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Jones A, Sturrock A, Elliott E, Gussy M, Maidment I, Nelson D, Chew-Graham CA, Aggarwal VR. Community pharmacists' perceptions on managing people with oral health problems-A prioritisation survey. J Oral Rehabil 2024; 51:851-860. [PMID: 38225810 DOI: 10.1111/joor.13657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 06/29/2023] [Accepted: 01/05/2024] [Indexed: 01/17/2024]
Abstract
BACKGROUND Alternative sources of oral health information are likely to be of benefit to the public, particularly where access to dental services is limited. There is evidence that community pharmacists are willing to advocate for oral health, but it is unclear what is needed to develop this role. OBJECTIVES The aims of this study were to obtain the views of community pharmacy staff on the frequency and type of oral health conditions they encounter challenges in management and training/research priorities. METHODS An anonymous online survey targeted pharmacy staff and elicited quantitative data related to the types and frequencies of oral health conditions experienced. Participants were stratified by age, gender, ethnicity, experience and setting. Free text responses allowed participants to detail challenging aspects of patient management, their priorities for service development and future research. Reflexive thematic analysis of free text responses identified key themes. RESULTS Oral/facial pain and swelling were seen weekly by most respondents, and daily by 28.8%. Other commonly presenting conditions were ulcers, dry-mouth, thrush and denture issues. Challenges in managing oral health conditions included: access to NHS dentistry, awareness of referral pathways, examination/diagnosis and understanding 'Red Flags'. CONCLUSION Acute and chronic oral health conditions commonly present to community pharmacists who lack necessary knowledge/training, which may result in missing 'red flag' symptoms for oral cancer or acute facial swellings which can be life threatening. There is a need to support pharmacists, who are willing to act as oral health advocates, in recognition, prevention and onward referral for oral diseases.
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Affiliation(s)
- Adam Jones
- School of Dentistry, University of Leeds, Leeds, UK
| | - Andrew Sturrock
- Department of Nursing, Midwifery and Health, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne, UK
| | - Emma Elliott
- School of Dentistry, University of Leeds, Leeds, UK
| | - Mark Gussy
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
| | - Ian Maidment
- Pharmacy, College of Health and Life Sciences, Aston University, Birmingham, UK
| | - David Nelson
- Lincoln International Institute for Rural Health, University of Lincoln, Lincoln, UK
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Idris S, Aghanwa S, O'Halloran J, Durey A, Slack-Smith L. Homebound oral care for older adults: A qualitative study of professional carers' perspectives in Perth, Western Australia. Gerodontology 2024; 41:94-100. [PMID: 37454389 DOI: 10.1111/ger.12704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE To examine professional support workers and case managers' (professional carers) perspectives of what promoted or compromised oral health care in homebound adults aged over 65 years in Perth, Western Australia and identify professional carers' need for support in this context. BACKGROUND Accessing dental services can be difficult to navigate and unaffordable for homebound older adults. Paid carers often play a substantial role in facilitating access to services yet there is limited qualitative evidence of the perspectives of these stakeholders. METHODS Given limited evidence in this area, this simple qualitative study was informed by constructivist grounded theory. Participants comprised 15 professional carers of homebound older adults. Transcripts were analysed to identify participant perceptions of key barriers and enablers to providing oral health care. RESULTS Barriers to clients accessing dental care included participants' uncertainty around navigating the dental system, low priority of oral health care, affordability and confusion around who was responsible to provide oral care. Enablers included participants supporting clients' autonomy around oral care, better integration of oral care into primary health care and education and opportunity for training for professional carers. CONCLUSION Ensuring oral health is part of primary health plans, clarifying roles and responsibilities around delivering oral health care to homebound older adults and training carers were key findings. Inter-sectoral collaboration between the dental and aged care sectors can benefit dental practitioners and professional carers in shared learning and has likely flow-on effects for homebound older adults.
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Affiliation(s)
- Safaa Idris
- UWA Dental School, University of Western Australia, Perth, WA, Australia
| | - Somto Aghanwa
- UWA Dental School, University of Western Australia, Perth, WA, Australia
| | | | - Angela Durey
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
| | - Linda Slack-Smith
- School of Population and Global Health, University of Western Australia, Perth, WA, Australia
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Patterson-Norrie T, Ramjan L, Sousa MS, Kezhekkekara S, George A. Oral health knowledge, attitudes and practices of dietitians in Australia: A national survey. Health Promot J Austr 2024. [PMID: 38192008 DOI: 10.1002/hpja.840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 12/18/2023] [Accepted: 12/22/2023] [Indexed: 01/10/2024] Open
Abstract
AIM Dietitians are a well-placed profession to be providing pre-emptive oral health promotion. Despite recommendations that oral health promotion should be routinely part of dietetic practice, there is limited data informing the current practices of clinical dietitians in this area across Australia. Hence, the aim of this study was to investigate the knowledge and practices of Australian dietitians and oral health promotion. METHODS A cross-sectional survey was undertaken involving registered clinical dietitians in Australia using purposive and snowballing sampling (social media/dietetic organisations/public databases). Data were analysed using descriptive and inferential statistics. RESULTS A total of 149 dietitians participated in the national survey. Overall, dietitians were knowledgeable about oral health risk factors and preventative measures across general health domains. Majority of dietitians agreed that oral health can affect nutrition interventions (95.5%) and dietitians should be discussing oral health (88.0%). However, nearly half were not confident in providing counselling or education and felt that undergraduate training for oral health promotion was inadequate (78.2%). A small proportion (6.0%) of dietitians were already providing oral health promotion regularly. Key barriers included a lack of clear guidelines for practice, limited training opportunities and indistinct referral pathways. CONCLUSION Dietitians have acknowledged that oral health promotion should be incorporated into their practice. However, they are challenged by a lack of resources and training to support this in clinical practice. SO WHAT?: Capacity building dietitians to promote oral health allows opportunity for improvement in the oral health, nutritional status and quality of life of priority population groups.
