Gender and geographic diversity of global oral health organisations.

Introduction Diversity of leadership of global oral health organisations is critical to ensure a global agenda.Aim To analyse the gender and geographic diversity of global oral health organisations.Methods Publicly available data on the gender of their staff and leadership, and congress locations, were analysed. Gender was allocated from photographs if available, and using Genderize, an online allocation platform. Location of leaders and global congresses were analysed by country, region and World Bank income category. The organisations analysed were the International Association of Dental Research (IADR), FDI World Dental Federation, International Federation of Dental Hygienists (IFDH) and 15 dental specialist global associations.Results The majority of headquarter staff in the IADR (76%) and FDI (84%) are female. Gender diversity in the leadership differs across the various organisations, with recent progress towards gender parity. The IFDH was and is exclusively female-led. The majority of leaders are from high-income countries in Europe and North America. Of the 370 congress locations, 90% were held in high-income countries.Conclusion There is recent progress towards gender diversity in the leadership; however, this leadership is essentially from high-income countries. There is an urgent need to publicly commit to diversity goals and implement strategies to reflect the oral health workforce and be truly diverse and global.

Learning on the country: Motivating dental students to attend a rural placement.

PURPOSE/OBJECTIVES: This research aimed to identify factors that affect dental students' attitudes toward participation in rural clinical outplacements (RCOP) in Australia, and to suggest strategies that will increase students' desire to attend RCOP in the future. METHODS: Dental students from the nine dental schools in Australia were invited to an online survey on their willingness to participate in an RCOP and the factors that influence this willingness. These factors were grouped into themes of education, personal and health, social, financial, and information-related. RESULTS: The study had an estimated response rate of 10% with 202 responses. More than two-thirds (68%) of students were willing to participate in an RCOP. Students who grew up in a rural area were significantly more likely to be willing to attend an RCOP, compared to those from urban settings. Attitudes toward the anticipated educational experience of RCOP were positive, while factors related to finances and pre-existing information were of concern to students. Educational, personal/health-related, and social factors had significant impacts on participants' willingness to attend RCOP. CONCLUSION: Overall, despite students holding negative opinions on certain social and financial factors, their positive attitudes toward other factors outweighed these. Universities should aim to further promote the educational benefits of RCOP to improve students' attitudes prior to attending RCOP. In-depth qualitative analysis is required to explore students' concerns regarding RCOP and longitudinal research is warranted to monitor students' attitudes toward RCOP and rural work over time.

Socio-economic status and access to fluoridated water in Queensland: an ecological data linkage study.

OBJECTIVES: To investigate the relationship between access to fluoridated drinking water and area-level socio-economic status in Queensland. STUDY DESIGN: Ecological, geospatial data linkage study. SETTING: Queensland, by statistical area level 2 (SA2), 2021. MAIN OUTCOME MEASURES: Proportion of SA2s and of residents with access to fluoridated drinking water (natural or supplemented); relationship at SA2 level between access to fluoridated water and socio-economic status (Index of Relative Socio-economic Advantage and Disadvantage, IRSAD; Index of Economic Resources, IER). RESULTS: In 2021, an estimated 4 050 168 people (79.4% of the population) and 397 SA2 regions (72.7%) in Queensland had access to fluoridated water. Access was concentrated in the southeastern corner of the state. After adjusting for SA2 population, log area, and population density, the likelihood of access to fluoridated drinking water almost doubled for each 100-rank increase in IRSAD (adjusted odds ratio [aOR], 1.93; 95% confidence interval [CI], 1.59-2.36) or IER (aOR, 1.77; 95% CI, 1.50-2.11). CONCLUSIONS: The 2012 decision to devolve responsibility for water fluoridation decisions and funding from the Queensland government to local councils means that residents in lower socio-economic areas are less likely to have access to fluoridated water than those in more advantaged areas, exacerbating their already greater risk of dental disease. Queensland water fluoridation policy should be revised so that all residents can benefit from this evidence-based public health intervention for reducing the prevalence of dental caries.

Oral health related quality of life of oral cancer patients treated with radiotherapy alone or with chemotherapy in a tertiary referral centre in Sri Lanka.

