Effects of the Child Dental Benefits Schedule on dental hospitalisation rates in Australian children.

Objective The Child Dental Benefits Schedule (CDBS) was introduced in 2014, and its aim was to support access to dental care for eligible children in Australia. Dental caries, and pulp and periapical diseases were the major dental reasons for children's hospitalisations. This study investigated if the availability of the CDBS had any effects on hospitalisation rates in Australian children. Methods This study was a retrospective analysis of Medicare data from the Australian Government and the hospitalisation data from The Australian Institute of Health and Welfare (AIHW) from 2008 (6 years before the commencement of the CDBS) to 2020 (6 years after the commencement of the CDBS). Results Although the hospitalisation rate trend was reducing before the CDBS started (2008-14), this reduction was not statistically significant. The reduction of hospitalisation rates was higher after the commencement of the CDBS (2014-20) and was statistically significant, but the regression model analysis showed a positive correlation between the CDBS and hospitalisation rate. The analysis without 'abnormal' year data (2019-20, COVID-19 pandemic year) supported no statistically significant decrease in hospitalisation rate after the commencement of the CDBS in 2014 until 2019. Conclusion Although the CDBS is improving access to dental care for eligible children, any possible effects the CDBS might have on hospitalisations are not yet evident.

Special needs dentistry in multidisciplinary head and neck cancer management - characterizing scope and complexity of patient care.

AIMS: To describe the involvement and need for specialists in special needs dentistry (SND) in the multidisciplinary management of patients and to characterize the complexity of patients with special health care needs. METHODS: Referrals for SND review from the Fiona Stanley Hospital head and neck cancer (HNC) multidisciplinary team between January 1 and December 31, 2019 were screened. Data recorded included demographic information, medical history, dental status, and dental treatment provided prior to HNC management. RESULTS: In total 127 patients were referred to the SND clinic in 2019 of which 89.0% were males and 74.8% were aged 50-79. The mean waiting time for SND review was 19.6 days. On average patients had a decayed, missing, filled tooth (DMFT) score of 20.3. During the study period 407 extractions and 30 restorations were completed. Seventeen patients (13.4%) had all their teeth removed prior to HNC management. The majority of patients (79.6%) were categorized as either moderate or severe complexity. Increasing complexity was seen in older age groups. CONCLUSIONS: Significant oral disease is seen in patients with HNC often requiring extensive dental treatment. Complexity is seen in patients requiring multidisciplinary care however characteristics that constitute complexity are varied given the spectrum encompassing 'special needs'.

Evaluation of a deep learning system for automatic detection of proximal surface dental caries on bitewing radiographs.

OBJECTIVE: This study aimed to evaluate a deep learning (DL) system using convolutional neural networks (CNNs) for automatic detection of caries on bitewing radiographs. STUDY DESIGN: In total, 2468 bitewings were labeled by 3 dentists to create the reference standard. Of these images, 1257 had caries and 1211 were sound. The Faster region-based CNN was applied to detect the regions of interest (ROIs) with potential lesions. A total of 13,246 ROIs were generated from all 'sound' images, and 50% of 'caries' images (selected randomly) were used to train the ROI detection module. The remaining 50% of 'caries' images were used to validate the ROI detection module. Caries detection was then performed using Inception-ResNet-v2. A set of 3297 'caries' and 5321 'sound' ROIs cropped from the 2468 images was used to train and validate the caries detection module. Data sets were randomly divided into training (90%) and validation (10%) data sets. Recall, precision, specificity, accuracy, and F1 score were used as metrics to assess performance. RESULTS: The caries detection module achieved recall, precision, specificity, accuracy, and F1 scores of 0.89, 0.86, 0.86, 0.87, and 0.87, respectively. CONCLUSIONS: The proposed DL system demonstrated promising performance for detecting proximal surface caries on bitewings.