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Affiliation(s)
- Tiffany Patterson-Norrie
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Lucie Ramjan
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
| | - Mariana S Sousa
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- IMPACCT-Improving Palliative, Aged and Chronic Care through Clinical Research and Translation, Faculty of Health, University of Technology Sydney, Broadway, New South Wales, Australia
| | - Shwetha Kezhekkekara
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
| | - Ajesh George
- Australian Centre for Integration of Oral Health (ACIOH), School of Nursing & Midwifery, Western Sydney University, Liverpool, New South Wales, Australia
- Ingham Institute for Applied Medical Research, Liverpool, New South Wales, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
- School of Nursing, University of Wollongong, Wollongong, New South Wales, Australia
- School of Dentistry, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Nguyen S, Ahmed L, Villarosa A, George A, Yaacoub A. The use of antibiotics in acute oral health patients presenting at public dental clinics in the Western Sydney region. Fam Pract 2023; 40:9-15. [PMID: 35703923 DOI: 10.1093/fampra/cmac057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There is a limited need for antibiotics when treating oral health problems, yet they are often prescribed, increasing risk of antimicrobial resistance (AMR). With AMR a threat to public health, the objectives of this study were to assess the frequency, suitability, and factors associated with antibiotic prescriptions for acute dental problems across Greater Western Sydney public dental clinics. METHODS Patients' reason for attending, details of any antibiotics use, and the treating dental practitioner's clinical examination and diagnosis were compared to current prescribing guidelines, and logistic regression was used to identify predictors of antibiotic prescription. RESULTS In all, 1,071 patients participated in the study, and 15.9% reported to using antibiotics for their dental problem. Over three-quarters obtained the antibiotics from their general medical practitioner (GMP). A high prevalence of antibiotics were not indicated for the patient's complaint (71.8%) including for those with a history of extraction, pain, or intraoral swelling, who had significantly higher odds of antibiotic prescription (OR > 9). The antibiotic type prescribed was generally suitable. CONCLUSIONS In summary, the data suggest that the majority of antibiotics were inappropriately prescribed for the patient's dental complaints and there is a need for interventions to improve compliance with antibiotic prescribing guidelines.
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Affiliation(s)
- Stephanie Nguyen
- Nepean Blue Mountains Local Health District Oral Health Services, Nepean Hospital, Derby St, Kingswood, NSW 2747, Australia
| | - Lamis Ahmed
- Nepean Blue Mountains Local Health District Oral Health Services, Nepean Hospital, Derby St, Kingswood, NSW 2747, Australia
| | - Amy Villarosa
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University/South Western Sydney Local Health District/Ingham Institute Applied Medical Research/University of Sydney, Liverpool, NSW 1871, Australia
| | - Ajesh George
- Centre for Oral Health Outcomes & Research Translation (COHORT), Western Sydney University/South Western Sydney Local Health District/Ingham Institute Applied Medical Research/University of Sydney, Liverpool, NSW 1871, Australia
| | - Albert Yaacoub
- Nepean Blue Mountains Local Health District Oral Health Services, Nepean Hospital, Derby St, Kingswood, NSW 2747, Australia
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Cheng AL, Eberhard J, Gordon J, Balasubramanian M, Willink A, Sohn W, Dai J, Harrison C. Encounters and management of oral conditions at general medical practices in Australia. BMC Health Serv Res 2022; 22:1013. [PMID: 35941685 PMCID: PMC9361532 DOI: 10.1186/s12913-022-08299-2] [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: 02/11/2022] [Accepted: 07/01/2022] [Indexed: 11/17/2022] Open
Abstract
Background Poor oral health has been widely recognised as an ongoing public health issue. Patients with oral conditions may visit either a general practitioner (GP) or a dental practitioner for management. The aims of this study are to report (i) the GP management rate of oral health conditions by patient and GP demographics, (ii) what specific oral conditions were managed, and (iii) how GPs managed oral conditions. Methods Data from the Bettering the Evaluation and Care of Health study (2006 to 2016 inclusive) were analysed. Descriptive statistics with 95% confidence intervals around point estimates were used to summarise data. Multivariate logistic regression was performed to determine the independent effect of patient and GP characteristics. Results A total of 972,100 GP encounters were included in the dataset, with oral condition-related encounters managed at a rate of 1.19 oral conditions per 100 GP encounters. Patients who were aged 54 years or younger, resided in a socioeconomically disadvantaged area, came from a non-English speaking background or Indigenous background were more likely to have oral conditions managed by GPs. The most commonly reported oral conditions were dental and oral mucosa-related. Over 60% of oral conditions were managed by GPs through prescribed medications. Conclusions This study provided an overview of management of oral conditions by GPs in Australia. Patients from certain vulnerable demographic groups were more likely to attend a GP for management of oral conditions. Common oral conditions and management approaches were identified. The findings of this study contribute to public health and health policy discussions around optimising primary care provision in oral health. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08299-2.
