ABSTRACT
BACKGROUND: Social disadvantage leads to dental caries during childhood. AIM: This study investigated whether dental caries occur earlier in children from households experiencing social disadvantage than those not experiencing social disadvantage. DESIGN: The overall risk of, and relative time to, early childhood caries (ECC) according to sociodemographic characteristics in Victoria, Australia, was quantified. Records for 134 463 children in Victoria, Australia, from 2009 to 2019 were analysed. Time ratios (TR) and hazard ratios (HR) of carious lesion(s) in early childhood were estimated. RESULTS: Compared with reference groups, Indigenous children had an adjusted TR of 0.80 (95% CI: 0.78, 0.82), children from households with languages other than English had an adjusted TR of 0.83 (95% CI: 0.82, 0.84), and dependants of concession cardholders had an adjusted TR of 0.81 (95% CI: 0.80, 0.81); therefore, 20%, 17% and 19% reduced times to the first carious lesion, respectively. The estimated HRs were 1.57 (95% CI: 1.49, 1.67) for Indigenous children, 1.46 (95% CI: 1.42, 1.50) for children from households with other languages and 1.57 (CI: 1.53, 1.60) for dependants of concession cardholders. CONCLUSION: Preventive oral health interventions must be targeted early in children from households experiencing social disadvantage to avoid social inequities in ECC.
ABSTRACT
OBJECTIVE: To assess the longitudinal trends in social inequalities in early childhood caries (ECC) using collected population-based data. METHODS: Clinical data on children were routinely collected from 2008 to 2019 in Victoria, Australia. ECC prevalence and severity (dmft) were quantified according to Indigenous status, culturally and linguistically diverse (CALD) status, concession cardholder status, geographic remoteness and area deprivation. The inverse probability weighting was used to quantify social inequalities in ECC. The weighted prevalence differences, and the ratio between the weighted prevalence of ECC and mean dmft and their 95% confidence interval, were then plotted. RESULTS: Absolute inequalities in ECC prevalence increased for children by 7% for CALD status and cardholder status between 2008 and 2019. Likewise, absolute inequalities in ECC severity in this time period increased by 0.6 for CALD status and by 0.4 for cardholder status. Relative inequalities in ECC increased by CALD (ratio: 1.3 to 2.0), cardholder status (1.3 to 2.0) and area deprivation (1.1 to 1.3). Relative inequalities in severity increased by CALD (1.5 to 2.8), cardholder (1.4 to 2.5) or area deprivation (1.3 to 1.5). Although children with Indigenous status experienced inequalities in ECC prevalence and severity, these did not increase on the absolute (ECC: 0.1-0.1 Severity: 1.0-0.1) or relative scale (ECC ratio: 1.3-1.3 Severity ratio: 1.6-1.1). CONCLUSIONS: Trends in inequalities in ECC were different according to sociodemographic measures. Oral health policies and interventions must be evaluated on the basis of reducing the prevalence of oral diseases and oral health inequalities between population sub-groups.
Subject(s)
Dental Caries Susceptibility , Dental Caries , Child , Humans , Child, Preschool , Dental Caries/epidemiology , Socioeconomic Factors , Oral Health , Australia , PrevalenceABSTRACT
The aim of this study is to determine where Aboriginal people living in Victoria attend public oral health services; whether they access Aboriginal-specific or mainstream services; and the gap between dental caries (tooth decay) experience in Aboriginal and non-Aboriginal people. Analysis was undertaken on routinely collected clinical data for Aboriginal patients attending Victorian public oral health services and the distribution of Aboriginal population across Victoria. Approximately 27% of Aboriginal people attended public oral health services in Victoria across a 2-year period, with approximately one in five of those accessing care at Aboriginal-specific clinics. In regional Victoria, 6-year-old Aboriginal children had significantly higher levels of dental caries than 6-year-old non-Aboriginal children. There was no significant difference in other age groups. This study is the first to report where Aboriginal people access public oral health care in Victoria and the disparity in disease between Aboriginal and non-Aboriginal users of the Victorian public oral healthcare system. Aboriginal people largely accessed mainstream public oral healthcare clinics highlighting the importance for culturally appropriate services and prevention programs to be provided across the entire public oral healthcare system. The findings will guide development of policy and models of care aimed at improving the oral health of Aboriginal people living in Victoria.
