Assessment of the quality and accuracy of information contained within the websites of marketed orthodontic products: a cross-sectional investigation.

OBJECTIVES: To assess the quality and accuracy of information contained within the websites of providers of marketed orthodontic products. MATERIALS AND METHODS: Twenty-one websites of orthodontic appliance and adjunct (product) providers were identified. The website content was assessed via two validated quality-of-information instruments (DISCERN and the Journal of the American Medical Association [JAMA] benchmarks) and an accuracy-of-information instrument. Website content was qualitatively analyzed for themes and subthemes. RESULTS: More than half (n = 11; 52.3%) of the assessed websites contained clinician testimonials. The mean (SD) DISCERN score was 33.14 (5.44). No website recorded the minimum of three JAMA benchmarks required to indicate reliability. The most common content themes related to quality-of-life impact and treatment duration. Just 8% of the statements within the websites were objectively true. The Pearson correlation coefficient indicated that the DISCERN scores were correlated with the accuracy-of-information scores (r = .83; P < .001). CONCLUSIONS: The quality and accuracy of information contained within the websites of the providers of marketed orthodontic products was poor. The combined use of DISCERN and the accuracy-of-information instrument may help overcome the shortcomings of each. Clinicians should check the accuracy of information on orthodontic product provider websites before adding links to those websites on their own sites.

The protective effect of CALD identity in the presence of low income on missing teeth of Australian adults over time.

BACKGROUND: 'Culturally And Linguistically Diverse (CALD)' populations have diverse languages, ethnic backgrounds, societal structures and religions. CALD populations have not experienced the same oral health benefits as non-CALD groups in Australia. However, the socio-demographic profile of Australian CALD populations is changing. This study examined how household income modifies the oral health of CALD and non-CALD adults in Australia. METHODS: Data were from two National Surveys of Adult Oral Health (NSAOH) conducted in 2004-06 (NSAOH 2004-06) and 2017-18 (NSAOH 2017-18). The outcome was self-reported number of missing teeth. CALD status was identified based on English not the primary language spoken at home and country of birth not being Australia. Social disadvantage was defined by total annual household income. Effect-measure modification was used to verify differences on effect sizes per strata of CALD status and household income. The presence of modification was indicated by Relative Excess Risk due to Interactions (RERIs). RESULTS: A total of 14,123 participants took part in NSAOH 2004-06. The proportion identifying as CALD was 11.7% and 56.7% were in the low-income group, and the mean number of missing teeth was 6.9. A total of 15,731 participants took part in NSAOH 2017-18. The proportion identifying as CALD was 18.5% and 38.0% were in the low-income group, and the mean number of missing teeth was 6.2. In multivariable modelling, the mean ratio (MR) for CALD participants with low household income in 2004-06 was 2% lower than the MR among non-CALD participants with high household income, with the RERI being - 0.23. Non-CALD participants from lower income households had a higher risk of having a higher number of missing teeth than low income CALD individuals (MR = 1.66, 95%CI 1.57-1.74 vs. MR = 1.43 95%CI 1.34-1.52, respectively). In 2017-18, the MR for CALD participants with low household income was 3% lower than the MR among non-CALD participants with high household income, with the RERI being - 0.11. Low income CALD participants had a lower risk of missing teeth compared to their non-CALD counterparts (MR = 1.43, 95% CI 1.34-1.52 vs. MR = 1.57, 95% CI 1.50-1.64). CONCLUSIONS: The negative RERI values indicate that the effect-measure modification operates in a negative direction, that is, there is a protective element to being CALD among low income groups with respect to mean number of missing teeth.

Knowledge and Awareness of HPV, the HPV Vaccine and Cancer-Related HPV Types among Indigenous Australians.

