Oral hygiene and periodontal disease in Victorian nursing homes.

OBJECTIVE: To investigate oral hygiene and periodontal disease in residents of Victoria nursing homes. BACKGROUND: The Australian population is ageing with a growing proportion of elderly Australians living in nursing homes. With declining edentulism rates, periodontal disease is becoming more prevalent in this population. MATERIALS AND METHODS: A total of 275 dentate residents from 31 Victorian nursing homes had a questionnaire and clinical examination using the Visual Plaque Index and a modified Community Periodontal Index. RESULTS: Self-reported oral hygiene habits of residents were poor, with less than one-third of residents cleaning their teeth twice daily or more. Periodontal health was found to be extremely poor, and the prevalence of 4 mm+ periodontal pockets was 35.6%, with 10.2% having 6 mm+ pockets. Logistic regression found that age, gender, number of teeth present and oral hygiene were all strongly associated with the prevalence of 4 mm+ periodontal pockets. CONCLUSION: Poor oral hygiene and the presence of significant plaque and calculus were common findings in this study. Periodontal diseases are a significant problem for residents in nursing homes. Addressing this health issue will require improved training for carers and better access to appropriate dental services.

Edentulism and dental caries in Victorian nursing homes.

OBJECTIVES: The aim of this project was to investigate edentulism and dental caries in nursing home residents in Victoria, Australia. BACKGROUND: The Australian population is ageing with a growing number of people living in nursing homes. These residents are at increased risk for dental caries, have more teeth present now than at any time in the past 50 years and often have difficulty maintaining adequate oral hygiene. MATERIALS AND METHODS: Clinical dental examinations were conducted at 31 nursing homes in Melbourne and regional Victoria between May 2005 and June 2006. A total of 510 residents were examined out of 1345 eligible participants. Socio-demographic and medical history was collected via questionnaire. RESULTS: Just over half of the residents were dentate (53.9%), and dentate residents had a mean of 14.4 teeth present and 2.66 untreated decayed teeth. Residents who required total assistance with oral hygiene had more decayed teeth and fewer filled teeth than residents who did not require assistance. CONCLUSIONS: Nursing home residents in Victoria are retaining an increasing number of natural teeth and have more tooth surfaces at risk for dental caries. Untreated dental caries was a significant problem for residents, particularly for those who are dependent on others for their daily oral hygiene care.

Sociodemographic backgrounds and career decisions of Australian and New Zealand dental students.

This article describes the sociodemographic and career selection characteristics of dental students in Australia and New Zealand. A total of 672 dental students participated in the study. The survey covered age, language proficiency, type of school attended, place of residence, parental occupation, and level of education. The respondents had an average age of twenty-two years, with a range of eighteen to fifty. Fifty-six percent of respondents were female, and approximately half had completed secondary education in private schools with 44.3 percent having finished in public schools. The majority of students lived with their parents, with only a few respondents reporting a rural home address (6.8 percent). The majority of students (65.3 percent) had placed dentistry as their first career choice and had most likely made the decision after leaving high school or near the end of high school (81.4 percent), with self-motivation being the major influence on their decision. This study provides a description of the sociodemographic profile of Australian and New Zealand dental students and provides a better understanding of career decision issues. It also highlights areas for further investigation and management by educational institutions and public policy.

Comparison of radiographic and clinical diagnosis of approximal and occlusal dental caries in a young adult population.

OBJECTIVES: The aims of the study were: (1) to determine if bitewing radiographs provided additional diagnostic yield for occlusal and approximal dental caries in adults aged between 17 and 30 years of age when compared with a clinical examination only, (2) how this translated into the measurement of dental caries experience, and (3) to determine the influence of water fluoridation on the diagnosis of dental caries in occlusal and approximal surfaces by clinical examination alone and by radiographic examination. METHODS: Between November 2002 and March 2003 a total of 879 subjects aged 17-30 years had a clinical examination using visual and tactile criteria. Subsequent to this examination, bitewing radiographs were taken and viewed separately and blind. Approximal and occlusal surfaces of molars and premolars were examined on the radiographs. RESULTS: Between 22.9-32.9% of approximal caries and 75.9-82.9% of occlusal caries was detected by clinical examination, while 93.1-97.1% of approximal caries and 33.1-42.6% of occlusal caries was detected by radiographic examination. In addition, while only 0.97% of clinically sound approximal surfaces and 0.83% of clinically sound occlusal surfaces were diagnosed with dentine caries on the radiographs, 67.1-77.1% of approximal caries was detected by radiographs alone, an additional diagnostic yield of 204-336%. The DS score increased 45-46% and the DMFS score increased 6-11% from the clinical examination with the addition of the radiographic information (P<0.001). CONCLUSIONS: The prevalence of approximal and occlusal caries was underestimated when clinical means only were employed. There was a significant increase in DS and DMFS scores from the clinical examination only when radiographic information was added across all age groups (P<0.001). This study confirms the value of bitewing radiographs in caries diagnosis.