Subject(s)
Dental Caries/epidemiology , Health Services, Indigenous/organization & administration , Healthcare Disparities/statistics & numerical data , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Oral Health/statistics & numerical data , Child , Dental Caries/therapy , Female , Humans , Male , Preventive Health Services/organization & administration , VictoriaABSTRACT
The aim of this study was to investigate the socio-demographic characteristics of the eligible population of users of public oral health care services in the Australian state of Victoria, aged 17 years or younger. The study was conducted as a secondary analysis of data collected from July 2008 to June 2009 for 45,728 young clients of public oral health care. The sample mean age was 8.9 (SD: 3.5) years. The majority (82.7%) was between 6 and 17 years of age, and 50.3% were males. The majority (76.6%) was Australian-born and spoke English at home (89.1%). The overall mean DMFT was 1.0 (SD: 2.1) teeth, with a mean dmft of 3.16 (SD: 5.79) teeth. Data indicate that, among six year olds in the Significant Caries Index (SiC) category, the mean dmft was 6.82 teeth. Findings corroborate social inequalities in oral health outcome and provide suggestions for oral health services to develop strategies and priorities to reduce inequalities in health and well-being, and better coordinate and target services to local needs.
Subject(s)
Dental Health Services/statistics & numerical data , Adolescent , Age Distribution , Child , DMF Index , Dental Care for Children/statistics & numerical data , Female , Health Services, Indigenous/statistics & numerical data , Humans , Male , Native Hawaiian or Other Pacific Islander/statistics & numerical data , Socioeconomic Factors , VictoriaABSTRACT
The aim of this study was to investigate the socio-demographic characteristics of the eligible population of users of public oral health care services in the Australian state of Victoria, aged 17 years or younger. The study was conducted as a secondary analysis of data collected from July 2008 to June 2009 for 45,728 young clients of public oral health care. The sample mean age was 8.9 (SD: 3.5) years. The majority (82.7%) was between 6 and 17 years of age, and 50.3% were males. The majority (76.6%) was Australian-born and spoke English at home (89.1%). The overall mean DMFT was 1.0 (SD: 2.1) teeth, with a mean dmft of 3.16 (SD: 5.79) teeth. Data indicate that, among six year olds in the Significant Caries Index (SiC) category, the mean dmft was 6.82 teeth. Findings corroborate social inequalities in oral health outcome and provide suggestions for oral health services to develop strategies and priorities to reduce inequalities in health and well-being, and better coordinate and target services to local needs.
O objetivo deste estudo foi investigar as características sociodemográficas de usuários do serviço público de saúde bucal no Estado de Vitória, Austrália, com até 17 anos de idade. O presente estudo é uma análise de dados secundários de 45.728 sujeitos que recorreram ao serviço público de saúde bucal entre julho de 2008 a junho de 2009. A idade média da amostra foi 8,9 (DP: 3,5) anos. A maioria dos sujeitos (82,7%) apresentava entre 6 e 17 anos de idade e 50,3% eram do gênero masculino. A maioria (76,6%) havia nascido na Austrália e falava inglês em casa (89,1%). O índice CPOD médio foi 1,0 (DP: 2,1) e o ceod 3,16 (DP: 5,79). Os dados indicam que entre as crianças de 6 anos categorizadas no Significant Caries Index (SiC), o índice ceod médio foi 6,82. Os achados demonstram desigualdade social nos desfechos de saúde bucal e fornecem sugestões para que os serviços de saúde bucal desenvolvam estratégias e prioridades para reduzir tais desigualdades na saúde e bem-estar, de forma a adequar os serviços às necessidades locais.
El objetivo de este estudio fue describir las características sociodemográficas de la población de usuarios de los servicios públicos de atención odontológica, de 17 o menos años de edad, en el estado australiano de Victoria. El estudio realiza un análisis secundario de los datos de 45.728 pacientes que asistieron a los servicios de atención odontológica públicos entre julio 2008 y junio 2009. El promedio de edad de la muestra fue 8,9 (s.d. 3,5) años. La mayoría (82,7 %) tenía entre 6 y 17 años de edad, y el 50,3 % fue de sexo masculino. La mayoría (76,6%) nació en Australia y hablaba inglés en casa (89,1%). El COPD promedio fue 1.0 (s.d. 2.1) dientes, con un ceod promedio de 3,16 (s.d. 5,79) dientes. A los 6 años de edad en la categoría de Índice de Caries Significativo, el dmft promedio fue de 6.82 dientes. Los resultados confirman desigualdades sociales en salud bucodental y proporcionan sugerencias para los servicios de salud bucodental, con el fin de desarrollar estrategias y prioridades tendientes a la reducción de desigualdades en salud y bienestar.