BACKGROUND: Oral cancer is the number one cancer among males in Sri Lanka. Radiotherapy is a common treatment modality for oral cancer, but this can affect oral health related quality of life (OHRQOL). This study assessed the OHRQOL and its changes from baseline to the last week of radiotherapy and three months post radiotherapy among oral cancer patients who received this treatment alone or with chemotherapy. METHODS: A prospective longitudinal study was conducted among 90 oral cancer patients awaiting for radiotherapy alone or with chemotherapy. The modified Sinhala version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Oral Health Module (EORTC QLQ-OH15) was used to gather data related to OHRQOL before radiotherapy. Socio-demographic and clinical data were also recorded. The same cohort of patients were followed up and assessed their OHRQOL during the last week of radiotherapy and three months post radiotherapy. The Modified EORTC QLQ-OH15 assesses the OHRQOL under three domains namely 'Eating problem', 'Gum and speech problem' and 'Soreness', and one item named as 'Teeth'. RESULTS: The majority of the sample (88%) was males. The anterior two-thirds of the tongue (40%) and buccal mucosa (22%) were the most common sites. The median scores of 'Eating problem' domain at baseline, last week of radiotherapy and three months post radiotherapy were 20 (IQR = 6.7-33.3), 100 (IQR = 86.9-100.0) and 66.7 (IQR = 46.7-93.3) respectively. 'Gum and speech problem' was higher during last week of radiotherapy (median, 50.0, IQR, 25.0-58.3) than three months post radiotherapy (median, 8.3, IQR, 0.0-33.3). The changes of OHRQOL between the time frames were statistically significant (p < 0.05). Baseline OHRQOL in relation to 'Gum and speech problem' domain and 'Teeth' item was identified as an influential factor for OHRQOL during last week of radiotherapy. CONCLUSION: The OHRQOL of oral cancer patients who received radiotherapy alone or with chemotherapy had deteriorated from the baseline level to the last week of radiotherapy but then improved at three months post radiotherapy. The OHRQOL however did not return to the baseline level three months post radiotherapy. OHRQOL during the last week of radiotherapy was influenced by the OHRQOL at baseline, civil status and sites of metastasis.

Positive oral health outcomes: A partnership model improves care in a rural Indigenous community.

OBJECTIVE: The purpose of this study was to explore the benefits of a partnership between a university dental school and a Community Controlled Health Service, specifically in relation to improving the oral health of an underserved rural Indigenous community. We sought community opinions on health and social outcomes arising from the service provided by the dental student clinical outplacement. SETTING: In Dalby, Queensland. PARTICIPANTS: In total, 38 participants in five focus groups were representative of local Indigenous community Elders, community health support group members and management and staff. DESIGN: A descriptive qualitative study employing semi-structured audio-recorded focus group discussions conducted with purposefully selected Indigenous community groups to explore participant views and experience of the partnership model. Qualitative data were analysed using thematic content analysis. RESULTS: The Indigenous community representatives expressed positive benefit in both their general and oral health awareness, in improved access to dental care provided in their own safe space, while they were pleased to assist with students' learning. They viewed the partnership as mutually beneficial. Suggestions for enhancement of the oral health service were also offered. CONCLUSION: This partnership between a university and a Community Controlled Health Service provides sustainable positive social and health benefits for the targeted Indigenous community and for the wider local population, while simultaneously providing enhanced educational benefits for students on clinical outplacement. Translation and uptake of this successful model of care would benefit both underserved communities and dental and other health care professional educators worldwide.

Health professionals delivering oral health interventions in early childhood: A scoping review of Australian and New Zealand literature.

ISSUE ADDRESSED: Dental caries is highly prevalent in very young Australian and New Zealand children. Health professionals other than registered dental professionals can help prevent early childhood caries, promoting oral health to assist families establish preventative oral health habits at a child's early age. This review identifies oral health promotion (OHP) delivered by nondental health professionals in Australia and New Zealand involving very young children. METHODS: Databases (MEDLINE, CINAHL, Embase, Emcare, Web of Science, Scopus, ProQuest, Google Scholar, TROVE) and digital libraries were searched between 2001 and 2021 for eligible studies and grey literature. Studies with a focus on preventative oral health strategies in a primary health care context were included. RESULTS: The review identified 76 studies. Seven met the inclusion criteria, and were conducted in Australia across metropolitan, rural, and remote settings. Studies that successfully engaged nondental health professionals to promote oral health to families reported a positive change in oral health practices among very young children. Delivering OHP during a child's early life stage positively influenced their oral health outcomes. CONCLUSIONS: Integration of dental and primary health care increased access to oral health care and advanced positive oral health outcomes for children. With adequate training, resources, and support mechanisms, nondental health professionals can deliver oral health strategies that facilitate behaviour change in parents to improve children's oral health. So What? Health promotion generates enabling conditions that support and empower families to improve and maintain their oral health. Nondental health professionals can play a crucial role promoting oral health for very young children and improving equitable access to preventative oral health care.

