Temporomandibular dysfunction among working Australian adults and association with workplace effort-reward imbalance.

OBJECTIVES: To explore the prevalence of temporomandibular dysfunction (TMD) among working Australian adults and examine whether workplace effort-reward imbalance is associated with TMD. METHOD: Data were from Australia's National Survey of Adult Oral Health (NSAOH) 2004-06, a cross-sectional stratified clustered sample of Australian adults. The NSAOH data included information from a Computer Assisted Telephone Interview, self-complete questionnaire and oral epidemiological examination. Data included demographics, socio-economic characteristics, caries experience, diagnostic criteria for TMD, the Perceived Stress Scale (PSS) and a modified version of the Effort-Reward Imbalance instrument (ERI) where ERI ratio is the weighted ratio of workplace effort/reward subscales. Subpopulation analysis for working adults was conducted including complex sample descriptive statistics, bivariate and multivariable logistic regression models. RESULTS: NSAOH had 4014 participants with 2329 (65.1%, SE=1.3%) working adults included in the subpopulation analysis. Among working adults, TMD prevalence was 9.4% (SE=1.0%), which was slightly less than population prevalence (PR=9.9%, SE=0.8%), and was higher for females (PR=12.4%, SE=1.4%), people aged ⟨35 years (PR=11.2%, SE=2.2%) and uninsured (PR=11.8%, SE=1.7%). TMD prevalence was associated with the ERI ratio (OR=2.5, 95% CI: 1.3-4.5) and PSS scores (OR=1.1, 95% CI: 1.0-1.09) in bi-variate associations. In multivariable logistic regression, TMD was associated with being female (OR=2.1, 95% CI:1.3-3.6), university qualified (OR=0.43, 95%CI: 0.21-0.88) and with the ERI ratio (OR=2.63, 95% CI: 1.47-4.72). CONCLUSION: Greater effort-reward imbalance in the workplace is a psychosocial risk factor for TMD. This finding might need to be considered by clinicians managing TMD patients with need for investigating the efficacy of workplace stress management interventions.

Development of the Turkish version of the Index of Dental Anxiety and Fear (IDAF-4C+): Dental anxiety and concomitant factors in pediatric dental patients.

OBJECTIVE: The aim of this study was to develop the Turkish version of the Index of Dental Anxiety and Fear (IDAF-4C+) and also to explore factors associated with dental anxiety in clinical pediatric dental patients (PDPs). STUDY DESIGN: The study sample consisted of 421 PDPs aged 12-14, 104 of whom were selected for test-retest analysis. The psychometric evaluation included linguistic validity, exploratory factor analysis, reliability by internal consistency (Cronbach's alpha) and test-retest reliability (intra-class correlation coefficient, ICC). Construct validity was tested by comparing a commonly used instrument, the Children's Fear Survey Schedule Dental Subscale (CFSS-DS). Associations between parental dental anxiety, frequency of dental visits, dental caries, dental visit behaviour and children's dental anxiety were also examined. RESULTS: The Turkish version of the IDAF-4C demonstrated good internal consistency (Cronbach's alpha α=.96) and test-retest reliability (ICC=.87). Factor analysis showed a fit IDAF-4C model with a single factor, 8 items. Dental anxiety scores were significantly correlated with all measured variables (p<0.001). Girls showed significantly higher dental anxiety scores than boys (p<0.05). CONCLUSIONS: This study suggests that the Turkish version of the IDAF-4C+ is a valid and reliable instrument for assessing dental anxiety and fear in Turkish children.

Preferences for dental decisional control and associations with quality of life among third molar patients attending public dental services.

