5 results
4 - Measuring representativeness of the study participants
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- By L Luzzi, University of Adelaide, DH Ha, University of Adelaide, A Ellershaw, University of Adelaide, C Koster, University of Adelaide, DS Brennan, University of Adelaide, S Chrisopoulos, University of Adelaide
- Edited by Loc G. Do, University of Adelaide, A. John Spencer, University of Adelaide
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- Book:
- Oral Health of Australian Children
- Published by:
- The University of Adelaide Press
- Published online:
- 05 September 2017
- Print publication:
- 31 December 2016, pp 48-85
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Summary
This Survey gathered information from a representative sample of the Australian child population aged 5–14 years to describe the oral health status of the population and factors related to use of dental services and dental behaviours, as well as associated individual, family, and community factors such as the sociodemographic characteristics of the child's household.
Surveys provide a means of measuring a population's characteristics, self-reported and observed behaviour, and needs. Unlike a census, where all members of a population are studied, sample surveys gather information from only a portion of a population of interest. In a statistically valid survey, the sample is objectively chosen so that each member of the population will have a known non-zero chance of selection. Only then can the results be reliably projected from the sample to the population.
Surveys, however, are not exempt of errors (or bias), which can occur when some segments of the population do not participate in the survey. As not all Australian children were included in this Survey, there is potential that the sample does not accurately represent the population of interest.
Errors due to sampling depend on the sample selection strategy and can be measured statistically. Variability inherent to the sampling process is expressed using the 95% confidence interval. On the other hand, non-sampling error or bias is more problematic because it is more difficult to measure and control. Bias due to non-participation occurs when the participants differ from the non-participants or the targeted population in one or more characteristics. The potential for bias due to non-participation or non-response can be explored by examining key sociodemographic characteristics of the Survey sample, and comparing them with known characteristics of the target population.
As outlined in Chapter 3, this Survey employed rigorous sampling procedures to achieve a representative sample of the Australian child population aged 5–14 years. The procedures used to derive survey weights for this Survey reflect the standards of best practice for weighting complex survey data, and are procedures used by leading statistical agencies. Procedures used to derive survey weights ensure valid estimates and inferences of the target child population can be made. The methodologies employed in the Survey will minimise any potential bias, which will be assessed in this chapter.
11 - Trends in child oral health in Australia
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- By LG Do, University of Adelaide, L Luzzi, University of Adelaide, DH Ha, University of Adelaide, KF Roberts-Thomson, University of Adelaide, S Chrisopoulos, University of Adelaide, JM Armfield, University of Adelaide, AJ Spencer, University of Adelaide
- Edited by Loc G. Do, University of Adelaide, A. John Spencer, University of Adelaide
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- Book:
- Oral Health of Australian Children
- Published by:
- The University of Adelaide Press
- Published online:
- 05 September 2017
- Print publication:
- 31 December 2016, pp 288-305
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Summary
Assessing time trend in health and health-related factors is important in monitoring population health and its determinants. The social and economic changes have been at a fast pace in recent times. However, the rate of change is not similar for every population subgroup. There were also different changes in policies and practices related to dental service delivery for children between states and territories. All these differences can have an effect on child oral health.
This chapter presents an analysis of trends between the current Survey and several existing surveys of child oral health in Australia. Australia's previous national survey among children, the National Oral Health Survey of Australia (NOHSA) was conducted in 1987–88. Dental caries experience was collected for samples of children across Australia. The National Survey of Adult Oral Health (NSAOH) 2004-06 collected dental fluorosis experience that allows for analysing time trend of fluorosis by year of birth (Slade et al. 2007).
The other available surveys are a series of the National Dental Telephone Interview Surveys (NDTIS) 1994–2013 and the Child Dental Health Surveys (CDHS) series. Dental service use by Australian children has been routinely collected in the NDTIS. The CDHS series collects administrative data on the oral health status of children attending school dental services in Australian states and territories. Therefore, those surveys covered just a proportion of the child population within each state/territory. This difference should be taken into account in interpreting results of this analysis. The CDHS data have been presented for age groups 6 years and 12 years. The presented data had been collected in Australia for the CDHS series from 1989 to 2010.