Sources of occupational stress amongst dentistry academics.

BACKGROUND: Dentistry professionals may experience significantly higher occupational stress than other health professionals and dentistry academics may have specific work content and context sources of stress. AIMS: The aim of this study is to identify common sources of occupational stress, and how these are associated with wellbeing, in dentistry academics. MATERIALS & METHODS: A cross-sectional online survey with staff in Dentistry departments in Australia and New Zealand. Assessment included 23 items from five general domains of occupational stress from the NIOSH-Generic Job Stress Questionnaire, a 23-item list of sources of stress and the 22-item Psychological General Well-Being Index. Analyses used descriptive statistics and multiple linear regression. RESULTS: A total of 107 respondents (average age 50 ± 11.7 years, 56.8% men) completed the survey. Leading sources of occupational stress were job future, time pressure at work, work overload, and administration demands. A multiple linear regression model significantly predicted wellbeing, F(8,77) = 13.141, p = .000, adj.R2  = .53, but there were no significant associations for any of the specific sources of stress. CONCLUSION: The combination of time pressure, workload and responsibility, job dissatisfaction, low social support, and uncertain job future was inversely associated with wellbeing amongst these dentistry academics. Future studies should consider the development and evaluation of interventions to address these concerns.

'You can't be what you can't see': equity, diversity and inclusivity of editorial teams of dental journals.

Introduction Equity, diversity and inclusivity in research is critical to ensure all of society contributes.Aim This study analysed the gender and location (workplace) of editorial teams across 124 dental journals.Methods All chief editors of the 91 dental journals listed on the journal citation report for 2021 were contacted to provide details of the numbers of chief editors, other editors and the editorial board members, plus a summary of their demographic information including gender, age (group) and location. If chief editors did not respond, publicly available information was collated for the analysis. The same publicly available information of 45 PubMed indexed journals not on the citation report and three emerging online journals was also retrieved.Results Of the 159 chief editors across the 124 journals, 131 (82%) were men and 30% were based in the USA. Of the 1,265 other editors, two-thirds were from the USA, UK, Brazil and Japan. Of the 3,044 editorial board members, half were from the same four countries.Conclusions 'You can't be what you can't see': women and people from many parts of the world cannot see themselves as chief editors, other editors or editorial board members of dental journals.

Translation and validation of Sinhala version of modified EORTC QLQ-OH15 in oral cancer patients who receive radiotherapy with or without chemotherapy in Sri Lanka.

BACKGROUND: The recognition of patient-reported outcomes for oral cancer is important in improving patients' quality of life. The aim of this study was to translate and validate the modified Sinhala version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Oral Health Module (EORTC QLQ-OH15). METHODS: A cross-sectional study was conducted to validate the EORTC QLQ-OH15 that was modified after adding two questions to the original questionnaire. The two questions added were 'difficulty in opening the mouth wide' and 'trouble with talking' which affect oral health related quality of life (OHRQOL) of oral cancer patients receiving radiotherapy. The Sinhala translated modified EORTC QLQ-OH15 and already validated the core questionnaire EORTC QLQ-C30 were self-completed by 85 adult oral cancer patients who received initial anti-cancer treatment with radiotherapy with or without chemotherapy. Content and face validity were examined by an expert panel. Construct validity was confirmed by using factor analysis, multi-trait scaling analysis, and known group comparison. Reliability was assessed by internal consistency, test-retest reliability by Wilcoxon Signed Ranks Test and intra class correlation coefficient. Responsiveness to change was assessed. RESULTS: The majority of participants (58%) were aged 50-69 years and 84% were males. Nearly 32% had cancer of the anterior two thirds of the tongue. Of the sample, 66% received chemo radiotherapy. Thirteen items were included for the factor analysis. They were loaded for four factors. Three scales 'Eating problem', 'Gum and Speech problem' and 'Soreness' loaded with 5, 4 and 3 items respectively and single item 'teeth' to a one factor with the total variance explained was 72.74%. Mann-Whitney U tests for all three scales were statistically significant confirming the ability of the modified EORTC QLQ-OH15 to detect expected differences in OHRQOL in clinically different groups. Cronbach's alpha for all the scales were more than 0.8. Wilcoxon Matched Paired Sign Rank Test showed highly significant results (p < 0.05) for all three scales revealing high responsiveness. CONCLUSIONS: The modified Sinhala version of the EORTC QLQ-OH15 is a valid, reliable tool that can be used to measure OHRQOL in oral cancer patients who receive radiotherapy with or without chemotherapy.