OBJECTIVES: To explore (1) the prevalence of dental decisional control preferences (DDCP) among third molar (TM) patients attending public dental services and associated individual's characteristics, and (2) the association between DDCP and quality of life (QoL). METHOD: Participants were adult public dental patients with internet access referred for TM consultation. Collected data included patients' socio-demographic variables, the Control Preferences Scale (CPS), the Oral Health Impact Profile (OHIP-14) and the EuroQol EQ-5D-5L. RESULTS: Participants (n=163) were mainly females (73.6%) with a mean age of 26.2 years (SD=8.3). Most participants preferred an active DDCP (n=71, 44.1%) or a collaborative DDCP (n=60, 37.3%) while a minority preferred a passive DDCP (n=30, 18.6%). Gender (P=.05) and education (P=.03) were associated with DDCP. In a multinomial logistic regression model for DDCP, females were more likely to have an active DDCP (OR=2.73, P=.04) as were participants who had tertiary education (OR=2.72, P=.04). In a linear regression model for OHIP-14, active (P=.05) and collaborative DDCP (P=.04) were associated with less impact on oral health-related QoL. CONCLUSION: Patients attending public dental services preferred to be involved (either actively or collaboratively) in dental treatment decision-making. Being a female and/or having tertiary education were associated with an active DDCP. The positive association between patients' involvement in decision-making and oral health-related QoL might support the benefit for enhancing patients' involvement in decision-making.

Performance of the Index of Dental Anxiety and Fear in a population-based sample of adults.

BACKGROUND: The Index of Dental Anxiety and Fear (IDAF-4C) was introduced to overcome the theoretical and practical shortcomings of previously developed dental fear measures. This new scale has not been tested on population samples other than in its country of origin, Australia. The aim of this study was to validate the IDAF-4C in a different cultural setting and to determine the prevalence and sociodemographic associations of dental anxiety. METHODS: A cross sectional study of a representative New Zealand adult population sample was undertaken. The questionnaire was mailed to 523 randomly-selected participants. Data were collected on sociodemographic characteristics, oral and general health care, and dental anxiety using both the IDAF-4C and the Dental Anxiety Scale (DAS). RESULTS: The response rate was 51.8%. The factor structure of the IDAF-4C was confirmed. The prevalence estimates for high dental anxiety and fear were 18.6% using the DAS and 13.0% using the IDAF-4C. Mean scores for the IDAF-4C and DAS were higher among episodic dental visitors and those without a recent dental visit. CONCLUSIONS: The performance of the IDAF-4C in this New Zealand community sample supports its use for dental anxiety measurement.

Does early-life family income influence later dental pain experience? A prospective 14-year study.

BACKGROUND: The aim of this study was to investigate the association between early-life family income and dental pain experience from childhood to early adulthood. METHODS: Data came from a 14-year prospective study (1991/1992-2005/2006) carried out in South Australia, which included children and adolescents aged 4-17 years (N = 9875) at baseline. The outcome was dental pain experience obtained at baseline, 14 years later in adulthood and at a middle point of time. The main explanatory variable was early-life family income collected at baseline. RESULTS: The prevalence of dental pain was 22.8% at baseline, 19.3% at 'middle time' and 39.3% at follow up. The proportion of people classified as 'poor' at baseline was 27.7%. Being poor early in life was significantly associated with dental pain at 14-year follow up (odds ratio = 1.45; 95% confidence interval = 1.27-1.66). CONCLUSIONS: Early-life relative poverty is associated with more frequent dental pain across the 14-year follow up and may be a key exposure variable for later dental conditions.

Do people trust dentists? Development of the Dentist Trust Scale.

BACKGROUND: This study aimed to adapt a measure of trust in physicians to trust in dentists and to assess the reliability and validity of the measure. METHODS: Questionnaire data were collected from a simple random sample of 596 Australian adults. The 11-item General Trust in Physicians Scale was modified to apply to dentists. RESULTS: The Dentist Trust Scale (DTS) had good internal consistency (α = 0.92) and exploratory factor analysis revealed a single-factor solution. Lower DTS scores were associated with less trust in the dentist last visited, having previously changed dentists due to unhappiness with the care received, currently having dental pain, usual visiting frequency, dental avoidance, and with past experiences of discomfort, gagging, fainting, embarrassment and personal problems with the dentist. CONCLUSIONS: The majority of people appear to exhibit trust in dentists. The DTS shows promising reliability and validity evidence.