Response rate and nonresponse bias in a questionnaire survey of dentists.

OBJECTIVES: (a) To report on response rate and nonresponse bias of a questionnaire survey of dentists. (b) To make recommendations for future questionnaire survey research in dentistry. METHODS: A questionnaire was mailed to a stratified systematic sample of 908 Australian dentists. The strategy included three mailings, a final telephonic contact, university stationery, paid reply envelopes and personalized correspondence. Nonresponse bias was assessed by comparing responses to a simple 'yes/no' question from each contact (late responders), and by comparing demographic information (nonresponders). RESULTS: The response rate achieved was 87% and there was no evidence of nonresponse bias based on practice location or year of graduation. The cumulative proportions of 'yes/no' responses essentially remained constant after each contact, but significantly more late responders answered in the negative to the test question than did early responders. The telephonic contact aided in the identification of nonparticipants and ineligible units. CONCLUSIONS: The current survey indicates that differences in data between early and nonresponders can occur despite there being no demographic differences. Therefore, assessment of nonresponse bias based on demographic data alone would seem to be insufficient. Questionnaire survey research must first be based on sound sampling techniques, and then on achieving as high a response rate as possible using the many incentives available.

Parental perceptions of a school dental service in Australia.

OBJECTIVE: Data on parental perceptions of the School Dental Service in Australia are scarce. The aim of this study was to investigate parental attitudes towards the School Dental Service based in Victoria and to explore differences between parents who had recently used the service (SDS users) and those who had elected not to use it during the previous 12 months (SDS non-users). BASIC RESEARCH DESIGN: 1,060 questionnaires were distributed through primary schools that had recently been offered treatment through the School Dental Service. Questions were asked about quality of care, cost, access to services, and continuity of care. The response rate was 65%. PARTICIPANTS: The study sample consisted of 692 parents of primary school-age children. RESULTS: Statistical tests revealed significant differences between the two groups of parents. Those who chose not to use the service had greater concerns about the quality of care provided (P<0.001) and were more likely to perceive that the cost of $25 for a course of treatment was too high (P<0.05). In both groups combined, 68% of parents believed they did not have enough knowledge about the service, 79% felt that more appointments should be available out of school hours, and 93% felt that treatment should be available on a six-monthly basis. CONCLUSION: The results of this study suggest that parents' choice in utilising the School Dental Service in Victoria is strongly related to their level of perception and satisfaction.

Cultural consistency in Australian dental students from two different ethnic backgrounds.

The objective of this study was to examine the value orientations of dental students from different ethnic backgrounds studying in Australian dental schools. A ninety-eight-item questionnaire was used to collect the data, including fifteen subscales developed consistent with the Kluckhohn and Strodtbeck value orientation model. To compare the value orientation structure and to determine if any ethnic differences existed, a multivariate analysis of variance called profile analysis was performed on the fifteen value subscales. Of the 401 participants, 30.2 percent were Anglo-Australian and 44.9 percent were Asian. The remainder (24.9 percent) were "Other-background residents" or "Other-international students." This article presents data from Asian (n=184) and Anglo-Australian (n=124) background respondents. Mean age was 21.7 years (s.e. 0.35 years) among Anglo-Australian and 20.8 years (s.e. 0.17 years) among Asians. Asians born overseas represented 70.7 percent (n=130) of this group. Of Australia-born Asians (n=54), 90.6 percent were first-generation Australians. When comparing their value profile, we found a significant association between ethnicity and value orientation profile scores (p<0.05). Despite the significant overall result, the strength of the association (eta(2)=0.007) indicated that this effect was trivial relative to the unexplained variance in value orientation. The findings suggest that, behind an apparent ethnic diversity, a single distinctive value profile might exist to which the majority of dental students subscribe.