queensland, Australia
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