Internet use, online information seeking and knowledge among third molar patients attending public dental services.

BACKGROUND: While Australians are searching the internet for third molar (TM) information, the usefulness of online sources may be questioned due to quality variation. This study explored: (i) internet use, online information-seeking behaviour among TM patients attending public dental services; and (ii) whether patients' TM knowledge scores are associated with the level of internet use and eHealth Literacy Scale (eHEALS) scores. METHODS: Baseline survey data from the 'Engaging Patients in Decision-Making' study were used. Variables included: sociodemographics, internet access status, online information-seeking behaviour, eHEALS, the Control Preferences Scale (CPS) and TM knowledge. RESULTS: Participants (N = 165) were mainly female (73.8%), aged 19-25 years (42.4%) and had 'secondary school or less' education (58.4%). A majority (N = 79, 52.7%) had sought online dental information which was associated with active decisional control preference (odds ratio = 3.1, P = 0.034) and higher educational attainment (odds ratio = 2.7, P = 0.040). TM knowledge scores were not associated with either the level of internet use (F(2,152) = 2.1, P = 0.094, χ2 = 0.0310) or the eHEALS scores (r = 0.147, P = 0.335). CONCLUSIONS: 'The internet-prepared patient' phenomena exists among public TM patients and was explained by preference for involvement in decision-making. However, internet use was not associated with better TM knowledge. Providing TM patients with internet guidance may be an opportunity to improve TM knowledge.

Are Stage of Change constructs relevant for subjective oral health in a vulnerable population?

UNLABELLED: Stage of Change constructs may be proxy markers of psychosocial health which, in turn, are related to oral health. OBJECTIVE: To determine if Stage of Change constructs were associated with subjective oral health in a population at heightened risk of dental disease. METHODS: Stage of Change constructs were developed from a validated 18-item scale and categorised into 'Pre-contemplative', 'Contemplative' and 'Active'. A convenience sample of 446 Australian non-Aboriginal women pregnant by an Aboriginal male (age range 14-43 years) provided data to evaluate the outcome variables (self-rated oral health and oral health impairment), the Stage of Change constructs and socio-demographic, behavioural and access-related factors. Factors significant at the p < 0.05 level in bivariate analysis were entered into prevalence regression models. RESULTS: Approximately 54% of participants had fair/poor self-rated oral health and 34% had oral health impairment. Around 12% were 'Pre-contemplative', 46% 'Contemplative' and 42% 'Active'. Being either 'pre-contemplative' or 'contemplative' was associated with poor self-rated oral health after adjusting for socio-demographic factors. 'Pre-contemplative' ceased being significant after adjusting for dentate status and dental behaviour. 'Pre-contemplative' remained significant when adjusting for dental cost, but not 'Contemplative'. The Stages of Change constructs ceased being associated with self-rated oral health after adjusting for all confounders. Only 'Contemplative' (reference: 'Active') was a risk indicator in the null model for oral health impairment which persisted after adding dentate status, dental behaviour and dental cost variables, but not socio-demographics. When adjusting for all confounders, 'Contemplative' was not a risk indicator for oral health impairment. CONCLUSIONS: Both the 'Pre-contemplative' and 'Contemplative' Stage of Change constructs were associated with poor self-rated oral health and oral health impairment after adjusting for some, but not all, covariates. When considered as a proxy marker of psychosocial health, Stage of Change constructs may have some relevance for subjective oral health.

Dental anxiety screening practices and self-reported training needs among Australian dentists.