São Paulo urban health index: measuring and mapping health disparities / Índice de saúde urbana de São Paulo: medindo e mapeando disparidades em saúde

ABSTRACT: Objective: To calculate and map the health inequalities in the city of São Paulo using the Urban Health Index (UHI) methodology. Methods: Seven indicators were selected from the Brazilian census: (1) proportion of households with access to sewage systems, (2) proportion of households served by regular waste collection, (3) proportion of households with two or more toilets, (4) proportion of households receiving tap water, (5) average income per household, (6) percentage of white people, and (7) literacy rate. Based on the UHI methodology, all health indicators were standardized and aggregated into a single metric at the census tract level. The UHI scores were ranked and plotted. The disparity ratio and the graph slope were calculated. The correlation between indicators was tested. Results were geocoded to produce a map of health risks. Results: The distribution of index values showed a linear middle section and deviations at each end. The disparity ratio found was 2.95, while the slope was 0.30. All indicators were significantly correlated. The map displayed a typical pattern of health inequality between the downtown and the periphery. The tracts located in the city's downtown had higher UHI values than those on the outskirts. Conclusions: The results of this study presented a visual distribution of health disparities in the city of São Paulo, proving to be a valuable method for identifying areas that require public health attention.

Resumo: Objetivo: Calcular e mapear as desigualdades em saúde na cidade de São Paulo por meio da metodologia do índice de saúde urbana (UHI). Métodos: Sete indicadores foram selecionados do censo brasileiro: (1) proporção de domicílios com acesso a esgoto, (2) proporção de domicílios com coleta regular de lixo, (3) proporção de domicílios com dois ou mais banheiros, (4) proporção de domicílios que recebem água encanada, (5) renda média por domicílio, (6) porcentagem de pessoas brancas e (7) taxa de alfabetização. Usando a metodologia UHI, todos os indicadores de saúde foram padronizados e agregados em uma única métrica para o setor censitário. Os valores de UHI foram classificados e plotados. A razão de disparidade e a inclinação do gráfico foram calculadas. A correlação entre os indicadores foi testada. Os resultados foram geocodificados, produzindo um mapa de risco à saúde. Resultados: A distribuição dos valores do índice apresentou uma seção intermediária linear e desvios nas extremidades. A taxa de disparidade encontrada foi de 2,95, enquanto o coeficiente angular foi 0,30. Todos os indicadores apresentaram correlação significativa. O mapa exibiu um arranjo característico de desigualdade em saúde entre o centro e a periferia. Os setores localizados na região central da cidade apresentaram valores de UHI mais elevados do que os da periferia. Conclusão: Os resultados deste estudo apresentaram uma distribuição visual das disparidades de saúde na cidade de São Paulo, demonstrando ser um método valioso para a identificação de áreas que requerem atenção da saúde pública.

Dental specialist workforce and distribution in the United Kingdom: a specialist map.

Objectives To illustrate, identify and assess a contemporary model of the geographic distribution of specialist dentists in relation to population age groups and rurality.Methods All UK dental specialists registered with the General Dental Council were extracted and paired with publicly available locations of work. Geographic information system tools were used to map specialist locations against population and rural-urban classifications of England, Wales, Scotland and Northern Ireland. The latest 2019 population estimates and health board areas were superimposed to create a specialist map. All other data were collected at the smallest geographic statistical areas and corresponding population data from the latest census.Results A total of 4,439 specialist titles were held by 3,041 individuals, linked to 3,459 unique locations of work. Specialist locations were mapped against 135 Clinical Commissioning Groups (CCGs) of England, seven Local Health Boards of Wales, 14 Health Boards of Scotland and five Health and Social Care Trusts of Northern Ireland. NHS Central London CCG had the highest specialist dentists per 100,000 people at 118.9; paediatric dentists per 20,000 children at 6.4; orthodontic dentists per 20,000 schoolchildren at 23.2; oral surgery dentists at 4.8 per 20,000 adults; and prosthodontic dentists at 7.2 per 20,000 adults. Orthodontics and oral surgery had the highest specialist-to-population ratios at 1:45,545 and 1:77,510, compared to oral and maxillofacial radiology and oral microbiology with the lowest ratios of 1:2,178,316 and 1:9,024,452, respectively. In England, Wales, Scotland and Northern Ireland, there were 79.5% (n = 42,140,039), 55.6% (n = 1,703,248), 46.9% (n = 2,481,996) and 42.9% (n = 776,295) of the respective populations that lived within 2.5 km of a specialist location. There were significant disparities in rural proximity to specialist locations across all nations. In Scotland, 40.8% of the rural population lived outside 10 km of a specialist location.Conclusions Stark inequalities exist in the geographic distribution of UK specialist dentists and high disparities were found in accessing a specialist, especially for vulnerable populations.