Human Papilloma Virus (HPV) infection is a common, preventable, sexually transmitted disease with oncogenic potential and increasing incidence. This study aimed to gain an understanding of the knowledge and awareness of HPV, the HPV vaccine, and HPV-related cancers, and to evaluate the relationship between participant factors and HPV knowledge, vaccination uptake, and high-risk HPV (16/18) infection, among Indigenous Australians. Data from the 12-month follow-up of a longitudinal cohort study were utilized, involving 763 Indigenous Australian adults in South Australia. The data analysis found that the mean 7-item HPV knowledge tool (HPV-KT) score was 2.3 (95% CI: 2.1-2.4), HPV vaccination prevalence was 27.0% (95% CI: 23.6-30.5) and oral HPV 16/18 infection was 4.7% (95% CI: 3.2-6.2). Multivariable log-Poisson regression models showed ratios of approximately 1.5 times higher HPV-KT scores in females, previous recreational drug users, those who had self-rated as having excellent, very good or good general health and who had heard of HPV; and participants who were not HPV vaccinated had 0.8 times (MR = 0.8, 95% CI: 0.7-0.9) lower HPV-KT scores than their counterparts. The findings suggest that culturally safe education strategies are a necessary investment to improve vaccination coverage among Indigenous Australians and to reduce the impact of HPV and related cancers.

Deadly places: The role of geography in Aboriginal and Torres Strait Islander COVID-19 vaccination.

OBJECTIVE: The objective of this study was to investigate the geospatial distribution of COVID-19 vaccination rates for Aboriginal and Torres Strait Islander Peoples across Local Government Areas in Australia. METHODS: We described the patterns of COVID-19 vaccination across jurisdictions, identified clusters with different levels of vaccination uptake, and assessed the relationship between contextual factors and vaccination (spatial error model, spatial lag model, and geographic weighted regression). RESULTS: The proportion of the Aboriginal and Torres Strait Islander population that received at least two doses of a COVID-19 vaccine by the last week of June 2022 ranged from 62.9% to 97.5% across Local Government Areas. The proportion of the overall population who is Aboriginal or Torres Strait Islander (ß = 0.280, standard deviation [SD] = 1.92), proportion of the total labour force employed (ß =0.286, SD = 0.98), and proportion of individuals who speak an Aboriginal or Torres Strait Islander language (ß =0.215, SD = 0.15) had, on average, the strongest effects on COVID-19 vaccination rates. CONCLUSION: Findings underscore the extent to which area-level demographic influence the COVID-19 vaccination for Aboriginal and Torres Strait Islander Australians. IMPLICATIONS FOR PUBLIC HEALTH: Findings can inform vaccination strategies that prioritise geographic areas with higher vulnerability to promote equity for Aboriginal and Torres Strait Islander Peoples.

An 18-day, 3 °C cold treatment effectively kills Ceratitis capitata (Diptera: Tephritidae) in kiwifruit (Actinidia spp.).

A series of experiments were carried out to develop a phytosanitary disinfestation protocol to kill Ceratitis capitata (Weidemann) (Mediterranean fruit fly, Diptera: Tephritidae) in 'Hayward' kiwifruit (Actinidia deliciosa (A. Chev.) C.F. Liang and A.R. Ferguson) and 'Zesy002' kiwifruit (Actinidia chinensis Planch.). Experiments on 4 immature life stages (eggs and 3 larval instars) with treatment durations of between 5 and 18 days showed that third instars were the most tolerant to temperatures around 3 °C, with the lethal time to 99.9968% (probit 9) mortality (LT99.9968) estimated to be 17.3 days (95% confidence interval (CI) 16.4-18.2). Larvae reared and treated in 'Zesy002' were significantly more susceptible to cold treatment than those reared in 'Hayward'. A large-scale trial testing a disinfestation protocol of 3 ±â€…0.5 °C for 18 days treated over 500,000 third-instar C. capitata with no survivors. These results demonstrate that a cold treatment of 3.5 °C or below for 18 days induces C. capitata mortality in kiwifruit at a rate that exceeds 99.9968% with a degree of confidence greater than 99%.

Oral Health, Social and Emotional Well-Being, and Economic Costs: Protocol for the Second Australian National Child Oral Health Survey.