BACKGROUND: It is recommended that dentists screen for dental anxiety (DA) so that fearful patients may be better managed. The main aim of this study was to determine what dentists are being taught in relation to DA as well as whether and how anxious patients are identified in the clinic. METHODS: Two hundred and forty-six practising dentists (adjusted response rate = 40.1%), from a random sample of registered Australian dentists, completed a mailed questionnaire. RESULTS: Dentists estimated that high DA affected 23.3% of children and 19.4% of adults seen. Only 3.7% of dentists reported using a published scale for screening DA, with the most common reason being lack of awareness (56.5%). Approximately one-half of responding dentists directly asked their patients about DA and this was more common among younger dentists (χ(2) = 7.75, p = 0.021). There were few differences in DA screening by other practitioner or practice characteristics (p > 0.05). Only one-third of dentists had received undergraduate training related to DA and only 41.7% considered this to be 'good' or better. Almost 37% of respondents expressed an interest in future training opportunities. CONCLUSIONS: The use of formal, validated scales for screening DA is minimal. Training in anxiety management appears to be low and is an area that could be expanded upon.

Self-rated oral health and oral health-related factors: the role of social inequality.

BACKGROUND: The reasons why social inequality is associated with oral health outcomes is poorly understood. This study investigated whether stratification by different measures of socio-economic status (SES) helped elucidate these associations. METHODS: Cross-sectional survey data were used from Australia's 2004-06 National Survey of Adult Oral Health. The outcome variable was poor self-rated oral health. Explanatory variables comprised five domains: demographic, economic, general health behaviour, oral health-related quality of life and perceived need for dental care. These explanatory variables were each stratified by three measures of SES: education, income and occupation. RESULTS: The overall proportion of adults reporting fair or poor oral health was 17.0% (95% CI 16.1, 18.0). Of these, a higher proportion were older, Indigenous, non-Australian born, poorly educated, annual income <$20 000, unemployed, eligible for public dental care, smoked tobacco, avoided food in the last 12 months, experienced discomfort with their dental appearance, experienced toothache or reported a need for dental care. In stratified analyses, a greater number of differences persisted in the oral health impairment and perceived need for dental care domains. CONCLUSIONS: Irrespective of the SES measure used, more associations between self-rated oral health and dental-specific factors were observed than associations between self-rated oral health and general factors.

Management of fear and anxiety in the dental clinic: a review.

People who are highly anxious about undergoing dental treatment comprise approximately one in seven of the population and require careful and considerate management by dental practitioners. This paper presents a review of a number of non-pharmacological (behavioural and cognitive) techniques that can be used in the dental clinic or surgery in order to assist anxious individuals obtain needed dental care. Practical advice for managing anxious patients is provided and the evidence base for the various approaches is examined and summarized. The importance of firstly identifying dental fear and then understanding its aetiology, nature and associated components is stressed. Anxiety management techniques range from good communication and establishing rapport to the use of systematic desensitization and hypnosis. Some techniques require specialist training but many others could usefully be adopted for all dental patients, regardless of their known level of dental anxiety. It is concluded that successfully managing dentally fearful individuals is achievable for clinicians but requires a greater level of understanding, good communication and a phased treatment approach. There is an acceptable evidence base for several non-pharmacological anxiety management practices to help augment dental practitioners providing care to anxious or fearful children and adults.

Community water fluoridation support and opposition in Australia.

OBJECTIVE: To estimate the level of support for water fluoridation across Australia and examine the association between water fluoridation stance and demographic and socioeconomic characteristics, commitment to the stance, and opinions, beliefs and knowledge regarding water fluoridation. METHODS: Cross-sectional questionnaire data were obtained from 510 Australian adults (response rate = 34%) in 2008. Data were weighted by age, gender and state and territory estimated resident population. MAIN OUTCOME MEASURES: Participants were asked to rate the strength of their support for or opposition to water fluoridation on a 7-point scale. RESULTS: Approximately 70% of survey respondents supported water fluoridation, 15.4% were opposed, and 14.5% were neutral. Those strongly opposed were most resistant to altering their opinion on the basis of new information or research. However, approximately 90% of people who were neutral, slightly supportive or moderately supportive would "maybe" or "definitely" change their stance. Fluoridation opposition was associated with lower income and educational attainment, more self-rated knowledge, and with beliefs about reduced benefits and greater harms. Opinions about who should be responsible for the introduction of water fluoridation and sources of information on fluoridation varied significantly by water fluoridation opinion. CONCLUSIONS: While this survey lends further weight to the evidence confirming extensive support for water fluoridation in Australia, a large percentage of the public may be open to changing their stance if presented with new information or research. To maintain the widespread acceptance of water fluoridation, it is important that the public are provided with unbiased and accurate interpretations of the continual stream of research related to fluorides and water fluoridation.