Does socioeconomic status influence oral cancer awareness? The role of public education.

BACKGROUND: Public awareness on oral cancer is thought to improve prevention and early diagnosis; however, the role of socioeconomic status in this awareness is not clear. AIMS: The aim was to investigate whether an association exists between socioeconomic status and oral cancer awareness in adults. METHODS: A multi-stage random sample of adults was investigated in Tehran in 2016-2017. The outcome was awareness of oral cancer and knowledge of risk factors and signs and symptoms using a self-administered questionnaire. The main exposures were self-reported socioeconomic status of 8 indicators of family assets and economic situation. Wealth index was created using principal component analysis, and participants were classified into 5 quintiles. Regression analysis was applied to test associations. RESULTS: Out of 1800 adults, 1312 completed questionnaires were returned (72.8% response rate). The mean age was 37.8 (standard deviation 9.0) years; about 60% were female. Statistical analysis revealed the higher the wealth index, the higher the score for oral cancer knowledge and awareness. Awareness and knowledge were significantly lower among participants in the poorest quintile: they had a knowledge score on oral cancer risk factors 1.58 points [95% confidence interval (CI): -2.19;-0.96] lower, and a knowledge score on oral cancer signs 1.34 points (95 CI: -1.98;-0.72) lower compared with the richest quintile. CONCLUSION: Socioeconomic inequalities were observed in oral cancer awareness in the Islamic Republic of Iran.

Dispensing patterns of emergency medicines prescribed by Australian dentists from 1992 to 2018 - a pharmacoepidemiology study.

OBJECTIVE: As the population ages, dentists are likely to encounter medical emergencies due to metabolic factors and polypharmacy. To date, there have been no documented studies in Australia that have analysed the prescription rate of Pharmaceutical Benefits Scheme (PBS)-funded emergency medicines for dentists. Therefore, this pharmacoepidemiology study aims to describe the dispensing patterns of emergency medicines as prescribed by dental practitioners, related to medicines covered by the Australian PBS system. METHODS: Data on dental medications used for emergencies, under the PBS, from 1992 to 2018, were accessed. Cumulative dispensing counts were calculated. Data on medications that were not utilised were also collected in the form of the crude cumulative count. RESULTS: Out of the 56 medications on the dental PBS schedule, eight were utilised for medical emergencies, with a total of 432 prescriptions on a national level, over 27 years. The commonly utilised lifesaving medicines of adrenaline, glucagon, as well as glyceryl trinitrate, had a total prescription count of 147, 88 and 27 respectively. Medicines used for opiate overdose; naloxone, had a total prescription count of one. Only one medicine (benztropine injection) for medical emergencies had a prescription count of 0. CONCLUSION: This study highlights the dispensing patterns of medicines prescribed by dentists for emergency scenarios. Although this study did not assess the appropriateness of use of the emergency medicines, further investigation may be required to ensure the future safety of patients when encountering emergency scenarios.

Population Survey of Knowledge about Oral Cancer and Related Factors in the Capital of Iran.

Knowledge about oral cancer risk factors and signs is thought to improve prevention and early diagnosis, and in turn, increases survival. In this population-based survey, knowledge about oral cancer was assessed in Iran. A total of 1800 self-administered questionnaires (collecting sociodemographic data and questions regarding oral cancer risk factors and signs) were distributed through random sampling. Final scores ranged between 0 and 15 for the risk factors and 0-11 for the signs. Scores below the median indicated a low level of knowledge, scores representing the third quartile of correct answers indicated a moderate level of knowledge, and scores representing the upper quartile indicated a high level of knowledge. Statistical tests were used for analysis of knowledge level in different sociodemographic categories. A total of 1312 participants completed the questionnaires. The average of knowledge scores for risk factors was 5.3 ± 3.0 and for signs was 4.5 ± 2.9. Overall, 75 and 56% respectively were able to identify major risk factors (smoking and alcohol); 23.5% could not define any related signs and symptoms. Dividing scores into quartiles indicated that three out of four people had "low" knowledge about risk factors and 58% had "low" knowledge about signs and symptoms. Females and highly educated people had more knowledge of oral cancer. Significant difference was found between job and level of knowledge (P = 0.001). This survey revealed that public knowledge of oral cancer was not satisfactory in Iran. Efforts should be done to inform and educate people with risk factors, initial clinical presentation, and symptoms, in order to improve prevention and promote early diagnosis.