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Affiliation(s)
- An-Lun Cheng
- School of Dentistry, University of Sydney, Camperdown, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, Australia
| | - Joerg Eberhard
- School of Dentistry, University of Sydney, Camperdown, Australia.,Charles Perkins Centre, University of Sydney, Camperdown, Australia
| | - Julie Gordon
- School of Health Sciences, University of Sydney, Camperdown, Australia
| | - Madhan Balasubramanian
- Menzies Centre for Health Policy and Economics, University of Sydney, Camperdown, Australia.,Health Care Management, College of Business, Government and Law, Flinders University, Adelaide, Australia
| | - Amber Willink
- Menzies Centre for Health Policy and Economics, University of Sydney, Camperdown, Australia
| | - Woosung Sohn
- School of Dentistry, University of Sydney, Camperdown, Australia
| | - Jennifer Dai
- Westmead Clinical School, University of Sydney, Camperdown, Australia
| | - Christopher Harrison
- Menzies Centre for Health Policy and Economics, University of Sydney, Camperdown, Australia.
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Currie C, Stone S, Pearce M, Landes D, Durham J. Urgent dental care use in the North East and Cumbria: predicting repeat attendance. Br Dent J 2022; 232:164-171. [PMID: 35149813 PMCID: PMC8837533 DOI: 10.1038/s41415-022-3886-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/05/2021] [Indexed: 12/29/2022]
Abstract
Introduction Around one-third of the UK population are 'problem-orientated dental attenders', only seeking care when suffering with dental pain and often on a repeated basis to secondary care. Little is known about attendance in primary care. The aim here was to examine the period prevalence of repeat urgent care attenders and establish predictors of repeat attendance in primary care. Methods Data on urgent and emergency dental care attendances in primary dental care in the North East and Cumbria were analysed from 2013-2019. Variables included: patient sex; ten-year age band; lower super output area; and Index of Multiple Deprivation. Period prevalence was calculated and data were considered year by year to identify trends in attendances. Analysis was with descriptive statistics and predictors of repeat attendance were identified using logistic regression modelling. Results Over the six-year period, there were 601,432 attendances for urgent primary dental care, equating to a period prevalence of 2.76% for the geographic population studied. In total, 16.15% of attendances were repeat attendances (period prevalence 0.45%) and predictors included being a woman and residence in deprived and rural areas. All urgent care attendances decreased over the six-year period, with one-off attendances beginning to increase again in 2019, while repeat attendances stabilised. Conclusion Interventions to encourage regular dental attendances should be targeted at patients from the most deprived and rural areas of the North East and Cumbria; however, a decrease in repeat attendance was noted in these areas. Predictors of being a repeat attender for urgent and emergency dental care included being a woman and living in the most deprived and rural areas of the North East and Cumbria. Over a six-year period (2013-2019), the number of one-off urgent and emergency dental care attenders to primary care in the North East and Cumbria decreased before beginning to increase. Over the same period, the number of repeat urgent and emergency dental care attenders to primary care in the North East and Cumbria decreased before stabilising.