Australian population norms for the Index of Dental Anxiety and Fear (IDAF-4C).

BACKGROUND: The Index of Dental Anxiety and Fear (IDAF-4C) is a theoretically derived test developed to allow clinicians and researchers to measure a person's level of dental fear. Population norms have not previously been made available for the IDAF-4C. The aim of this study was to provide Australian norms for the IDAF-4C using percentile ranks and to examine associations between scores and individual-level characteristics, dental avoidance and fear of pain. METHODS: A stratified random sample of 1511 Australian adults yielded complete questionnaire data for 1063 individuals (70.4%). Percentile ranks were calculated for IDAF-4C full scale scores stratified by age and gender. RESULTS: IDAF-4C mean scores varied significantly by age, gender, income, and speaking a language other than English at home. Tables to convert raw scores to percentiles showed that full scale scores varied by age and gender. Scores on the IDAF-4C had strong and significant associations with avoidance of the dentist due to fear, average dental visiting frequency and anxiety about pain when going to the dentist. CONCLUSIONS: Population norms allow clinicians or researchers to compare results for an individual or subgroup to the Australian population. It is recommended that a dental fear scale be used to screen all dental patients for dental fear to enable a more tailored and effective dental treatment experience.

The extent and nature of dental fear and phobia in Australia.

BACKGROUND: For the general dental practitioner, fearful patients are harder and more stressful to treat and are most likely to attend irregularly. This study presents updated and refined dental fear and phobia prevalence estimates in Australia as well as information on the nature of dental fear and phobia. METHODS: A total of 1084 Australian adults (response rate = 71.7%) completed a mailed questionnaire. The survey contained four measures of dental fear and phobia, as well as questions regarding potentially anxiety-eliciting dental stimuli and past aversive dental experiences. RESULTS: The prevalence of high dental fear ranged from 7.8% to 18.8%, and more incapacitating dental phobia from 0.9% to 5.4%, depending upon the scale, cut-point and specific criteria used. Dental phobia was significantly associated with blood-injection-injury (BII) concerns. The cost of dental treatment was endorsed as the most anxiety-eliciting dental situation (64.5%), followed by fear of needles/injections (46.0%) and painful or uncomfortable procedures (42.9%). Anxiety-eliciting stimuli and the type of aversive dental experiences varied significantly by gender, age, income, education, language spoken at home and dental visiting frequency. CONCLUSIONS: High dental fear and dental phobia are common in Australia although prevalence estimates are highly dependent on both the scale and cut-points used.

A retrospective longitudinal study of caries development in an Australian Aboriginal birth cohort.

There are a limited number of longitudinal investigations that examine the progression of dental disease in an indigenous population. Dental examinations of a cohort of indigenous Australians born in Darwin (Australia) between 1987 and 1990 were conducted at ages 6-8 and 11-13 years as part of the Child Dental Health Survey, and 18-20 years as part of the longstanding prospective Aboriginal Birth Cohort (ABC) study. Data was available at all ages for 145 participants. The percent DMFT >0 increased from 17.2 to 44.1 to 81.4%, representing a linear trajectory, whereas mean DMFT increased from 0.3 to 1.0 to 5.6, representing an exponential trajectory. Both trends were significant. At age 18-20 years, the percent DMFT >0 among ABC study participants was 1.2 times that of their counterparts at a national level. The differences were more marked when dental caries severity was considered, with mean DMFT among 18- to 20-year-old ABC study participants being 1.7 times that of similarly aged adults at a national level. Most of this disparity was constituted by the decayed component, with ABC study participants having eight times the mean DT of their national-level counterparts. The findings indicate that Aboriginal young adults in this birth cohort experience a disproportionate amount of dental disease relative to their non-indigenous counterparts, and that this pattern is consistent across the life course.