Disparities in Oral Cancer Awareness: a Population Survey in Tehran, Iran.

Oral cancer is a life-threatening disease with low survival rates, especially when diagnosed in an advanced stage. Lack of awareness about this cancer among the population is proposed as a possible reason for this diagnostic delay. The aim of this study was to evaluate oral cancer awareness, as well as the association of this with sociodemographic status in Tehran. In this cross-sectional population-based survey, 1800 self-administered questionnaires (collecting sociodemographic data, questions regarding oral cancer awareness and the source of information) were distributed through multistage stratified random sampling. Scores for questions ranged from 0 to 4, and totals were summed. The outcome of question responses was also analyzed separately. In total, 1312 questionnaires were available for analysis, from 788 females and 489 males (37.8 ± 9.02 years). Only 30% of the respondents were aware of oral cancer. The average score for awareness was 1.09 ± 1.6 with no significant differences between age groups and genders. Almost 6.5% of participants had complete awareness about oral cancer. A significant difference was found between mean scores in different levels of education and occupation (p = 0.0001). From 585 responses to the "source of information" question, "public media" was the most important source (almost 50%). Only 2% mentioned "dentists" as a source of information. This study indicated an alarming lack of oral cancer awareness and literacy in Tehran, Iran. Dentists should be obliged to practice their pivotal role in informing the public about oral cancer.

Geographical Variation in Oral and Oropharynx Cancer Mortality in Brazil: A Bayesian Approach.

Recent studies have shown a high number of deaths from oral and oropharyngeal cancer worldwide, Brazil included. For this study, the deaths data (ICD-10, chapter II, categories C00 to C14) was obtained from Mortality Information System (SIM) and standardized by gender and population for each of the 554 Microregions of Brazil. The raw mortality rates were adopted as the standard and compared to the application of smoothing by the Bayesian model. In order to describe the geographical pattern of the occurrence of oral cancer, thematic maps were constructed, based on the distributions of mortality rates for Microregions and gender. Results: There were 7882 deaths registered due to oral and oropharyngeal cancer in Brazil, of which 6291 (79.81%) were male and 1591 (20.19%) female. The Empirical Bayesian Model presented greater scattering with mosaic appearance throughout the country, depicting high rates in Southeast and South regions interpolated with geographic voids of low rates in Midwest and North regions. For males, it was possible to identify expressive clusters in the Southeast and South regions. Conclusion: The Empirical Bayesian Model allowed an alternative interpretation of the oral and oropharynx cancer mortality mapping in Brazil.

A resource reallocation model for school dental screening: taking advantage of teledentistry in low-risk areas.

OBJECTIVE: To estimate the scale of resource transfer that could be achieved by screening low-risk schoolchildren using teledentistry rather than using traditional visual dental examination. METHODS: This study was based on a previous cost-minimisation study that compared the costs of two dental-screening approaches (visual and teledentistry). The data for the population of children 5-14 years of age was obtained from the Australian Bureau of Statistics and was divided across Australia according to statistical local area (SA2). The cost models (for teledentistry and visual screening) for each SA2 relative to the state, Remoteness Area (RA) and Socio-Economic Index for Area (SEIFA) indexes were estimated. The geographical information system was used to superimpose modelled cost data on the geographical map to provide a visual presentation of the data. Resource transfer scenarios, based on risk minimisation, were then developed and analysed. RESULTS: This study demonstrated a suboptimal allocation of dental-care resources, such that children living in high socio-economic areas (major cities) with low disease burdens consuming half of the estimated resources of a universal visual dental screening system. The findings suggest that utilising teledentistry screening for low-risk children has the potential to free up $40 million per annum. Such resources can be reallocated to increase care access and improve the quality of dental services for vulnerable children. CONCLUSION: To reduce inequalities in dental health within a community, scarce health-care resources should be targeted at the population at most risk. These findings can be used to inform policymakers, guide the appropriate distribution of scarce resources and target dental services to benefit high-need children.