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Haresaku S, Umezaki Y, Egashira R, Naito T, Kubota K, Iino H, Aoki H, Nakashima F. Comparison of attitudes, awareness, and perceptions regarding oral healthcare between dental and nursing students before and after oral healthcare education. BMC Oral Health 2021; 21:188. [PMID: 33845813 PMCID: PMC8040009 DOI: 10.1186/s12903-021-01554-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 04/06/2021] [Indexed: 01/29/2023] Open
Abstract
Background Oral healthcare education for health professional students is important to promote collaborative oral healthcare practice among health professionals. The purpose of this follow-up, cross-sectional study was to investigate attitudes, awareness, and perceptions regarding oral healthcare among dental and nursing students and to compare them both between baseline and the completion of the education programme and between dental and nursing students to identify problems with oral healthcare programmes in dental education. Method The subjects included 88 dental and 119 nursing students. The dental students participated in geriatric and preventive dentistry courses for oral healthcare education. The nursing students participated in independent oral healthcare courses comprising 45 h of training with case-based learning and were taught and instructed by multiple health professionals, including dentists. Questionnaires were distributed to the participants to compare attitudes, awareness, and perceptions regarding oral healthcare between baseline and the completion of the education programme and between dental and nursing students. A chi-square test, Wilcoxon signed-rank test, and Mann–Whitney U test were used to compare the data. Result and Conclusion The data of 48 (28 male and 20 female) dental students and 103 (9 male and 94 female) nursing students who completed the questionnaires both at baseline and after the education programme were used for the comparisons. After the education programme, more than 90% of the students were interested in oral healthcare practice; hoped to practise oral healthcare post-qualification; and perceived oral healthcare to be effective for preventing dental caries, periodontal diseases, and aspiration pneumonia. These attitudes and perceptions were statistically significantly improved after the education. However, the level of awareness of oral healthcare and the level of perception of the importance of collaboration with healthcare workers in oral healthcare practice after education were lower in the dental students than in the nursing students. Multi-professional oral healthcare education with case-based learning has the potential to improve awareness of oral healthcare and perceptions of the importance of collaborative oral healthcare practice. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-021-01554-8.
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Affiliation(s)
- Satoru Haresaku
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan.
| | - Yojiro Umezaki
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Rui Egashira
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Toru Naito
- Section of Geriatric Dentistry, Department of General Dentistry, Fukuoka Dental College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Keiko Kubota
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Hidechika Iino
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Hisae Aoki
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
| | - Fuyuko Nakashima
- Department of Nursing, Fukuoka Nursing College, 2-15-1 Tamura, Sawara-ku, Fukuoka, 814-0193, Japan
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Herkrath FJ, Vettore MV, Werneck GL. Utilisation of dental services by Brazilian adults in rural and urban areas: a multi-group structural equation analysis using the Andersen behavioural model. BMC Public Health 2020; 20:953. [PMID: 32552777 PMCID: PMC7301519 DOI: 10.1186/s12889-020-09100-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Accepted: 06/12/2020] [Indexed: 12/22/2022] Open
Abstract
Background The utilisation of health services is determined by complex interactions. In this context, rural populations face greater barriers in accessing dental services than do urban populations, and they generally have poorer oral health status. The evaluation of the determinants of health services utilisation is important to support planning and management of dental services. The aim of this study was to evaluate the predictors of dental services utilisation of Brazilian adults living in rural and urban areas. Methods Data from 60,202 adults aged 18 years or older who took part in the Brazilian National Health Survey carried out in 2013 were analysed. Predisposing (age, sex, education, social networks), enabling financing (income, durable goods and household’s crowding), enabling organisation (health insurance, registration in primary health care [PHC]) and need variables (eating difficulties, self-perceived tooth loss and self-perceived oral health) were selected based upon the Andersen behavioural model. Multi-group structural equation modeling assessed the direct and indirect associations of independent variables with non-utilisation of dental services and the interval since the last dental visit for individuals living in rural and urban areas. Results Adults living in urban areas were more likely to use dental services than those living in rural areas. Lower enabling financing, lower perceived dental needs and lack of PHC registration were directly associated with lower utilisation of dental services (non-utilisation, β = − 0.36, β = − 0.16, β = − 0.03, respectively; and interval since last dental visit, β = 1.25, β = 0.82, β = − 0.12, respectively). The enabling financing (non-utilisation, βrural = − 0.02 [95%CI: − 0.03 to − 0.02], βurban = 0.00 [95%CI: − 0.01 to 0.00]) and PHC registration (non-utilisation, βrural = − 0.03 [95%CI: − 0.04 to − 0.02], βurban = − 0.01 [95%CI, − 0.01 to − 0.01]) non-standardised total effects were stronger in rural areas. Enabling organisation (β = 0.16) and social network (β = − 2.59) latent variables showed a direct effect on the interval since last dental visit in urban areas. Education and social networks influenced utilisation of dental services through different pathways. Males showed less use of dental services in both urban and rural areas (non-utilisation, βrural = − 0.07, βurban = − 0.04; interval since last dental visit, βrural = − 0.07, βurban = − 0.07) and older adults have used dental services longer than younger ones, mainly in rural areas (βrural = 0.26, βurban = 0.17). Conclusion Dental services utilisation was lower in rural areas in Brazil. The theoretical model was supported by empirical data and showed different relationships between the predictors in the two geographical contexts. In rural areas, financial aspects, education, primary care availability, sex and age were relevant factors for the utilisation of services.