BACKGROUND: Given the significant investment of governments and families into the provision of child dental care services in Australia, continued population oral health surveillance through national oral health surveys is imperative. OBJECTIVE: The aims of this study are to conduct a second National Child Oral Health Survey (NCOHS-2) to (1) describe the prevalence, extent, and impact of oral diseases in contemporary Australian children; (2) evaluate changes in the prevalence and extent of oral diseases in the Australian child population and socioeconomic subgroups since the first National Child Oral Health Study (NCOHS-1) in 2012-2013; and (3) use economic modeling to evaluate the burden of child oral disease from the NCOHS-1 and NCOHS-2 and to estimate the cost-effectiveness of targeted programs for high-risk child groups. METHODS: The NCOHS-2 will closely mimic the NCOHS-1 in being a cross-sectional survey of a representative sample of Australian children aged 5-14 years. The survey will comprise oral epidemiological examinations and questionnaires to elucidate associations between dental disease in a range of outcomes, including social and emotional well-being. The information will be analyzed within the context of dental service organization and delivery at national and jurisdictional levels. Information from the NCOHS-1 and NCOHS-2 will be used to simulate oral disease and its economic burden using both health system and household costs of childhood oral health disease. RESULTS: Participant recruitment for the NCOHS-2 will commence in February 2024. The first results are expected to be submitted for publication 6 months after NCOHS-2 data collection has been completed. Thematic workshops with key partners and stakeholders will also occur at this time. CONCLUSIONS: Regular surveillance of child oral health at an Australian level facilitates timely policy and planning of each state and territory's dental public health sector. This is imperative to enable the most equitable distribution of scarce public monies, especially for socially disadvantaged children who bear the greatest dental disease burden. The last NCOHS was conducted in 2012-2014, meaning that these data need to be updated to better inform effective dental health policy and planning. The NCOHS-2 will enable more up-to-date estimates of dental disease prevalence and severity among Australian children, with cost-effective analysis being useful to determine the economic burden of poor child dental health on social and emotional well-being and other health indicators. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/52233.

A Silver Fluoride Intervention to Improve Oral Health Trajectories of Young Indigenous Australians: Protocol for a Cluster Randomized Controlled Trial.

BACKGROUND: Indigenous Australian children and adolescents experience profound levels of preventable dental disease. The application of silver fluoride (AgF) to active dental caries is a noninvasive alternative to traditional dental treatment approaches. There is particular utility among Indigenous children and young people with dental fear, who may not have access to timely or culturally safe dental service provisions. OBJECTIVE: The aims of this study are to: (1) assess levels of active dental caries among Indigenous children and young people in 6 Australian states and territories; (2) determine if an AgF intervention reduces levels of active disease over 12-24 months; (3) measure the impact of improved oral health on social and emotional well-being (SEWB) and oral health-related quality of life; and (4) calculate the cost-effectiveness of implementing such an initiative. METHODS: The study will use a 2-arm, parallel cluster randomized controlled trial design. Approximately 1140 Indigenous children and youth aged between 2 and 18 years will be recruited. Each state or territory will have 2 clusters. The intervention group will receive the AgF intervention at the start of the study, with the delayed intervention group receiving the AgF intervention 12 months after study commencement. The primary outcome will be the arrest of active carious lesions, with arrested caries defined as nonpenetration by a dental probe. Secondary outcomes will include SEWB, oral health-related quality of life, and dental anxiety, with covariates including dental behaviors (brushing and dental visits). Effectiveness measures for the economic evaluation will include the number of children and young people managed in primary oral health care without the need for specialist referral, changes in SEWB, the numbers and types of treatments provided, and caries increments. RESULTS: Participant recruitment will commence in May 2023. The first results are expected to be submitted for publication 1 year after a 24-month follow-up. CONCLUSIONS: Our findings have the potential to change the way in which active dental disease among Indigenous children and young people can be managed through the inclusion of specifically tailored AgF applications to improve dental health and SEWB delivered by Indigenous health care workers. Desired impacts include cost savings on expensive dental treatments; improved SEWB, nutrition, social, and learning outcomes; and improved quality of life for both children and young people and their caregivers and the broader Indigenous community. The AgF application could be easily implemented into the training program of Indigenous health workers and yield critical information in the management armamentarium of health and well-being recommendations for Australia's First Peoples. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/48558.