Spatial analysis and climatic factors related to dengue in a small municipality of São Paulo, Brazil / Análise espacial e fatores climáticos relacionados à dengue, em município de pequeno porte de São Paulo, Brasil

Objective: to analyze the relationship of climatic variables, temperature and rainfall, - with dengue, in addition to identifying possible areas of greater spatial concentration of confirmed dengue cases. Methods: This is an ecological study with secondary data in the city of Ubirajara / SP. The confirmed cases of Dengue, assumed as an outcome, were obtained from the Aging and Notification Information System (SINAN) of the Ministry of Health; while the climatic data were used as independent variables and temperature and precipitation were provided by IPMet - Center of Meteorology of Bauru / SP, from 2007 to 2015. Pearson's correlation (r) was used for statistical analyzes. The addresses were geocoded and related to the digital cartoFigureic base of the municipality through the software QGIS and elaborated the thematic map through the kernel intensity estimator. Results: 187 cases of dengue were reported in the study period, with 119 cases (63.7%) occurring in 2015 with an incidence coefficient of 25.39 cases per 1,000 inhabitants. Mean annual temperature correlated positively with dengue and (r) (Pearson) cases = 0.6889, p = 0.0401 (α = Type I error) and ß = 0.6652 (Type II error). The Kernel map identified four areas of greatest concentration for dengue transmission. Conclusions: The relationship between temperature increase and dengue cases requires adequate responses from the institutions, with continuous monitoring of trends, construction of predictive models for the formulation of plans by using spatial analysis in the identification of the priority areas for actions that will be performed. (AU)

Objetivo: analisar a relação das variáveis climáticas, temperatura e precipitação pluviométrica, com a dengue, além de identificar possíveis áreas de maior concentração espacial de casos confirmados de dengue. Métodos: Trata-se de um estudo ecológico com dados secundários do município de Ubirajara/ SP. Os casos confirmados de Dengue, assumidos como desfecho, foram obtidos junto ao Sistema de Informação de Agravos e Notificações (SINAN) do Ministério da Saúde; enquanto os dados climáticos utilizados como variáveis independentes foram temperatura e precipitação, os quais foram fornecidos pelo Centro de Meteorologia de Bauru/ SP - IPMet, no período de 2007 a 2015. Utilizou- se a correlação Pearson (r) para as análises estatísticas. Os endereços foram geocodificados e relacionados com a base cartográfica digital do município, por meio do software QGIS. Foi elaborado o mapa temático segundo o estimador de intensidade de Kernel. Resultados: Foram notificados 187 casos de dengue no período do estudo; no entanto, somente em 2015 registraram-se 119 casos (63,7%), com um coeficiente de incidência de 25,39 casos por 1.000 habitantes. A temperatura média anual se correlacionou positivamente com os casos de dengue e r (Pearson) = 0,6889, p = 0,0401 (α = Erro tipo I) e ß = 0,6652 (Erro tipo II). O mapa de Kernel identificou quatro áreas de maior concentração para a transmissão da dengue. Conclusões: A relação do aumento da temperatura com os casos de dengue exige respostas adequadas das instituições, como o acompanhamento permanente de tendências, de construção de modelos preditivos e de formulação de planos que façam uso de análise espacial na identificação de áreas prioritárias para as ações que serão realizadas. (AU)

Does green tea consumption improve the salivary antioxidant status of smokers?

OBJECTIVE: Considering the higher rate of oral cancer, and reduction in salivary antioxidants in smokers as indicated in previous studies, antioxidant- containing nutrients such as green tea, seem to be beneficial in counteracting against oxidative stress in this group. This study assessed the salivary total antioxidant alteration in smokers compared to nonsmokers, after short-tem (7days) and long-term (3 weeks), green tea drinking. DESIGN: In this experimental study, 20 volunteer moderate-to-heavy male smokers, and 20 matched healthy non-smokers were selected to participate, according to the inclusion criteria. Participants were instructed to drink two cups of green tea per day, by dissolving 2g of green tea in 150ml of hot water for each cup. After saliva collection, antioxidant capacity of saliva was measured at baseline, after 7days, and after 21days. Statistical evaluation was done by SPSS 21, using paired samplet tests, one-way ANOVA and Bonferroni tests. RESULTS: At day zero nonsmokers had a higher antioxidant capacity than smokers (686.6±62.22 vs. 338.8±59.9) mM/50µl, P<0.001. There was also a significant difference between two groups in salivary total antioxidant capacity after one week and three weeks of green tea consumption (P<0.001). However, there was an upward trend in both smokers and non-smokers over the study period (after tea drinking). In addition, a significant difference was found in total antioxidant capacity alteration in smokers compared to non-smokers from baseline to day 21. CONCLUSIONS: Results support the effectiveness of green tea consumption in salivary antioxidants enhancement in smokers, in both the short- and long term.