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Affiliation(s)
- Fernando José Herkrath
- Escola Superior de Ciências da Saúde, Universidade do Estado do Amazonas, Av. Carvalho Leal, 1777, Cachoeirinha, Manaus, Amazonas, 69065-001, Brazil. .,Instituto Leônidas e Maria Deane, Fundação Oswaldo Cruz, Rua Teresina, 476, Adrianópolis, Manaus, Amazonas, 69057-070, Brazil. .,Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier, 524, Maracanã, Bloco D, 7° andar - UERJ, Rio de Janeiro, Rio de Janeiro, 20550-013, Brazil.
| | - Mario Vianna Vettore
- Departamento de Odontologia Social e Preventiva, Faculdade de Odontologia, Universidade Federal de Minas Gerais, Av. Presidente Antônio Carlos, 6627, Pampulha, Belo Horizonte, Minas Gerais, 31270-901, Brazil.,School of Clinical Dentistry, University of Sheffield, 19 Claremont Crescent, Sheffield, S10 2TA, UK
| | - Guilherme Loureiro Werneck
- Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rua São Francisco Xavier, 524, Maracanã, Bloco D, 7° andar - UERJ, Rio de Janeiro, Rio de Janeiro, 20550-013, Brazil.,Instituto de Estudos em Saúde Coletiva, Universidade Federal do Rio de Janeiro, Avenida Horácio Macedo, S/N, Ilha do Fundão, Cidade Universitária, Rio de Janeiro, Rio de Janeiro, 21941-598, Brazil
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Gardiner FW, Richardson A, Gale L, Bishop L, Harwood A, Lucas RM, Strickland L, Taylor S, Laverty M. Rural and remote dental care: Patient characteristics and health care provision. Aust J Rural Health 2020; 28:292-300. [PMID: 32462697 DOI: 10.1111/ajr.12631] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 04/03/2020] [Accepted: 04/14/2020] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE To describe the characteristics of patients who used the Royal Flying Doctor Service dental clinics and determine Royal Flying Doctor Service and non-Royal Flying Doctor Service dental service provision in mainland Australia. DESIGN A prospective cohort study. SETTING All Royal Flying Doctor Service dental clinics located throughout rural and remote Australia. PARTICIPANTS All patients who accessed an Royal Flying Doctor Service dental clinic from April 2017 to September 2018. INTERVENTIONS Royal Flying Doctor Service mobile dental clinics. MAIN OUTCOME MEASURES Patient demographics and dental procedures conducted (by age, sex and Indigenous status); and the dental service provision and coverage (Royal Flying Doctor Service and non-Royal Flying Doctor Service) within mainland rural and remote Australia. RESULTS There were 8992 patient episodes comprising 3407 individual patients with 27 897 services completed. There were 920 (27%) Indigenous and 1465 (43%) non-Indigenous patients (n = 1022 missing ethnicity data). The mean (SD) age was 31.5 (24.8) years; the age groups 5-9 years and 10-14 years received 17.6% and 15.1% of the services, respectively. There were 1124 (33%) men and 1295 (38%) women (n = 988 with missing sex data). Women were more likely (all P < .05) to receive preventive services, diagnostic services, restorative services, general services, endodontics and periodontics. Men were more likely (both P < .05) to receive oral surgery and prosthodontics. There are many rural and remote people required to travel more than 60 minutes by vehicle to access dental care. CONCLUSION Without increasing dental provision and preventive services in rural areas, it seems likely that there are and will be unnecessary oral emergencies and hospitalisations.
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Affiliation(s)
- Fergus W Gardiner
- The Royal Flying Doctor Service, Canberra, ACT, Australia.,National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | - Alice Richardson
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT, Australia.,Statistical Consulting Unit, The Australian National University, Canberra, ACT, Australia
| | - Lauren Gale
- The Royal Flying Doctor Service, Canberra, ACT, Australia
| | - Lara Bishop
- The Royal Flying Doctor Service, Canberra, ACT, Australia
| | - Abby Harwood
- The Royal Flying Doctor Service, Canberra, ACT, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, The Australian National University, Canberra, ACT, Australia
| | | | - Sandra Taylor
- The Royal Flying Doctor Service, Canberra, ACT, Australia
| | - Martin Laverty
- The Royal Flying Doctor Service, Canberra, ACT, Australia
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Luther M, Gardiner FW, Bishop L. Management of Traumatic Tooth Avulsion Using 2-Octyl Cyanoacrylate Tissue Adhesive Splint: A Case Report. J Emerg Nurs 2020; 46:693-697. [PMID: 32414605 DOI: 10.1016/j.jen.2020.03.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 03/09/2020] [Accepted: 03/26/2020] [Indexed: 10/24/2022]
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11
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Shiraishi A, Wakabayashi H, Yoshimura Y. Oral Management in Rehabilitation Medicine: Oral Frailty, Oral Sarcopenia, and Hospital-Associated Oral Problems. J Nutr Health Aging 2020; 24:1094-1099. [PMID: 33244566 PMCID: PMC7349468 DOI: 10.1007/s12603-020-1439-8] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/19/2020] [Indexed: 12/14/2022]
Abstract
Oral health is a crucial but often neglected aspect of rehabilitation medicine. Approximately 71% of hospitalized rehabilitation patients and 91% of hospitalized acute care patients have impaired oral health. Poor oral condition in hospitalized patients can be attributed to factors such as age, physical dependency, cognitive decline, malnutrition, low skeletal muscle mass and strength, and multimorbidity. Another major factor is a lack of knowledge and interest in oral problems among health care workers. Recently, new concepts have been proposed, such as oral frailty, oral sarcopenia, and hospital-associated oral problems. Oral frailty, the accumulation of a slightly poor status of oral conditions and function, strongly predicts physical frailty, dysphagia, malnutrition, need for long-term care, and mortality in community-dwelling older adults. Oral sarcopenia refers to sarcopenia associated with oral conditions and function, although its definition has not yet been fully discussed. Hospital-associated oral problems are caused by disease, disease treatment, surgery, endotracheal intubation, poor self-care abilities, lack of care by medical staff, drugs, and iatrogenic factors during hospitalization. Furthermore, oral problems have negative impacts on rehabilitation outcomes, which include functional recovery, length of hospital stay, discharge home, and in-hospital mortality. Oral health management provided by dental hygienists improves not only oral status and function, swallowing function, and nutritional status but also activities of daily living, discharge home, and in-hospital mortality in post-acute rehabilitation. Oral rehabilitation, promotion, education, and medical-dental collaboration can be effective interventions for oral problems and therefore are necessary to improve rehabilitation outcomes.