Water fluoridation, dental caries and parental ratings of child oral health.

OBJECTIVES: Previous studies have identified many demographic, socioeconomic, behavioural and clinical variables associated with subjective parental ratings of child oral health. This study investigated associations between children's lifetime exposure to fluoridated drinking water (LEFW) and dental caries prevalence and parental ratings. METHODS: Australia's National Child Oral Health Study 2012-2014 conducted oral epidemiological examinations for 24 664 children aged 5-14 and investigated risk factors for child oral health and disease through questionnaires. Parents also subjectively rated their child's oral health. This cross-sectional study estimated prevalence ratios for associations between LEFW and prevalence of dental caries in the primary and permanent dentitions and parental oral health ratings for 5-8 year old and 9-14 year old children. E-value sensitivity analyses helped assess whether observed effect sizes may have arisen through unmeasured confounding. RESULTS: Children aged 5-8 with 0%-10% or 11%-89% LEFW are respectively 1.5 (95% CI 1.2-1.8) and 1.5 (95% CI 1.1-2.0) times more likely than children with 90%-100% LEFW to receive a fair or poor parental oral health rating. Children aged 9-14 with 0%-10% or 11%-89% LEFW are 1.2 (95% CI 1.0-1.4) times more likely than children with 90%-100% LEFW to receive a fair or poor parental oral health rating. Children aged 5-8 with 0%-10% or 11%-89% LEFW are respectively 1.4 (1.3-1.6) and 1.3 (95% CI 1.1-1.4) times more likely than children with 90%-100% LEFW to experience caries in their primary teeth. Children aged 9-14 with 0%-10% or 11%-89% LEFW are respectively 1.4 (95% CI 1.3-1.5) and 1.1 (95% CI 1.0-1.2) times more likely than children with 90%-100% LEFW to experience caries in their permanent teeth. CONCLUSIONS: Longer lifetime exposure to fluoridated drinking water is causally associated with a lower childhood dental caries prevalence and more positive parental ratings of child oral health. The associations are stronger for younger children.

Oral health: Epidemiology and concordance in Australian children and parents.

INTRODUCTION: Studying parent-child pair health provides the opportunity to identify risk factors and opportunities for oral health prevention and intervention focusing on the family context. The aim of this study was to describe the oral health of children aged 11-12 years and their parents in a national sample of parent-child dyads in Australia. METHODS: The Child Health CheckPoint is a study of 11 to 12-year-old children and one parent nested within the Longitudinal Study of Australian Children, a nationally representative cohort study. In 2015-16, the study collected two-dimensional photographic intra-oral images and was scored using visual assessments of the teeth, oral hygiene and malocclusion. RESULTS: Of the 1874 CheckPoint families, 1396 biological parent-child pairs had at least one oral health measure recorded. Over two-thirds of children had moderate to severe gingival inflammation (69.7%, 95%CI 64.7-74.9). Parents had a lower proportion of poor oral hygiene (2.1%, 95% CI 1.4-3.0) than children (13.0%, 95% CI 11.3-14.9). High concordance was seen in the Modified Gingival Index correlation coefficient 0.49 (95%CI 0.44-0.53). CONCLUSION: The high concordance in gingival health between child-parent pairs supports the familial and behavioural links established in previous studies. Children had poorer oral hygiene but fewer visible dental caries lesions than their parents. As dental caries is a chronic and cumulative disease, preventive interventions targeting children's oral hygiene are needed.

Predicting dental caries increment using salivary biomarkers in a remote Indigenous Australian child population.