Is Western Australia's rural surgical workforce going to sustain the future? A quantitative and qualitative analysis.

Objective Despite public interest in the rural workforce, there are few published data on the geographical distribution of Australia's rural surgeons, their practice skill set, career stage or work-life balance (on-call burden). Similarly, there has not been a peer-reviewed skills audit of rural training opportunities for surgical trainees. The present study undertook this baseline assessment for Western Australia (WA), which has some of the most remote practice areas in Australia. Methods Hospital staff from all WA Country Health Service hospitals with surgical service (20 of 89 rural health services) were contacted by telephone. A total of 18 of 20 provided complete data. The study questionnaire explored hospital and practice locations of practicing rural surgeons, on-call rosters, career stage, practice skill set and the availability of surgical training positions. Data were tabulated in excel and geographic information system geocoded. Descriptive statistics were calculated in Excel. Results Of the seven health regions for rural Western Australia, two (28.6%) were served by resident surgeons at a ratio consistent with Royal Australasian College of Surgeons (RACS) guidelines. General surgery was offered in 16 (89%) hospitals. In total, 16 (89%) hospitals were served by fly-in, fly-out (FIFO) surgical services. Two hospitals with resident surgeons did not use FIFO services, but all hospitals without resident surgeons were served by FIFO surgical specialists. The majority of resident surgeons (62.5%) and FIFO surgeons (43.2%) were perceived to be mid-career by hospital staff members. Three hospitals (16.7%) offered all eight of the identified surgical skill sets, but 16 (89%) offered general surgery. Conclusions Relatively few resident rural surgeons are servicing large areas of WA, assisted by the widespread provision of FIFO surgical services. The present audit demonstrates strength in general surgical skills throughout regional WA, and augers well for the training of general surgeons. What is known about the topic? A paper published in 1998 suggested that Australia's rural surgeons were soon to reach retirement age. However, there have been no published peer-reviewed papers on Australia's surgical workforce since then. More recent workforce statistics released from the RACS suggest that the rural workforce is in crisis. What does this paper add? This paper provides up-to-date whole-of-state information for WA, showing where surgical services are being provided and by whom, giving a precise geographical spread of the workforce. It shows the skill set and on-call rosters of these practitioners. What are the implications for practitioners? The present study provides geographical workforce data, which is important to health planners, the general public and surgeons considering where to practice. In particular, these data are relevant to trainees considering their rural training options.

Hospital admissions of older people for oral health-related conditions: implications for the future.

OBJECTIVE: This study analysed all hospitalisations of persons over the age of 65 years for oral health-related conditions, over a decade, and projected future hospitalisation rates. BACKGROUND: The proportion of older Australians is increasing, and their oral health is improving. At the same time, there is concern about the increasing burden that hospitalisations place on government health budgets. METHODS: Hospitalisation data of all patients older than 65 years, admitted to hospital for an oral health-related condition in Western Australia over a decade, were analysed. RESULTS: Over a ten-year period, a total of 11608 people over the age of 65 were admitted to hospital, with 10% 85 years and older, 52% were men, and 0.1% were Aboriginal patients. The highest rates of hospitalisation were for those from the most disadvantaged areas. Over ten years, there was a significant annual increase in rates of hospitalisation (4.4%). Overall, most admissions were for 'Malignant neoplasms' (16.6%), 'Dental caries' (15.4%) and 'Other disorders of the teeth and supporting structures' (14.3%). These three conditions accounted for almost half of all admissions (46.4%). Projections indicate high future burdens of hospitalisation. CONCLUSIONS: It is of concern that hospitalisations for oral health-related reasons among the oldest patients include high numbers with potentially preventable conditions such as dental caries. Projections indicate that if current trends are set to continue, hospitalisations for oral health-related conditions among Western Australians older than 65 years will place a considerable burden on the health system.

Incidence of oral cancer in Western Australia (1982-2009): Trends and regional variations.