Quarter of a century of change: caries experience in Australian children, 1977-2002.

BACKGROUND: The establishment of the evaluation programme of the Australian School Dental Scheme has led to continuous surveillance of child oral health extending from 1977 to the present day. The aims of this study were to examine the state of child oral health in Australia in 2002 and to explore longer term trends across the quarter of a century of recorded surveillance activity. METHODS: Caries data were obtained for children who were enrolled in the School Dental Services of each state and territory for the years 1977-2002. Data collection derived from routine examinations within the School Dental Service with oral examinations carried out by dentists and dental therapists. RESULTS: There were considerable declines in caries experience between 1977 and the mid to late 1990s, with mean decayed, missing and filled deciduous teeth (dmft) for 6-year-old children decreasing from over 3 in 1977 to approximately 1.6 in 1996, and permanent 12-year-old decayed, missing and filled teeth (DMFT) decreasing from 4.8 in 1977 to 0.89 in 1998. However, since the mid to late 1990s, deciduous 6-year-old dmft has increased by 24 per cent and 12-year-old DMFT has increased by almost 15 per cent. Reductions in caries experience of those children with the most disease have also ceased, and between 1999 and 2002 an increase in the Significant Caries Index occurred. CONCLUSIONS: Improvements in the oral health of Australian children halted during the mid 1990s, after which caries experience has increased. It is important that we understand the changes taking place and their causes, so that action can be taken to halt any further possible declines in child oral health.

Exposure to water fluoridation and caries increment.

OBJECTIVE: The objective of this cohort study was to examine the association between exposure to water fluoridation and the increment of dental caries in two Australian states: Queensland (Qld)--5 per cent fluoridation coverage; and South Australia (SA)--70 per cent fluoridation coverage. METHOD: Stratified random samples were drawn from fluoridated Adelaide and the largely non-fluoridated rest-of-state in SA, and fluoridated Townsville and non-fluoridated Brisbane in Qld. PARTICIPANTS: Children were enrolled between 1991 and 1992 (SA: 5-15 yrs old, n = 9,980; Qld: 5-12 yrs old, n = 10,695). Follow-up caries status data for 3 years (+/- 1/2 year) were available on 8,183 children in SA and 6,711 children in Qld. MAIN OUTCOME MEASURES: Baseline data on lifetime exposure to fluoridated water, use of other fluorides and socio-economic status (SES) were collected by questionnaire, and tooth surface caries status by dental examinations in school dental service clinics. RESULTS: Higher per cent lifetime exposure to fluoridated water (6 categories: 0;1-24; 25-49; 50-74; 75-99; 100 per cent) was a significant predictor (ANOVA, p < 0.01) of lower annualised Net Caries Increment (NCI) for the deciduous dentition in SA and Qld, but only for Qld in the permanent dentition. These associations persisted in multiple linear regression analyses controlling for age, gender, exposure to other fluorides and SES (p < 0.05). CONCLUSIONS: Water fluoridation was effective in reducing caries increment, even in the presence of a dilution effect from other fluorides. The effect of fluoridated water consumption was strongest in the deciduous dentition and where diffusion of food and beverages from fluoridated to non-fluoridated areas was less likely.

Community effectiveness of fissure sealants and the effect of fluoridated water consumption.