BACKGROUND: The burden of childhood dental caries amongst Indigenous Australians is higher than in other Australians. Because of differences in lifestyle and the evolutionary history of the oral microbiota, associated risk indicators may differ. Here, we evaluate associations between caries increment, salivary biomarkers and baseline caries among children aged 5-17 years residing in a remote rural Indigenous community. METHODS: This study was part of a trial assessing cost-effectiveness of an intervention to prevent dental caries among children. Baseline epidemiology and application of topical caries-preventive measures was conducted in 2015, followed-up in 2016 and 2017. Children who did not consent or failed to attend the prevention visits but did attend for follow-up epidemiology constituted a natural comparison group for evaluating the intervention. Saliva flow, pH, buffering and bacterial loads were measured at all visits. Caries was scored by the International Caries Detection and Assessment system. Outcome was caries increment. Explanatory variables were sex, being in experimental or comparison group, baseline caries, saliva flowrate and buffering, pH, and salivary loads of mutans streptococci (MS), Lactobacilli (LB), and yeast. Chi Square tests compared caries incidence in relation to explanatory variables and Generalised Linear Models explored associations between explanatory and outcome variables. RESULTS: Of 408 participants at baseline, only 208 presented at 2-year follow-up. Of caries-free children at baseline, significantly fewer had incipient (p = 0.01) and advanced (p = 0.04) caries after two years. Children in the experimental group experienced fewer tooth surfaces with advanced caries (p = 0.02) than comparison children. Having caries at baseline (p = 0.02) and low salivary flow-rates (p < 0.001) saw a significant increase in advanced caries after two years. Children with high salivary loads of MS (p = 0.03) and LB (p = 0.004) experienced more advanced carious surfaces. Multivariable analysis revealed 58% reduction (p = 0.001) in advanced caries among children with high salivary flow rates. Caries increment was 61% (p = 0.03) more for incipient and 121% (p = 0.007) more for advanced caries among children who harboured higher loads of MS. CONCLUSION: As with other ethnicities, children with low salivary flow and those with high MS had higher incipient and advanced caries increments after two years. Such risk assessments facilitate targeted preventive interventions for such communities. TRIAL REGISTRATION: Australian New Zealand Clinical Trials Registry (ANZCTR), No: ACTRN12615000693527: 3 July 2015.

Avoidable emergency department presentations for dental comorbidities of psychiatric disorders: A population-based record-linkage analysis.

BACKGROUND: Indigenous peoples and those from non-Caucasian, poorer or rural backgrounds are at greater risk of emergency department (ED) presentations for non-traumatic or avoidable dental conditions. There is no information on people with mental illness. OBJECTIVE: To compare avoidable dental ED admissions in psychiatric patients with those of the general population over 2 years. METHODS: A population-based record-linkage analysis across state-based facilities in Queensland, Australia. Avoidable dental ED presentations were defined using ICD10 codes K02.9, K04.7, K05.0, K08.8 and K12. RESULTS: There were 1,381,428 individuals in the linked database, of whom 657,933 (47.6%) were male. Of the sample, 177,157 (13%) had a history of contact for mental health problems and 22,046 (1.5%) had at least one avoidable dental presentation. The most two common were unspecified disorders of teeth or supportive structures (n = 10,184) and periapical abscesses (n = 7970). After adjusting for confounders, those who had ever needed psychiatric treatment were 72% more likely to experience an avoidable dental presentation (95% = 1.65-1.79; p < 0.0001). Other significant independent risk factors were lower income, rurality and Indigenous status. Within the inpatient psychiatric group, those with substance use or personality disorders had the highest risk of avoidable presentations. CONCLUSIONS: In common with other marginalised groups, psychiatric patients have increased avoidable presentations. Possible clinical interventions could include an increased emphasis on oral health assessment in primary health care and early dental referral. Dental education and service planning should consider this population's needs including easier navigation of services, availability outside normal office hours, and free outreach dental clinics.

Carious lesions in permanent dentitions are reduced in remote Indigenous Australian children taking part in a non-randomised preventive trial.