Two other oral epidemiological studies conducted among children attending school dental services were the Child Fluoride Study (CFS) Mark I 1992–93 and the Child Fluoride Study Mark II 2002–03. The CFS Mark I was conducted in Queensland and South Australia while the CFS Mark II was conducted in four states: Queensland, South Australia, Victoria and Tasmania. Information on child oral health behaviours was collected.
Trends in oral health status
Trend in dental caries experience
Time trend in dental caries experience was assessed using the NOHSA 1987–88, the CDHS series and the NCOHS 2012–14.
5 - Children's oral health status in Australia, 2012–14
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- By DH Ha, University of Adelaide, KF Roberts-Thomson, University of Adelaide, P Arrow, University of Adelaide, KG Peres, University of Adelaide, LG Do, University of Adelaide
- Edited by Loc G. Do, University of Adelaide, A. John Spencer, University of Adelaide
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- Book:
- Oral Health of Australian Children
- Published by:
- The University of Adelaide Press
- Published online:
- 05 September 2017
- Print publication:
- 31 December 2016, pp 86-152
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Summary
Introduction
Dental caries is the most common chronic infectious disease in childhood, caused by a complex interaction over time between acid-producing bacteria and fermentable carbohydrates (sugars and other carbohydrates from food and drink that can be fermented by bacteria), as well as many host factors including teeth condition and saliva (Fejerskov 2004; Fisher-Owens et al. 2007). Dental caries is characterised by the loss of mineral ions from the tooth (demineralisation), stimulated largely by the presence of bacteria and their by-products. Remineralisation occurs when partly dissolved crystals are induced to grow by the redepositing of minerals via saliva. The demineralisation of the tooth surface can be limited by the use of fluorides. Normally, a balance occurs between the demineralisation and remineralisation of the tooth surface (enamel). However, this balance is disturbed under some conditions, and the subsequent chronic demineralisation leads to the formation of holes or cavities in the tooth surface. In its early stages the damage can be reversed with the use of fluoride. Cavitation (a hole in the tooth) beyond the outer enamel covering of the tooth into the tissues can lead to a bacterial infection, which may cause considerable pain and require surgery or the removal of the tooth. Once the cavity has formed a filling is needed to restore the form and function of the tooth. Childhood caries is a serious public health problem in both developing and industrialised countries (Casamassimo et al. 2009).
At about the age of 5 or 6 years, children start losing their primary (deciduous/baby) teeth, which are replaced by their permanent teeth. Most children have lost all their primary teeth and have gained their permanent teeth (with the exception of wisdom teeth, which may erupt several years, or even decades, later) by the age of 12 years. Therefore, analyses of dental caries in adolescents only report the level of disease in permanent teeth. Younger children generally have a mixture of primary and permanent teeth, from ages 5 to 12 years. The convention is to report on these two sets of teeth separately.
Methods
Dental caries experience and other oral conditions were collected through oral epidemiological examinations. Didactic and clinical training for the examination teams was conducted. Frequent refresher sessions were also provided. Examinations were held in fixed or mobile dental clinics under standardised conditions.
8 - Australian children's general health behaviours
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- By LG Do, University of Adelaide, JE Harford, University of Adelaide, DH Ha, University of Adelaide, AJ Spencer, University of Adelaide
- Edited by Loc G. Do, University of Adelaide, A. John Spencer, University of Adelaide
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- Book:
- Oral Health of Australian Children
- Published by:
- The University of Adelaide Press
- Published online:
- 05 September 2017
- Print publication:
- 31 December 2016, pp 212-236
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Summary
Oral health is an integral part of general health and shares a number of common determinants with general health. Those common determinants are mostly related to diet. General health behaviours that affect child oral health centre largely on consumption of water and of drinks and foods containing sugar.