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Affiliation(s)
- A Shiraishi
- Hidetaka Wakabayashi, Dpt. of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Japan., 8-1, Kawada-cho, Shinjuku-ku, Tokyo, Japan. Code; 162-0054, , Tel: +81-3-3353-8111, FAX: +81-3-5269-7639
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Bansal R, Jain A, Goyal M, Singh T, Sood H, Malviya HS. Antibiotic abuse during endodontic treatment: A contributing factor to antibiotic resistance. J Family Med Prim Care 2019; 8:3518-3524. [PMID: 31803645 PMCID: PMC6881914 DOI: 10.4103/jfmpc.jfmpc_768_19] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2019] [Revised: 09/16/2019] [Accepted: 09/30/2019] [Indexed: 12/24/2022] Open
Abstract
Antibiotic resistance is one of our most serious global health threats. The adverse effects of overusing and misusing antibiotics are highly publicized in the health professional literature. Antibiotic abuse occurs during routine endodontic treatment and there are deficiencies in knowledge regarding prescribing antibiotic and appropriate prophylactic antibiotic use. Multidisciplinary coordination and cooperation among dentists, pharmacists, and patients is needed to curb antibiotic abuse. As endodontists, we can become part of the solution to the antibiotic resistance crisis and deal with it conclusively. This review article discusses antibiotic resistance resulting from antibiotic abuse during endodontic treatment, various factors contributing to it, and measures required for stopping antibiotic abuse in endodontic treatment. A web-based research on MedLine was performed with terms Review Articles published in the last 10 year's dental journals in English for literature researching, extracting, and synthesizing data. Relevant articles were shortlisted. Important cross-reference articles were also reviewed.
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Affiliation(s)
- Ramta Bansal
- Department of Conservative Dentistry and Endodontics, Desh Bhagat Dental College and Hospital, Mandi Gobindgarh, District Fatehgarh Sahib, Punjab, India
| | - Aditya Jain
- Department of Physiology, Government Medical College, Patiala, Punjab, India
| | - Mehak Goyal
- Department of Oral and Maxillofacial Surgery, Desh Bhagat Dental College and Hospital, Mandi Gobindgarh, District Fatehgarh Sahib, Punjab, India
| | - Tejveer Singh
- Department of Oral and Maxillofacial Surgery, Desh Bhagat Dental College and Hospital, Mandi Gobindgarh, District Fatehgarh Sahib, Punjab, India
| | - Himanshu Sood
- Department of Conservative Dentistry and Endodontics, Desh Bhagat Dental College and Hospital, Mandi Gobindgarh, District Fatehgarh Sahib, Punjab, India
| | - Harjeet Singh Malviya
- Department of Conservative Dentistry and Endodontics, Geetanjali Dental and Research Institute, Udaipur, Rajasthan, India
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Shimpi N, Glurich I, Panny A, Acharya A. Knowledgeability, attitude, and practice behaviors of primary care providers toward managing patients' oral health care in medical practice: Wisconsin statewide survey. J Am Dent Assoc 2019; 150:863-872. [PMID: 31446976 DOI: 10.1016/j.adaj.2019.05.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 05/21/2019] [Accepted: 05/22/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND In this study, the authors sought to explore the receptivity, preparedness, and rates of adoption of integrated medical-dental models of care (MOCs) in the practice setting among primary care providers (PCPs) treating patients with diabetes mellitus (DM). METHODS The authors conducted an anonymous statewide survey targeting PCPs across a range of Wisconsin-based practice settings to evaluate knowledgeability, attitude, practice behaviors, and perceived barriers to oral health screening in a medical setting. Qualitative analytical approaches included thematic analyses applied to evaluate the status of and barriers to integrated medical-dental MOC adoption. RESULTS The integrated medical-dental MOC adoption rate was 34%. Top perceived barriers to integrated medical-dental MOC adoption included insurance coverage (71%) and care access (70%). A total of 39% indicated competency for educating patients about the association between DM and periodontitis. Although 72% of PCPs indicated optimal periodicity for oral health assessment as frequent, 39% reported frequently conducting such assessments. CONCLUSIONS Although PCPs indicate receptivity to integrated medical-dental MOCs, PCPs identify suboptimal education, lack of adequate training in oral-systemic disease assessment, and barriers to oral health care access as barriers to integrated medical-dental MOC adoption. PRACTICAL IMPLICATIONS Integrated medical-dental MOC adoption in care delivery to patients with DM remains below average. Interdisciplinary efforts and education are needed to address identified barriers to care integration.