We tested the effect of an annual caries preventive intervention, delivered by a fly-in/fly-out oral health professional team, with Indigenous children residing in a remote Australian community. Around 600 Indigenous children aged 5 to 17 years were invited to participate at baseline, of who 408 had caregiver consent. One hundred and ninety-six consented to the epidemiological examination and intervention (Intervention group) and 212 consented to the epidemiological examination only (Comparison group). The intervention, which occurred annually, comprised placement of fissure sealants on suitable teeth, and application of povidone-iodine and fluoride varnish to the whole dentition, following completion of any necessary restorative dental treatment. Standard diet and oral hygiene advice were provided. Caries increment (number of tooth surfaces with new dental caries) in both deciduous and permanent dentitions was measured at the 2-year follow-up. Comparison group children had significantly higher number of new surfaces with advanced caries in the permanent dentition than the Intervention group (IRR = 1.61; 95% CI: 1.02-2.54; p = 0.04); with a preventive fraction of 43%. The effect of intervention remained significant with children in the Comparison group developing significantly more advanced caries lesions in the permanent dentition than the Intervention group children in the adjusted multivariable analysis (IRR = 2.21; 95% CI: 1.03-4.71). Indigenous children exposed to the intervention had less increment in advanced dental caries in the permanent dentition than those not exposed to the intervention.

Biocultural Drivers of Salivary Microbiota in Australian Aboriginal and Torres Strait Islander Children.

Australian Aboriginal and Torres Strait Islander children experience unacceptably high rates of dental caries compared to their non-Indigenous Australian counterparts. Dental caries significantly impacts the quality of life of children and their families, particularly in remote communities. While many socioeconomic and lifestyle factors impact caries risk, the central role of the oral microbiota in mediating dental caries has not been extensively investigated in these communities. Here, we examine factors that shape diversity and composition of the salivary microbiota in Aboriginal and Torres Strait Islander children and adolescents living in the remote Northern Peninsula Area (NPA) of Far North Queensland. We employed 16S ribosomal RNA amplicon sequencing to profile bacteria present in saliva collected from 205 individuals aged 4-17 years from the NPA. Higher average microbial diversity was generally linked to increased age and salivary pH, less frequent toothbrushing, and proxies for lower socioeconomic status (SES). Differences in microbial composition were significantly related to age, salivary pH, SES proxies, and active dental caries. Notably, a feature classified as Streptococcus sobrinus increased in abundance in children who reported less frequent tooth brushing. A specific Veillonella feature was associated with caries presence, while features classified as Actinobacillus/Haemophilus and Leptotrichia were associated with absence of caries; a Lactobacillus gasseri feature increased in abundance in severe caries. Finally, we statistically assessed the interplay between dental caries and caries risk factors in shaping the oral microbiota. These data provide a detailed understanding of biological, behavioral, and socioeconomic factors that shape the oral microbiota and may underpin caries development in this group. This information can be used in the future to improve tailored caries prevention and management options for Australian Aboriginal and Torres Strait Islander children and communities.

Planning the oral health workforce: Time for innovation.

The levels and types of oral health problems occurring in populations change over time, while advances in technology change the way oral health problems are addressed and the ways care is delivered. These rapid changes have major implications for the size and mix of the oral health workforce, yet the methods used to plan the oral health workforce have remained rigid and isolated from planning of oral healthcare services and healthcare expenditures. In this paper, we argue that the innovation culture that has driven major developments in content and delivery of oral health care must also be applied to planning the oral health workforce if we are to develop 'fit for purpose' healthcare systems that meet the needs of populations in the 21st century. An innovative framework for workforce planning is presented focussed on responding to changes in population needs, service developments for meeting those needs and optimal models of care delivery.

Response of Salivary Microbiota to Caries Preventive Treatment in Aboriginal and Torres Strait Islander Children.

A once-annual caries preventive (Intervention) treatment was offered to Aboriginal and Torres Strait Islander schoolchildren-a population with disproportionately poorer oral health than non-Indigenous Australian children-in the Northern Peninsula Area (NPA) of Far North Queensland (FNQ), which significantly improved their oral health. Here, we examine the salivary microbiota of these children (mean age = 10 ± 2.96 years; n = 103), reconstructing the bacterial community composition with high-throughput sequencing of the V4 region of bacterial 16S rRNA gene. Microbial communities of children who received the Intervention had lower taxonomic diversity than those who did not receive treatment (Shannon, p < 0.05). Moreover, the Intervention resulted in further decreased microbial diversity in children with active carious lesions existing at the time of saliva collection. Microbial species associated with caries were detected; Lactobacillus salivarius, Lactobacillus reuteri, Lactobacillus gasseri, Prevotella multisaccharivorax, Parascardovia denticolens, and Mitsuokella HMT 131 were significantly increased (p < 0.05) in children with severe caries, especially in children who did not receive the Intervention. These insights into microbial associations and community differences prompt future considerations to the mechanisms behind caries-preventive therapy induced change;  important for understanding  the long-term implications of like treatment to improve oral health disparities within Australia. Trial registration: ANZCTR, ACTRN12615000693527. Registered 3 July 2015, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368750&isReview=true.

