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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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- Chapter
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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.
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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- Chapter
- Export citation
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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.