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Shrivastava R, Power F, Tanwir F, Feine J, Emami E. University-based initiatives towards better access to oral health care for rural and remote populations: A scoping review. PLoS One 2019; 14:e0217658. [PMID: 31150463 PMCID: PMC6544292 DOI: 10.1371/journal.pone.0217658] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2019] [Accepted: 05/13/2019] [Indexed: 11/18/2022] Open
Abstract
This scoping review maps a wide array of literature to identify academic programs that have been developed to enhance oral health care for rural and remote populations and to provide an overview of their outcomes. Arksey and O'Malley's 5-stage scoping review framework has steered this review. We conducted a literature search with defined eligibility criteria through electronic databases, websites of academic records, professional and rural oral health care organizations as well as grey literature spanning the time interval from the late 1960s to May 2017. The charted data was classified, analyzed and reported using a thematic approach. A total of 72 citations (67 publications and seven websites) were selected for the final review. The review identified 62 universities with program initiatives towards improving access to oral health care in rural and remote communities. These initiatives were classified into three categories: training and education of dental and allied health students and professionals, education and training of rural and remote community members and oral health care services. The programs were successful in terms of dental students' positive perception about rural practice and their enhanced competencies, students' increased adoption of rural practices, non-dental health care providers' improved oral health knowledge and self-efficacy, rural oral health and oral health services' improvement, as well as cost-effectiveness compared to other strategies. The results of our review suggest that these innovative programs were effective in improving access to oral health care in rural and remote regions and may serve as models for other academic institutions that have not yet implemented such programs.
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Affiliation(s)
- Richa Shrivastava
- Faculty of Dentistry, Université de Montréal, Montreal, Quebec, Canada
| | - Frances Power
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Farzeen Tanwir
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Jocelyne Feine
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Elham Emami
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
- * E-mail:
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Iyer K, Krishnamurthy A, Pathak M, Krishnan L, Kshetrimayum N, Moothedath M. Oral health taking a back seat at primary health centers of Bangalore urban district, India - A situation analysis. J Family Med Prim Care 2019; 8:251-255. [PMID: 30911515 PMCID: PMC6396600 DOI: 10.4103/jfmpc.jfmpc_270_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Even though a dramatic change in pattern of oral diseases has been observed at a global level, oral health equality still remains as a dream to achieve. Studies have documented disparities in delivery and utilisation of oral health services among urban, suburban, and rural regions of India. Therefore, the aim of the present study was to conduct a situation analysis at PHCs to understand resource availability and oral health seeking behavior from perspective of medical officers of Bangalore City, India. Materials and Methods: A structured questionnaire was validated using Lawshe technique and was given across medical and dental officers present at 65 Primary Health Centers. Data collected was entered in Excel sheet and further subjected to Descriptive statistics using SPSS version 20. Results: Among 65 PHCs, about 18 PHCs had dental officers posted. In those 18 PHCs only 2 were maintained by the state government and others by Private dental college. In the 65 PHCs , only one PHC maintained a separate register for dental complaints, whereas 48 of them had maintained a combined register for both general and oral complaints. With regard to the management of tooth-related complaints, about 48 of medical officers reported that they dispense the patients affected by providing antibiotics and pain killers (analgesics) and recall, whereas 12 medical officers reported that they get the existing condition treated and refer and the rest refer the patients directly to hospitals. clinics. Conclusion: The results highlight the challenges experienced by nondental primary-care providers and their views on access to oral health to be improved. It is high time that the state government should put oral health policies into practice by recruiting adequate dental officers and providing separate dental infrastructure at the urban PHCs for better utilisation of dental care services.
