Early childhood caries sequelae and relapse rates in an Australian public dental hospital.

BACKGROUND: Early childhood caries (ECC) remains one of the most prevalent childhood diseases in Australia, disproportionately affecting disadvantaged populations. AIM: To investigate the ECC experience including risk factors, incidence of caries, pain and infection as well as relapse rates of caries and secondary dental general anaesthesia (GA). DESIGN: A retrospective cohort study included dental records of children with ECC, aged <72 months at an Australian public dental hospital paediatric dentistry department from 2013 to 2015 (n = 102). Dental caries, pain, infection, referral patterns, demographic and caries risk factor data were recorded for 24 months. Descriptive statistics were used for patient characteristics and clinical data, and Kaplan-Meier curves and parametric exponential survival models for time-to-event series. RESULTS: The study population demonstrated higher-than-national average dmft and disease progression at baseline. Major risk factors for the development of caries, pain and infection were daily consumption of sweetened beverages, poor oral hygiene, residing in lower socio-economic areas, older age and being male. Rates of caries relapse and new referral for secondary treatment under general anaesthesia were relatively high. CONCLUSION: A high degree of ECC progression and recurrence in this population indicates a need for a more comprehensive approach to ECC addressing multilevel root causes and systemic risk factors.

Dental workforce capacity and California's expanding pediatric Medicaid population.

The number of children eligible for Medicaid dental coverage in California will increase to nearly 5 million because of the Affordable Care Act the transition of nearly 880,000 children from California's Children's Health Insurance Program (CHIP) to Medicaid. This study assesses the dental capacity to serve this population. Supply projections indicate that deficits are likely in rural and urban counties after the CHIP population is and the ACA is fully implemented.

Intraprofessional learning: Dentistry and oral health students' readiness and experience.

INTRODUCTION: Intraprofessional learning is a promising approach to enhance teamwork and patient care. This mixed-method study aimed to assess the readiness and experience of dental and oral health students toward intraprofessional learning. METHODS: Dental and oral health students were paired alternatively in a clinician and assistant role in a pediatric clinical setting. The Readiness for Interprofessional Learning Scale was adapted for a pre- and post-survey. Focus groups were conducted to elicit the students' shared learning experience. RESULTS: Approximately 50% of dental and oral health students participated in the pre- and post-survey. Pre-test findings revealed similar attitudes toward intraprofessional practice for both groups. However, a statistically significant lower score (p < 0.022) for the oral health students in the post-test suggested a less positive attitude toward their experience. Qualitative results indicated that dental students acquired a better understanding of the clinical scope of oral health students, and they learned clinical skills and behavior management from their counterparts. Conversely, oral health students experienced a hierarchical lack of collegiality and reciprocity from dental students, which may have contributed to their lower post-test score. Despite this, some oral health students gained more confidence in their roles and abilities within the intraprofessional team. Overall, dental students valued this learning experience more and desired more intraprofessional opportunities. CONCLUSION: Both groups of dental and oral health students had similar readiness levels to enter intraprofessional practice, appreciated the intraprofessional experience, and gained an increased appreciation for the collaborative approach to patient care. Intraprofessional learning during training may assist with developing collegiality across the dental professions in practice.

Effectiveness of telehealth in providing preventive oral health care: A pilot evaluation of patient, carer, and clinician experience.

BACKGROUND: This pilot study aimed to characterize the experience, satisfaction, and views on feasibility of an oral health primary prevention telehealth service at a public dental hospital's department of pediatric dentistry, from the viewpoint of patients, carers, and clinicians. METHODS: Data were collected using an anonymous questionnaire for parents/guardians, a focus group for clinicians; and were summarized using descriptive statistics, chi-square tests, analysis of variance, and by thematic analysis for the qualitative data. RESULTS: Thirty-seven parents/guardians and four clinicians were included. The mean patient age was 5 years (SD = 3.3). Over half of the parents (51.4%) were aged 30-39 years. There was high satisfaction (97.3%) and acceptability (81.1%) of the telehealth service. Native English-speakers were significantly more likely to agree that telehealth was an acceptable mode of preventive care and that they would use it again (p = 0.033). Parents reporting difficulty traveling to dental appointments were significantly more likely to score favorably in categories of usefulness, technical quality, and satisfaction relating to telehealth (all p < 0.001). Important themes from the clinician focus group included specific benefits for patients with special needs or who live rurally, reduced stress on families, and an enhanced focus on prevention. CONCLUSIONS: The findings suggest ongoing benefits of providing preventive oral health services as an adjunct to face-to-face care, especially to the identified subset of patients who will benefit the most.

A Cross-Sectional Evaluation of the Food Environment at an Australian University Campus.

University food environments have a strong influence on the dietary choices of students and staff. The aim of this study was to assess the food environment at a large university in Sydney, Australia. Data were collected between March and July 2022 from 27 fixed food outlets and 24 vending machines. The healthiness of the food environment was evaluated using the Healthy Food and Drink in NSW Health Facilities for Staff and Visitors Framework ('Framework'), which assesses food environment parameters including the availability, placement, and promotion of 'Everyday' (healthy) and 'Occasional' (less healthy) products. Each parameter was evaluated overall and across each food outlet type. Across all outlets, Everyday foods and drinks made up 43.9% of all products. Only two outlets met the Framework's product availability benchmark of ≥75% Everyday foods and drinks. A total of 43 outlets (84.3%) sold sugary drinks as part of their product range. Occasional products made up 68.4%, 53.3%, and 59.9% of all items for sale at checkout areas, countertops, and eye-level shelves, respectively. Finally, 79.7% of meal deals included Occasional products. Our findings highlight the need to improve the availability, placement, and promotion of foods and drinks sold at a major university campus in Sydney, Australia.