AIM: Oral cancer remains a significant issue for many communities of the world. In Australia, there are approximately 2000 new diagnoses each year, and the rates are growing. The divide between city and rural, rich and poor, is, in many countries, found to be linked to the incidence of oral cancer. The aim of this study was to determine the trends in the incidence of oropharyngeal cancer (specifically cancer of the parotid and major salivary glands, pharynx, and tongue) in Western Australia over a 27-year period, from 1982 to 2009, and determine the geographic distribution of incidence within the state. METHODS: The de-identified data were provided by the Western Australian Cancer Registry, as oral cancer is a notifiable condition in Australia. RESULTS: There were a total of 2801 cases reported with pharynx, tongue, major salivary glands and parotid cancers over a 27-year period: 73.2 percent were male and 26.8 percent were female. The age-standardized incidence rate was 67.4 per 100 000 persons per annum for pharyngeal cancer, 54.1 for tongue cancer, 22.2 for parotid gland cancer and 5.5 for major salivary gland cancer. The age-standardized rates for pharyngeal and tongue cancer (but not parotid) were higher in country areas of Western Australia than in the metropolitan areas. The burden of some site-specific oral cancers is continuing to rise. An increasing trend with older age is also consistent throughout the study period. CONCLUSION: This study finds that the incidence of oral cancers in Western Australia is not inconsistent with other parts of Australia and fundamentally shows there is a rural-urban difference for oral cancer.

Development and Practice of Store-and-Forward Telehealth Systems in Ophthalmology Dental and Emergency.

Store-and-forward (S&F) telehealth system has been becoming an increasing application in remote medical consultations. In this paper, we will introduce three novel S&F telehealth systems we developed for ophthalmological, dental and emergency applications. We will explain the general system architecture of the S&F systems. Then we will focus on the specific features and components in each system implemented for meeting their respective clinical requirements. In the final section we will present further implementation details and practices and provide discussions.

Effect of prosthodontic planning on lateral occlusion scheme: a comparison between conventional and digital planning

Recently, digital wax-up is proposed as a tool to aid prosthodontic planning. However, there are no data about the effect of prosthodontic planning on lateral occlusion scheme. Objective : This study aims to evaluate the impact of conventional and digital prosthodontic planning on lateral occlusion scheme. Material and Methods : Dental models of 10 patients were collected. All models had Angle Class I occlusion and were undergoing prosthodontic treatment that would influence the lateral occlusion scheme. Each set of models had received both conventional wax-up and digital wax-up. In relation to the lateral occlusion scheme, the following variables were evaluated: the prevalence of the different lateral occlusion scheme, number of contacting teeth and percentage of each contacting tooth. Four excursive positions on the working side were included: 0.5, 1.0, 2.0 and 3.0 mm from the maximal intercuspation position. Results : The lateral occlusion scheme of the two wax-up models was subjected to alterations following excursion. There was a tendency for the prevalence of canine-guided occlusion to increase and for the prevalence of group function occlusion to decrease with increasing excursion. The number of contacting teeth was decreasing with the increasing magnitude of excursion. For the 0.5 mm and 1.0 mm positions, the two wax-ups had significantly greater contacts than the pre-treatment models, while at the 2.0 mm and 3.0 mm positions, all the models were similar. For all models, canines were the most commonly contacting teeth, followed by the teeth adjacent to them. No difference was observed between the two wax-ups in relation to the number of contacting teeth. Conclusion : Although the prosthodontic planning had influenced the pattern of the lateral occlusion scheme and contacts, there was no difference between the conventional and digital prosthodontic planning. .

A critical discussion of the benefits of e-health in population-level dental research.

Population-level research is an essential area of health with the potential to affect quality of life and the broader economy. There are excellent epidemiological studies that have improved health services, but traditional research requires a considerable investment. Although electronic technology has changed the practice of many industries with improved efficiency, its application to health is relatively new. Termed 'e-health', this emerging area has been defined by the World Health Organization as the use of information technology to support many aspects of health such as in administration and scientific information. However, not all professionals are convinced of its use. This paper presents a novel application of this emerging area to describe the benefit in data collation and research to support one of the most pressing issues in public health: oral health and policy. Using the Chronic Disease Dental Scheme as an example, a critical discussion of its benefit to population-level research is presented. The Chronic Disease Dental Scheme method of electronic administration has been shown to enhance research and to complement existing progress in health data linkage. e-Health is an invaluable tool for population-level dental research.