A bibliometric analysis of Community Dentistry and Oral Epidemiology: Fifty years of publications.

OBJECTIVES: In celebration of the journal's 50th anniversary, the aim of the study was to review the whole collection of Community Dentistry and Oral Epidemiology (CDOE) publications from 1973 to 2022 and provide a complete overview of the main publication characteristics. METHODS: The study used bibliometric techniques such as performance and science mapping analysis of 3428 articles extracted from the Scopus database. The data were analysed using the 'Bibliometrix' package in R. The journal's scientific production was examined, along with the yearly citation count, the distribution of publications based on authors, the corresponding author's country and affiliation and citation count, citing source and keywords. Bibliometric network maps were constructed to determine the conceptual, intellectual and social collaborative structure over the past 50 years. The trending research topics and themes were identified. RESULTS: The total number of articles and average citations has increased over the years. D Locker, AJ Spencer, A Sheiham and WM Thomson were the most frequently published authors, and PE Petersen, GD Slade and AI Ismail published papers with the highest citations. The most published countries were the United States, United Kingdom, Brazil and Canada, frequently engaging in collaborative efforts. The most common keywords used were 'dental caries', 'oral epidemiology' and 'oral health'. The trending topics were healthcare and health disparities, social determinants of health, systematic review and health inequalities. Epidemiology, oral health and disparities were highly researched areas. CONCLUSION: This bibliometric study reviews CDOE's significant contribution to dental public health by identifying key research trends, themes, influential authors and collaborations. The findings provide insights into the need to increase publications from developing countries, improve gender diversity in authorship and broaden the scope of research themes.

Comparison of the Early Childhood Oral Health Impact Scale (ECOHIS-4D) and Child Health Utility Index (CHU-9D) in children with oral diseases.

OBJECTIVE: Accurate assessment of child oral health is important for guiding economic evaluations and informing healthcare decision-making. Early Childhood Oral Health Impact Scale (ECOHIS-4D) is a preference-based instrument that measures the oral health-related quality of life of young children. The aim of this study was to compare the utility scores of ECOHIS-4D and Child Health Utility Index (CHU-9D), against an oral health indicator to evaluate which utility score corresponds better with the oral health indicator. METHOD: The ECOHIS-4D and CHU-9D were applied to 314 parent/child dyads from preschools in a primary healthcare setting in Perth, Western Australia. Four parameters were used to assess which instrument corresponds better with the oral health indicator (decayed, missing and filled teeth score-dmft score): (i) discrimination, the ability to discriminate between different clinical severity groups, (ii) external responsiveness, how much the utility values relate to the changes in dmft scores, (iii) correlation, the association between the two instruments and the related dimensions and (iv) differences in the utility values across the two instruments. RESULTS: Most participants (81%) were 2-6 years old, and nearly 50% had a dmft score <3. ECOHIS-4D demonstrated a superior ability to differentiate between dmft severity groups and respond to changes in dmft scores. A significant weak correlation was observed between dmft and ECOHIS-4D (-0.26, 95%, CI -0.36 to -0.15) compared to a non-significant very poor correlation between dmft and CHU-9D (0.01, 95% CI -0.12 to 0.10). The utility scores of the two instruments had relatively good agreement towards good health and weak agreement towards poor health. CONCLUSIONS: ECOHIS-4D, the oral health-specific instrument, is more sensitive in assessing children's oral health-related quality of life than the generic CHU-9D. Thus, ECOHIS-4D is more appropriate for utility estimates in economic evaluations of oral health-related interventions and resource allocation decision-making.

Development and validation of the COVID-19 Impact Scale in Australia.