Socio-demographic and familial factors associated with hospital admissions and repeat admission for dental caries in early childhood: A population-based study.

OBJECTIVES: Dental caries remains a complex childhood condition often requiring preventable hospital admissions. There are limited population-based epidemiological studies that use large and linked data sets to quantify the clinical, socio-demographic and familial risk factors related to hospital admissions for dental caries. The aim of this study was to describe and quantify the rates, socio-demographic, clinical characteristics and familial factors including repeat admissions associated with young children admitted to hospital for dental caries. METHODS: This cohort study (n = 33,438) used longitudinally linked hospital admission data among all children aged

Health promotion interventions to improve oral health of adolescents: A systematic review and meta-analysis.

OBJECTIVES: To evaluate the effectiveness of health promotion interventions on oral health knowledge, behaviour and status of healthy adolescents. METHODS: This review included randomized controlled trials (RCTs) of oral health promotion interventions targeting adolescents. Primary clinical outcomes (gingival health, plaque scores, caries) and secondary proxy outcomes were evaluated. Meta-analysis of primary outcomes was conducted where possible, with subgroup analysis based on intervention (comprehensive health promotion and education-only). RESULTS: Thirty-seven eligible publications reporting on 28 unique RCTs of oral health promotion interventions were included. Quality appraisal of studies ranged from 48% to 96%. Interventions reported ranged from single-session interventions to community-wide programmes, including clinical preventive procedures and take-home products. Half used a health behaviour change theory to inform their intervention. The meta-analysis pooling of results favoured the intervention over control for all clinical outcomes, except DMFS in the education-only subgroup. Stronger intervention effects were seen in the comprehensive intervention subgroup than the education-only subgroup for DMFS (P = .02). This effect was slight, but not as clear in all other clinical categories. The majority of studies reported improvements in oral health knowledge, attitudes and behaviours. More positive outcomes were found with longer programmes, especially for dental caries outcomes. CONCLUSIONS: Oral health promotion programmes targeting adolescents have the ability to improve clinical oral health outcomes in the short and long term. Programmes should use more behavioural theory-based interactive and strategic methods, including self-awareness and the use of the wider community and peers for oral health promotion activities over a longer intervention duration.

Healthiness of Food and Beverages for Sale at Two Public Hospitals in New South Wales, Australia.

(1) Background: Our aim was to conduct objective, baseline food environment audits of two major western Sydney public hospitals and compare them to recently revised state nutritional guidelines. (2) Methods: A cross-sectional assessment was conducted (June-July2017) across 14 fixed food outlets and 70 vending machines in two hospitals using an audit tool designed to assess the guideline's key food environment parameters of availability, placement, and promotion of 'Everyday' (healthy) and 'Occasional' (less healthy) products. (3) Results: Availability: Overall, Everyday products made up 51% and 44% of all products available at the two hospitals. Only 1/14(7%) fixed outlets and 16/70(23%) vending machines met the guideline's availability benchmarks of ≥75% Everyday food and beverages. Proportion of Everyday products differed among different types of food outlets (café, cafeteria, convenience stores). Placement: On average, food outlets did not meet recommendations of limiting Occasional products in prominent positions, with checkout areas and countertops displaying over 60% Occasional items. Promotion: Over two-thirds of meal deals at both hospitals included Occasional products. (4) Conclusion: Baseline audit results show that substantial improvements in availability, placement, and promotion can be made at these public hospitals to meet the nutrition guidelines. Audits of other NSW hospitals using the developed tool are needed to investigate similarities and differences in food environment between sites. These findings highlight the need for ongoing tracking to inform whether the revised guidelines are leading to improved food environments in health facilities.

Oral Health Programmes in Indigenous Communities Worldwide-Lessons learned from the field: A qualitative systematic review.

OBJECTIVES: This systematic review examines the evidence on the effectiveness of programmes that aim to improve the oral health of Indigenous populations worldwide, as well as presents a qualitative analysis to explore the design and implementation of these initiatives. METHODS: MEDLINE and EMBASE were searched. Studies were included if they described an oral health programme for an Indigenous population in any country worldwide. A thematic synthesis of the qualitative findings was undertaken for each study's results and discussion sections. RESULTS: Nineteen studies were included. Sixteen studies reported positive results, twelve of which reported statistically significant findings. Three themes regarding design and implementation emerged from the qualitative analysis: (i) elements of successful programmes, (ii) challenges and barriers to successful interventions and (iii) suggestions for improvements. CONCLUSIONS: Successful programmes considered cultural appropriateness in their design-including extensive community engagement before, during and after implementation to enhance ownership of, and thus participation in the programme. Collaborative approaches were seen as an advantage, not only with Indigenous communities, but also with local health providers and organizations, with particular emphasis on incorporation into existing services. Challenges included low community participation, unstable funding and staffing issues. In addition, future programmes should also incorporate advocacy and community development, focus on changes to public policy, utilize evidence-based interventions that include traditional models of health, attempt to secure a stable funding base, target strategies to ensure staff retention and develop interventions that target the multilevel causes of general and oral health. This review provides an evidence base that can aid in the successful design, implementation and sustainability of oral health programmes for Indigenous people in the future.