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Affiliation(s)
- Kiran Iyer
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Uthandi, Chennai, Tamil Nadu, India
| | | | | | - Lakshmi Krishnan
- Department of Public Health Dentistry, Ragas Dental College and Hospital, Uthandi, Chennai, Tamil Nadu, India
| | - Nandita Kshetrimayum
- Department of Public Health Dentistry, Dental College, Regional Institute of Medical Sciences, Lamphelpat, Imphal West, Manipur, India
| | - Mahmood Moothedath
- Department of Public Health Dentistry, College of Applied Health Sciences, Qassim University, Al Qassim, Qassim Province, Saudi Arabia
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Godwin D, Blizzard L, Hoang H, Crocombe L. Evidence of the effect of rural background on rural practise in Australian dental practitioners: Does gender play a role? Aust Dent J 2016; 62:30-38. [PMID: 27459646 DOI: 10.1111/adj.12442] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND People residing outside the capital cities have poorer oral health than their city counterparts. Health workforce shortages and stability issues can have negative health effects on rural populations. There has been an increasing proportion of women entering the dental practitioner workforce in Australia. This study investigated whether dental practitioners who have a rural background are more likely to work in a rural area than those who do not have a rural background; and whether the gender of dental practitioners plays a role. METHODS A self-administered questionnaire was sent to a sample of dental practitioners via their professional dental associations. Practice location was assigned as either 'urban' or 'rural' using the Australian Standard Geographical Classification - Remoteness Area categories and measured with demographic characteristics of the respondents. Prevalence ratios (PR) were estimated using Poisson regression with robust standard errors. RESULTS Participants with a rural background were more than twice as likely (male PR = 2.23, 95% confidence interval (CI) = 0.79-6.26; female PR = 2.82, 95% CI = 1.35-5.87) to practise in a rural area than those with an urban background. CONCLUSIONS Dental practitioners with rural backgrounds were more than twice as likely to work in a rural practice as their urban counterparts.
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Affiliation(s)
- D Godwin
- Centre for Rural Health, University of Tasmania, Hobart, Tasmania, Australia
| | - L Blizzard
- Menzies Institute for Medical Research, Hobart, Tasmania, Australia
| | - H Hoang
- Centre for Rural Health, University of Tasmania, Hobart, Tasmania, Australia
| | - L Crocombe
- Centre for Rural Health, University of Tasmania, Hobart, Tasmania, Australia.,Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, South Australia, Australia
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Godwin D, Hoang H, Crocombe L. Views of Australian dental practitioners towards rural recruitment and retention: a descriptive study. BMC Oral Health 2016; 16:63. [PMID: 27251191 PMCID: PMC4888206 DOI: 10.1186/s12903-016-0221-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 05/24/2016] [Indexed: 11/17/2022] Open
Abstract
Background Despite an increase in the supply of dental practitioners in Australia in recent years, there remains an unequal distribution of dental practitioners with more dental practitioners working in city areas. This is in part due to difficulties in attracting and retaining dental practitioners to rural practice. The aim of this study was to investigate the attitudes of Australian dental practitioners towards what may attract them to rural areas and why they may remain in them. Method A descriptive study, utilising telephone, semi-structured interviews with dental practitioners across Australia. Dental practitioners were recruited through their professional associations. Data were analysed using content and thematic analysis. Results Fifty participants; 34 dentists, eight oral health therapists, and eight dental prosthetists working in rural and urban areas of Australia. Four main themes were identified: Business Case: concerns related to income and employment security, Differences in Clinical Practices: differences in clinical treatments and professional work, Community: fitting in and belonging in the area in which you live and work, and Individual Factors: local area provision for lifestyle choices and circumstances. The most influential of these themes were business case and individual factors. Smaller rural areas, due to low populations and being unable to provide individuals with their lifestyle needs were considered unappealing for dental practitioners to live. Previous experience of rural areas was highly influential. Conclusions The main factors influencing rural recruitment and retention were income sustainability and employment security, and individual factors. Dental practitioners felt that it was harder to earn a sustainable income and provide quality lifestyles for their family in rural areas. Previous experience of rural areas was influential towards long-term rural retention. These factors should be considered in order to develop effective strategies to address the unequal distribution of dental practitioners.
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Affiliation(s)
- Diana Godwin
- Centre for Rural Health, University of Tasmania, Hobart, Tasmania, Australia.
| | - Ha Hoang
- Centre for Rural Health, University of Tasmania, Hobart, Tasmania, Australia
| | - Leonard Crocombe
- Centre for Rural Health, University of Tasmania, Hobart, Tasmania, Australia.,Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, Australia
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Estai M, Kruger E, Tennant M. Will producing more dentists solve all the workforce issues in rural and remote areas? Aust Dent J 2016; 61:262-3. [DOI: 10.1111/adj.12423] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Mohamed Estai
- International Research Collaborative; Oral Health and Equity; Department of Anatomy, Physiology and Human Biology; The University of Western Australia; Western Australia Australia
| | - Estie Kruger
- International Research Collaborative; Oral Health and Equity; Department of Anatomy, Physiology and Human Biology; The University of Western Australia; Western Australia Australia
| | - Marc Tennant
- International Research Collaborative; Oral Health and Equity; Department of Anatomy, Physiology and Human Biology; The University of Western Australia; Western Australia Australia
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