OBJECTIVE: The COVID-19 pandemic significantly impacted and continues to impact the health and well-being of Australian adults. However, there has been no instrument validated to comprehensively measure how the COVID-19 pandemic impacted adults in Australia across several domains (e.g. fear of COVID-19, attitudes towards vaccination, psychosocial impact of lockdowns).The current study conducted a rigorous psychometric process to develop and validate an instrument to measure the impact of the COVID-19 pandemic in Australia, the COVID-19 Impact Scale (CIS). METHOD: Data was obtained from the Australian population. Participants (N = 563) aged between 19 and 91 years (M = 54.50, SD = 16.16) provided online responses between June, 2021 and May, 2022. The majority of participants were female (60.9%), employed either full-time (37.7%) or part-time (22.0%), and had completed an undergraduate degree or higher (70.1%). An initial pool of 30 items was developed based on a review of the literature and input from a panel of experts including psychologists, epidemiologists, and public health experts, among others. The study used network psychometrics to examine the psychometric properties of: (1) item score distributions; (2) item redundancy; (3) dimensionality; (4) model fit; (5) measurement invariance; (6) reliability; and (7) criterion validity. RESULTS: Following an evaluation of items for ceiling/floor effects and redundancy, the final CIS network model included eighteen nodes and displayed a three-dimensional structure. The three communities of "Fear" (consisting of three nodes; ω = 0.82), "Attitudes" (consisting of ten nodes; ω = 0.89), and "Ill-being" (consisting of five nodes; ω = 0.79) displayed adequate reliability. The evaluation of model fit indicated a good fit of the network model (RMSEA = 0.047; CFI =0.98). CONCLUSION: The instrument is available to be used by Australian researchers and implemented to evaluate public policies, adapted for future pandemics, or used internationally.

The Global Prevalence and Severity of Dental Caries among Racially Minoritized Children: A Systematic Review and Meta-Analysis.

Racially minoritized children often bear a greater burden of dental caries, but the overall magnitude of racial gaps in oral health and their underlying factors are unknown. A systematic review and meta-analysis were conducted to fill these knowledge gaps. We compared racially minoritized (E) children aged 5-11 years (P) with same-age privileged groups (C) to determine the magnitude and correlates of racial inequities in dental caries (O) in observational studies (S). Using the PICOS selection criteria, a targeted search was performed from inception to December 1, 2021, in nine major electronic databases and an online web search for additional grey literature. The primary outcome measures were caries severity, as assessed by mean decayed, missing, and filled teeth (dmft) among children and untreated dental caries prevalence (d > 0%). The meta-analysis used the random-effects model to calculate standardized mean differences (SMD) and 95% confidence intervals (95% CI). Subgroup analysis, tests for heterogeneity (I2, Galbraith plot), leave-one-out sensitivity analysis, cumulative analysis, and publication bias (Egger's test and funnel plots) tests were carried out. The New Castle Ottawa scale was used to assess risk of bias. This review was registered with PROSPERO, CRD42021282771. A total of 75 publications were included in the descriptive analysis. The SMD of dmft score was higher by 2.30 (95% CI: 0.45, 4.15), and the prevalence of untreated dental caries was 23% (95% CI: 16, 31) higher among racially minoritized children, compared to privileged groups. Cumulative analysis showed worsening caries outcomes for racially marginalized children over time and larger inequities in dmft among high-income countries. Our study highlights the high caries burden among minoritized children globally by estimating overall trends and comparing against factors including time, country, and world income. The large magnitude of these inequities, combined with empirical evidence on the oral health impacts of racism and other forms of oppression, reinforce that oral health equity can only be achieved with social and political changes at a global level.

Surface fractures in pre-crystallized and crystallized zirconia-containing lithium silicate glass-ceramics generated in ultrasonic vibration-assisted machining.