OBJECTIVES: This study investigated the effectiveness of fissure sealants in a community-based programme and the relationship between fissure sealants effectiveness and exposure to fluoridated water. DESIGN: Prospective cohort study of children attending the School Dental Service (SDS) of two Australian states, Queensland and South Australia, across a period of between 6 months and 3.5 years (mean = 2 years). METHODS: Oral health data on 4-15-year-olds were obtained as part of regular examinations by the SDS while questionnaire data on residential and water consumption history were provided by children's parents or guardians. PARTICIPANTS: A sub-group of 789 children (mean age = 10.5 years) was selected with one contralateral pair of permanent first molars at baseline where the occlusal surface of one molar had been fissure sealed while the paired surface was diagnosed as sound. RESULTS: The caries incidence of the fissure sealed occlusal surfaces was 5.6% compared to 11.1% for sound surfaces (p < 0.001), demonstrating a 50% reduction in caries incidence for sealed vs non-sealed surfaces. The reduction in caries increment attributable to fissure sealing increased across fluoridated water exposure categories--a 36.4% reduction was found for children with 0% exposure (p > 0.05), a 55.0% reduction for children with intermediate exposure (p < 0.01), and an 82.4% reduction for children with 100% lifetime exposure to fluoridated water (p < 0.001). Differences between odds ratios for fissure sealants across exposure categories were not statistically significant. CONCLUSIONS: The effectiveness of fissure sealants in community-based programmes may be further improved when coupled with increased lifetime exposure to optimally fluoridated water.

Dental caries trends among indigenous and non-indigenous Australian children.

OBJECTIVE: To examine trends in dental caries among indigenous and non-indigenous children in an Australian territory. BASIC RESEARCH DESIGN: Routinely-collected data from a random selection of 6- and 12-year-old indigenous and non-indigenous children enrolled in the Northern Territory School Dental Service from 1989-2000 were obtained. The association of indigenous status with caries prevalence (percent dmft or DMFT>0 and percent dmft>3 or DMFT>1), caries severity (mean dmft or DMFT) and treatment need (percent d/dmft or D/DMFT) was examined. RESULTS: Results were obtained for 10,687 6- and 12-year old indigenous children and 21,777 6- and 12-year-old non-indigenous children from 1989-2000. Across all years, indigenous 6-year-olds had higher caries prevalence in the deciduous dentition, greater mean dmft and percent d/dmft, and indigenous 12-year-olds had greater percent D/DMFT than their non-indigenous counterparts (p<0.05). From 1996-2000 the mean dmft and percent d/dmft for indigenous 6-year-olds and mean DMFT and percent D/DMFT for indigenous 12-year-olds increased, yet remained relatively constant for their non-indigenous counterparts (p<0.05). From 1997-2000, the percent dmft>3 for 6-year-old indigenous children was more than double that of non-indigenous children, while across the period 1994-2000, indigenous 6-year-old mean dmft was more than double that of their non-indigenous counterparts (p<0.05). CONCLUSIONS: Indigenous children in our study experienced consistently poorer oral health than non-indigenous children. The severity of dental caries among indigenous children, particularly in the deciduous dentition, appears to be increasing while that of non-indigenous children has remained constant. Our findings suggest that indigenous children carry a disproportionate amount of the dental caries burden among Northern Territory 6- and 12-year-olds.

Dental fear in Australia: who's afraid of the dentist?

BACKGROUND: This study aimed to describe both the prevalence of dental fear in Australia and to explore the relationship between dental fear and a number of demographic, socio-economic, oral health, insurance and service usage variables. METHODS: A telephone interview survey of a random sample of 7312 Australian residents, aged five years and over, from all states and territories. RESULTS: The prevalence of high dental fear in the entire sample was 16.1 per cent. A higher percentage of females than males reported high fear (HF). Adults aged 40-64 years old had the highest prevalence of high dental fear with those adults aged 80+ years old having the least. There were also differences between low fear (LF) and HF groups in relation to socioeconomic status (SES), with people from higher SES groups generally having less fear. People with HF were more likely to be dentate, have more missing teeth, be covered by dental insurance and have a longer time since their last visit to a dentist. CONCLUSIONS: This study found a high prevalence of dental fear within a contemporary Australian population with numerous differences between individuals with HF and LF in terms of socioeconomic, socio-demographic and self-reported oral health status characteristics.