Water consumption can affect oral health in two ways. First, water is a ‘tooth friendly’ drink. Water contains no decay-causing sugar and is generally in the range of acidity that is safe for teeth. Second, water is the main way in which fluoride is accessible to the whole community, irrespective of their individual oral hygiene behaviours. Multiple studies from more than 20 countries have shown that fluoridation reduces dental caries (National Health and Medical Research Council 2007; Rugg-Gunn and Do 2012; Iheozor- Ejiofor et al. 2015), which explains the high priority given to water fluoridation by public health authorities. Water fluoridation provides the greatest benefit to those who can least afford professional dental care (Slade et al. 1995b; Burt 2002). This chapter examines children's consumption of mains and tap water as well as bottled water to assess the extent to which children are likely to receive the benefits to their oral health than can be gained from the fluoridation of reticulated water.
Consumption of sugar is a key risk factor for dental caries (Moynihan and Kelly 2014; Sheiham and James 2014). The impact of sugar on oral health depends in large part on the type, quantity and pattern of consumption. For oral health purposes, sugar that does not occur naturally in milk or in whole fruit or vegetables can contribute to a child's risk of experiencing tooth decay. These sugars are known as ‘free sugars’ and are defined as ‘monosaccharides and disaccharides added to foods and beverages by the manufacturer, cook or consumer, and sugars naturally present in honey, syrups, fruit juices and fruit juice concentrates’ (Rosenberg et al. 2005). Dietary guidelines for Australia recommend that Australians ‘Limit intake of foods and drinks containing added sugars such as confectionary, sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and sports drinks’ (National Health and Medical Research Council 2013).
10 - Oral health status and behaviours of Indigenous Australian children
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- By KF Roberts-Thomson, University of Adelaide, K Kapellas, University of Adelaide, DH Ha, University of Adelaide, LM Jamieson, University of Adelaide, P Arrow, University of Adelaide, LG Do, University of Adelaide
- Edited by Loc G. Do, University of Adelaide, A. John Spencer, University of Adelaide
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- Book:
- Oral Health of Australian Children
- Published by:
- The University of Adelaide Press
- Published online:
- 05 September 2017
- Print publication:
- 31 December 2016, pp 264-287
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Summary
Chapter 10 compares the oral health and behaviours of various groupings within the population of Indigenous children. Differences are examined by sex, parental education, household income, residential location and reason for last dental visit.
Indigenous people in Australia have the poorest health outcomes. Indigenous children also have poorer health outcomes than their non-Indigenous counterparts (Australian Bureau of Statistics 2014). These have been related to social disadvantage. However, within the Indigenous population there is variation in social status. This chapter explores that social variation in relation to oral health status and oral health behaviours.
Indigenous identity data was collected using the Australian Bureau of Statistics (ABS) question ‘Are you of Aboriginal or Torres Strait Islander origin?’ Responses that the child was ‘Yes, Aboriginal’, ‘Yes, Torres Strait Islander’ or Yes, Torres Strait Islander and Aboriginal’ meant the child was classified as Indigenous.
Oral health status of Indigenous children
Oral health status was measured using both the prevalence in the population and the average number of tooth surfaces with dental decay experience. This was categorised into the following elements: untreated decayed surfaces, missing surfaces due to decay and surfaces filled due to decay. Both the primary and secondary dentitions were examined and are reported separately.
In this chapter on the oral health of Indigenous children, the age groups on which data are reported differ from those in Chapter 5. This difference was due to the insufficient numbers of Indigenous children in the study to report on two-year age groups. For caries experience in the primary dentition the tables report on children aged 5–9 years and for the permanent dentition 9–14 years.
Caries experience in the primary dentition
Table 10-1 shows the average number of tooth surfaces with untreated decay, missing due to decay and filled surfaces and the average total number of affected surfaces (dmfs) by sociodemographic factors for Indigenous children aged 5–8 years. The average number of tooth surfaces decayed, missing or filled gives an indication of the severity of the disease, the burden it makes for the child and reflects access to timely dental care. Each tooth was divided into five surfaces and each surface decayed or filled was counted, but each missing tooth was counted as three surfaces.