Machining-induced surface fractures in ceramic restorations is a long-standing problem in dentistry, affecting the restorations' functionality and reliability. This study approached a novel ultrasonic vibration-assisted machining technique to zirconia-containing lithium silicate glass-ceramics (ZLS) and characterized its induced surface fracture topographies and morphologies to understand the microstructure-property-processing relations. The materials were processed using a digitally controlled ultrasonic milling machine at a harmonic vibration frequency with different amplitudes. Machining-induced surface fracture topographies were measured with a 3D white light optical profilometer using the arithmetic mean, peak and valley, and maximum heights, as well as the kurtosis and skewness height distributions, and the texture aspect ratios. Fracture morphologies were analysed using scanning electron microscopy (SEM). The surface fracture topographies were significantly dependent on the material microstructure, the mechanical properties, and the ultrasonic machining vibration amplitudes. Larger scale fractures with higher arithmetic mean, peak and valley heights, and kurtosis and skewness height distributions were induced in higher brittleness indexed pre-crystallized ZLS than lower indexed crystallized ZLS by conventional machining. Conchoidal fractures occurred in pre-crystallized ZLS while microcracks were found in crystallized state although brittle fractures mixed with localized ductile flow deformations dominated all machined ZLS surfaces. Ultrasonic machining at an ideal vibration amplitude resulted in more ductile removal, reducing fractured-induced peaks and valleys for both materials than conventional processing. This research demonstrates the microstructure-property-processing interdependence for ZLS materials and the novel machining technique to be superior to current processing, reducing fractures in the materials and potentially advancing dental CAD/CAM techniques.

Oral Health Inequities among CALD and Non-CALD Older Australians: A Decomposition Analysis.

BACKGROUND: Among Australia's older population, the burden of oral disease is disproportionality borne by culturally and linguistically diverse (CALD) communities. This study aims to examine changes in untreated decay surfaces (DS) between 2004-2006 and 2017-2018 among older CALD and non-CALD Australians. METHODS: Data were sourced Australian national oral health surveys conducted in 2004-2006 and 2017-2018. An Oaxaca-Blinder decomposition analysis was used to assess the contribution of socio-demographics and dental behaviours. RESULTS: A total of 246 CALD and 2853 non-CALD dentate participants aged 60+ years took part in 2004-2006, and 363 and 4278 in 2017-2018, respectively. There were increases in mean DS for both CALD (0.74 to 1.42) and non-CALD (0.72 to 1.50) groups between 2004-2006 and 2017-2018. The decomposition model showed that, for CALD participants in 2004-2006 with untreated DS, 40% of the contribution was from not having dental insurance; nearly three-quarters of the contribution was from last dental visit being over one year ago (72.9%) in 2017-2018. Among non-CALD participants in 2017-2018 with untreated DS, 42.5% of the contribution was from the last dental visit being over one year ago. CONCLUSIONS: Our findings suggest that social determinants, including increased access to dental insurance, could mitigate the oral health inequities observed.

Correlates of poor oral health related quality of life in a cohort of people who use methamphetamine in Australia.

OBJECTIVES: Methamphetamine use impacts oral health, but little is known about its impacts on oral health related quality of life (OHRQoL). In this study we examined OHRQoL in a cohort of people who use methamphetamine and assessed associations with sociodemographic, behavioural, psychosocial and dental service utilisation correlates. A secondary aim was to examine the relationship between methamphetamine route of administration and OHRQoL, to test whether smoking the drug is associated with reduced OHRQoL. METHODS: Cross-sectional analysis was performed, using data from VMAX, a cohort of people who use methamphetamine at least monthly in Victoria, Australia (n = 194). Utilising the oral health impact profile (OHIP-14), we assessed three OHRQoL outcomes: OHIP-14 prevalence, OHIP-14 extent and OHIP-14 severity. Regression analyses examined associations between independent variables and the three OHIP-14 outcome measures. RESULTS: A significant segment of the cohort (35%) reported poor OHRQoL. Overall, no statistically significant association was detected between methamphetamine route of administration and the three OHIP-14 outcomes. Participants living in rural areas, with moderate-to-severe self-reported depression and with methamphetamine dependence had significantly worse OHRQoL levels, which persisted after adjusting for other covariates. CONCLUSION: Overall, VMAX cohort participants reported reduced OHRQoL levels. Our findings highlight the need for upstream interventions to improve the OHRQoL of people who use methamphetamine, with specific focus on those living in rural locations. Further research on the links between OHRQoL and mental health among people who use methamphetamine is required.

Facilitators and Challenges to Maintaining Oral Health for Indigenous Communities Globally: A Qualitative Systematic Review.