Tooth loss, denture wearing and implants: Findings from the National Study of Adult Oral Health 2017-18.

BACKGROUND: We aimed to describe the prevalence of different tooth loss outcomes along with the use of dentures and implants among Australians aged 15+ years across socioeconomic and demographic groups. In addition, we performed time trend analyses of tooth loss. METHODS: Data from the National Study of Adult Oral Health 2017-18 included gender, age, residential location, household income, Socio-Economic Indexes for Areas, possession of dental insurance and pattern of dental visiting. Outcomes were complete tooth loss, inadequate dentition, average number of missing teeth, denture wearing and implants. We compared our findings with data from previous surveys carried out in 1987-88 and 2004-06. RESULTS: Tooth loss decreased from 14.4% in 1987-88 to 6.4% in 2004-06, and to 4.0% in 2017-18. The proportion of people with lack of functional dentition halved from 20.6% 1987-88 to 10.2% in 2017-18; the average number of teeth lost due for any reason slightly reduced from 2004-06 (6.1) to 2017-18 (5.7). Tooth loss increased with age and was higher among socioeconomically disadvantaged, uninsured and those with unfavourable pattern of dental visiting groups than in their counterparts. CONCLUSIONS: An overall improvement in tooth retention was identified over the last decades. However, socioeconomic inequalities persist.

Surface-Specific Caries Preventive Effect of an Intervention Comprising Fissure Sealant, Povidone-Iodine and Fluoride Varnish in a Remote Indigenous Community in Australia.

This study evaluates the effect of a topical intervention comprising of fissure sealant, povidone-iodine, and fluoride varnish in preventing caries on occlusal, approximal, and smooth surfaces. This three-year clinical trial was conducted in a remote Indigenous community of Australia. All schoolchildren (age range: 4-17) were invited to participate; those with parental consents to receive three-annual epidemiological examinations and interventions constituted the experimental group, while those with consents for only the epidemiological examination formed a comparison group. The intervention group received an annual application of fissure sealant, povidone-iodine and fluoride varnish for two consecutive years along with the restoration of any cavitated lesions, while the comparison group did not receive any intervention except for the usual care that included emergency treatment and restorations. Incipient and advanced caries were recorded in the permanent dentition while data on confounding variables were collected through questionnaires. Caries increment and progression were the outcome variables. A total of 408 children participated in the baseline examination, 208 finished the study. After adjusting for confounders, the prevented fraction (PF) on occlusal surfaces for advanced caries in the experimental group was 76.1% (mean difference- -0.35, 95% CI: -0.67-0.04), while the PF for progression from incipient to advanced caries was 100%(mean difference- -0.30, 95% CI: -0.52-0.09). The mean number of smooth surfaces that progressed from incipient to advanced caries in the comparison group was more than twice that of the experimental group, the mean difference was -0.25 (95% CI: -0.46--0.03) with a PF of 61%. The intervention was only effective in preventing advanced caries on occlusal surfaces and in halting the progression of caries on occlusal and smooth surfaces but not on approximal caries.

Family-Level Predictors of Australian Children's Dental Caries and Injuries.

Purpose: Fisher-Owens et al. described the diverse family-level factors influencing children's oral health, but few studies have investigated these relationships using longitudinal data. This study investigated the association between family and child oral health using the Longitudinal Study of Australian Children (LSAC), a cross-sequential dual cohort study. Methods: A total of 10,090 children were recruited at baseline, and seven waves of data are available. Children's parents or guardians reported experiences of dental caries and injury. Data were used to model family-level predictors with generalized estimating equations. Results: In the final model, predictors of dental caries over time were younger mothers (odds ratio [OR] equals 1.37, 95 percent confidence interval [95% CI] equals 1.01 to 1.87) and lower parental education (OR equals 1.24, 95% CI equals 1.10 to 1.39). Other significant factors were poor parental health, parents smoking, English as the main language, and Indigenous parents. Parents with consistent parenting styles protected against caries. Predictors of dental injury included socioeconomic status and parental age. Conclusions: This study highlighted a number of significant family-level constructs that predict dental caries and injury. Understanding the influence of family provides evidence to warrant investigation into tailored interventions targeting young mothers, common health risk factors, and parenting styles.