Globally, Indigenous Peoples experience pervasive oral health inequities due to a complex interplay of social determinants of health including the sustained effects of colonisation, racism, and intergenerational disruption to Indigenous communities. This qualitative systematic review aimed to synthesise evidence related to facilitators and challenges that affect the ability of global Indigenous communities to maintain oral health. Two independent reviewers searched PubMed, SCOPUS, Web of Science, and Embase. Qualitative studies including illustrations from Indigenous Peoples regarding facilitators and challenges to oral health maintenance were considered. Included articles were critically appraised. The search identified 4,247 articles eligible for inclusion; 22 articles were included. Challenges and facilitators were synthesised across child, carer, community, and service levels during the meta-aggregation. The prioritisation of integrated oral health services, programs, and research that encompass multiple factors at various levels of influence are needed to strengthen the oral health of Indigenous communities.

Natural History of Oral HPV Infection among Indigenous South Australians.

This study aims to describe the natural history of and identify the risk factors associated with oral human papillomavirus (HPV) infections in an Australian Indigenous cohort. A longitudinal cohort study design, with baseline (2018), 12-month, and 24-month data obtained from Indigenous Australians aged 18+ years in South Australia, was performed. Face-to-face interviews were conducted, and saliva samples for HPV testing were collected at each time point. Basic descriptive analyses were conducted to calculate prevalence, incidence, persistence, clearance, and incidence proportions of any HPV infection. Multivariable logistic regression analyses with adjusted prevalence ratios (PRs) were conducted to identify risk factors associated with oral HPV infection. Among 993 participants with valid saliva samples, 44 HPV types were identified. The prevalence of infection with any oral HPV infection was 51.3%, high-risk HPV was 11%, and types implicated in Heck's disease (HPV 13 or 32) was 37.4%. The incidence, persistence, and clearance of any and high-risk HPV infections were 30.7%, 11.8% and 33.3% vs. 9.3%, 2.8%, and 9%, respectively. Our findings indicate that the prevalence, incidence, and persistence of oral HPV infection in a large sample of Indigenous Australians were high, and clearance was low. Oral sex behaviours and recreational drug use were risk factors associated with incident high-risk HPV infection.

Demystifying the connection between periodontal disease and chronic kidney disease - An umbrella review.

Chronic kidney disease (CKD) and poor oral health are inter-related and their significant impact on each other is well established in the literature. Many systematic reviews and meta-analyses have demonstrated a strong relationship between CKD and periodontitis, where periodontal treatment has shown potential in improving CKD outcomes. However, the quality of the studies and heterogeneity of the results show variation. The aim of this umbrella review was to review the quality of the current systematic reviews on the relationship between CKD and oral health with an emphasis on periodontal disease and to generate clinically relevant guidelines to maintain periodontal health in patients with CKD. This umbrella review was conducted and reported in alignment with the Joanna Briggs Institute and the PRISMA 2020 guidelines. The review protocol was established prior to commencing the review and registered on JBI and PROSPERO (CRD42022335209). Search strings were established for PubMed, Embase, Web of Science, Cochrane Database of Systematic Reviews, and Dentistry & Oral Science Source up to April 2022. All systematic reviews and meta-analyses that considered the relationship between CKD and periodontitis or periodontal treatment were included. Of 371 studies identified through the systematic search, 18 systematic reviews met the inclusion criteria. Ten studies assessed the relationship between oral health status and CKD with a focus on periodontitis and CKD, five reviewed the impact of periodontal treatment on CKD outcomes, two included both relationship and effectiveness of periodontal treatment and one qualitatively reviewed oral health-related quality of life in patients with kidney failure. Findings indicate there is a bidirectional relationship between CKD and periodontal disease. In view of the heterogeneity of the existing literature on CKD and periodontal disease, specific recommendations for the management of periodontitis among patients with CKD are proposed for medical professionals, dental professionals, and aged care workers based on the evidence collated in this review.

Evaluation of orthodontic retention and retainer content on the Reddit social media website.

BACKGROUND: Social media can provide insight into patient experiences with health care. The aim of this study was to evaluate the content regarding orthodontic retention and retainers on the social media website, Reddit. METHODS: A systematic search for relevant content submitted over a 12-month period on the Reddit forum, r/braces, was conducted. Qualitative analysis of the initial posts for themes and subthemes was conducted by two investigators. Responding comments to the initial posts were assessed for supportiveness for each initial poster and alignment with the evidence-base. Quantitative assessment was via descriptive statistics. RESULTS: A total of 271 initial posts and 984 comments satisfied the inclusion/exclusion criteria. All initial posts were by patients. Just 1.12% (n = 11) of the comments appeared to be provided by oral health professionals. Most initial posts were negative (50.18%; n = 136), and most comments were positive (70.42%; n = 693). Alignment with the evidence-base was high among the comments (67.89%; n = 668). Eight main themes were identified with concerns regarding the negative impact of retention and retainers on quality of life, compliance with retention protocols and relapse commonly expressed. Concern regarding fear of relapse when waiting for the initial or renewal of retainers was a novel finding. More negative sentiments about orthodontists were expressed than positive. CONCLUSIONS: Reddit is a supportive and reliable environment for patients regarding orthodontic retention and retainers. The content evaluation suggested deficiencies in communication processes between clinicians and patients. Greater engagement of the orthodontic profession in the provision of supportive and evidence-based information on an individual patient basis and through appropriate information channels is required.

Development and validation of an HPV infection knowledge assessment scale among Aboriginal and Torres Strait Islander Peoples.

Background: An increased incidence of Human Papillomavirus (HPV) infection and its related cancers has been observed in recent years. Correct knowledge about HPV infection can lead to a significant decrease in transmission and a subsequent increase in vaccine uptake. Awareness and behavioural perception towards HPV infections are critical for improving HPV vaccination rates among Aboriginal and/or Torres Strait Islander Peoples. However, to the best of our knowledge, there has been no instrument designed to measure knowledge about HPV infection that is culturally appropriate and validated among Aboriginal and/or Torres Strait Islander People. Aim: To address this research gap, this paper aims to examine the psychometric properties of the HPV Knowledge Tool (HPV-KT) in an Indigenous population sample from South Australia. Methodology: Data from 747 Indigenous Australian Adults who participated in the 12-month follow-up of the HPV and Oropharyngeal Carcinoma in Indigenous Australians Study was utilised for this study. The psychometric properties examined included1) dimensionality and item redundancy; (2) network loadings; (3) model fit; (4) criterion validity; and (5) reliability. The network model was estimated using the Graphical Least Absolute Shrinkage and Selector Operator (GLASSO). Evaluation of the HPV-KT (10 items) dimensionality and item redundancy was conducted within the framework of Exploratory Graph Analysis (EGA). Reliability was evaluated with the McDonald's Omega (ω) coefficient. Results: After the exclusion of two items, the HPV-KT exhibited good psychometric properties for Aboriginal and/or Torres Strait Islander Peoples. The two dimensions of "General HPV Knowledge" and "Commonness of HPV" were identified. The dimension of "Commonness of HPV" displayed poor reliability, so a sum score for this subscale is not recommended (i.e. the items can still be used individually) The network model of the 7-item HPV-KT was fitted in the validation sample and model fit was adequate (x2 (7) = 17.17, p < 0.016; CFI = 0.980; TLI = 0.94; RMSEA = 0.063, 90% CI = 0.025-0.010). Furthermore, the reliability of the "General HPV Knowledge" subscale (ω = 0.76, 95% CI: 0.72-0.79), while the reliability of the "Commonness of HPV" subscale (ω = 0.58, 95% CI0.58-0.88) was poor. Conclusion: The HPV-KT was adapted for an Aboriginal and/or Torres Strait Islander population and is readily available for future use in Australia. The addition of items assessing specifications of HPV infection, natural history and behaviour will improve the reliability and usability to assess the level of accurate knowledge about HPV infection. Future studies should investigate the possibility of developing new items for the dimension 'Commonness of HPV'.