Andrew John Spencer

Oral Health Status of Vietnamese Children: Findings From the National Oral Health Survey of Vietnam 1999

The National Oral Health Survey of Vietnam 1999 was conducted to inform policy development. Aims. The aims were to describe the oral health status, to analyze its socioeconomic distribution, and to evaluate change over time in the oral health of Vietnamese children. Methods. A multistaged stratified sampling process was employed. Children aged 6 to 17 years were examined by trained and calibrated dental examiners. A parental questionnaire was used. Drinking water was analyzed. Results. Preventive oral health behaviors and dental care utilization were infrequent. The decayed, missing, and filled surfaces referring to primary dentition (dmfs) and permanent dentition (DMFS) scores (SD) were 8.9 (11.3) and 2.5 (4.4), respectively. Primary caries experience was associated with fluoride level in drinking water, age, gender, residential status, and geographical location. Permanent caries was also associated with dental visiting and parental education. There was an increase in the prevalence of dental caries in the Vietnamese child population compared with 10 years earlier. Conclusion. The oral health of Vietnamese children was characterized by high level of dental caries with variation among socioeconomic groups. It suggests the need for a population oral health program that includes measures to target high-need children.

Health-related quality of life and income-related social mobility in young adults

BackgroundTo assess the association of income-related social mobility between the age of 13 and 30xa0years on health-related quality of life among young adults.MethodsIn 1988-89 nu2009=u20097,673 South Australian school children aged 13xa0years were sampled with nu2009=u20094,604 children (60.0%) and nu2009=u20094,476 parents (58.3%) returning questionnaires. In 2005-06 nu2009=u2009632 baseline study participants responded (43.0% of those traced and living in Adelaide).ResultsMultivariate regressions adjusting for sex, tooth brushing and smoking status at age 30 showed that compared to upwardly mobile persons social disadvantage was associated (pu2009<u20090.05) with more oral health impact (Coeffu2009=u20095.5), lower EQ-VAS health state (Coeffu2009=u2009-5.8), and worse satisfaction with life scores (Coeffu2009=u2009-3.5) at age 30xa0years, while downward mobility was also associated with lower satisfaction with life scores (Coeffu2009=u2009-1.3).ConclusionsStable income-related socioeconomic disadvantage was associated with more oral health impact, and lower health state and life satisfaction, while being downwardly mobile was associated with lower life satisfaction at age 30xa0years. Persons who were upwardly mobile were similar in health outcomes to stable advantaged persons.

Oral Health Status of Vietnamese Adults: Findings From the National Oral Health Survey of Vietnam

Background. The National Oral Health Survey of Vietnam 1999 was conducted to inform policy development. Aims. This article aims to describe the oral health status, analyze its socioeconomic distribution, and evaluate change over time in the oral health of the adult population of Vietnam. Methods. A multistaged stratified sampling process was used. Adults aged 18+ years completed a social survey and were examined by trained and calibrated dentists. Results. Oral symptoms were frequent. Dental care utilization was low and mostly problem driven. One third of adults had periodontal pockets. Calculus was highly prevalent. Caries level was moderate with a mean decayed, missing, and filled teeth score of 4.98 (SD 5.7), with most as untreated decay. Factors related to caries were gender, hygiene practices, socioeconomic status, location, and dental visiting. Conclusions. The oral health status of the Vietnamese adult population was compromised by various factors. There was indication of deteriorating oral health of this population.

Is clinical oral health poorer in regional areas compared with major city areas

OBJECTIVEnTo determine if clinical oral health outcomes differ between people who reside in major city, inner regional and outer regional areas of Australia.nnnDESIGNnData from the National Survey of Adult Oral Health 2004-06 that used a clustered stratified random sampling design with telephone interviews, standardised oral epidemiological examinations and self-complete questionnaires were used to compare the clinical oral health.nnnMAIN OUTCOME MEASURESnDecayed, missing and filled permanent teeth.nnnPARTICIPANTSnAustralians aged 15 years or more. Data were weighted by age, sex and regional location to the Estimated Resident Population, bivariate analysis undertaken to determine confounders and multivariate analysis completed with dental caries clinical measures as dependent variables.nnnRESULTSnInner regional people had a significantly higher decayed, missing and filled teeth than people from major cities (Estimate = 1.15, P < 0.01), but there was no difference between inner and regional areas. Older people had higher outcomes for decayed, missing and filled teeth (15.42, P < 0.01) and missing teeth (9.66, P < 0.01), but less decayed teeth (-0.37, P < 0.01), and people with the highest incomes had lower dental caries experience (-1.34, P < 0.01) and missing teeth (-1.42, P < 0.01).nnnCONCLUSIONnDental caries experience was greater in inner regional areas than in major city areas, but not outer regional areas. Dental caries experience was similar in outer regional and major city areas.

Survey of Australian and new Zealand Oral and maxillofacial surgery trainees and recent specialists — education and experience

This study examined the demographic characteristics, educational background and attitudes toward training of all recent OMS specialists and all current trainees in Australia and New Zealand in 1996. The early nineties is a key period as it marks the transition from an essentially dentally based speciality (85% dental degree in 1990); to recent specialists with an increasing number with both medical and dental degrees (33% dual degree 1990-1996); to predominantly dual degree training (84.4% dual in 1996). Current trainees had more extensive experience in pathology, preprosthetic and reconstructive surgery. They were also strongly critical of the length and cost of training.

Dental knowledge and dental service utilization: A 2-year follow-up study.

OBJECTIVESnTo investigate associations of dental knowledge with dental service utilization over 2xa0years in South Australians aged 45-54xa0years.nnnMETHODSnIn 2004-2005, a random sample of 2469 adults aged 45-54xa0years from Adelaide, South Australia, who were selected from the Australian electoral roll was surveyed. The outcome variables were the numbers of visits and dental services received over 2xa0years. Data were analysed using log-binomial and Poisson regression. Statistical significance was determined at Pxa0<xa0.05.nnnRESULTSnThe response rates were 43.8% in the study group (nxa0=xa0879) and 50.7% in the comparison group (nxa0=xa0107). Oral examinations were conducted on 709 persons (81% of study group participants). Dental services data were collected from approximately 60% of participants at the end of years 1 and 2. After adjusting for sex, education, health card status, toothbrushing and inadequate dentition, higher caries knowledge and periodontal knowledge scores were associated with higher percentages of persons making dental visits (prevalence ratio, 95% CI: 1.2, 1.1-1.3 and 1.1, 1.0-1.3), and lower rates of extraction (rate ratio, 95% CI: 0.2, 0.1-0.4 and 0.4, 0.3-0.7) and endodontic services (0.5, 0.3-0.9 and 0.5, 0.3-0.7). Higher caries knowledge was associated with lower rates of fillings (0.8, 0.7-0.9) and denture services (0.1, 0.0-0.6), while higher periodontal knowledge was associated with higher numbers of visits (1.3, 1.2-1.5), and prophylaxis services (1.4, 1.1-1.8) and crowns (1.7, 1.1-2.5).nnnCONCLUSIONnSouth Australians aged 45-54xa0years with higher dental knowledge had lower rates of invasive treatment over 2xa0years. These findings warrant policy initiatives that highlight the importance of dental knowledge in improving oral health.

Critical review of the validity of patient satisfaction questionnaires pertaining to oral health care

OBJECTIVESnReview the validation process reported for oral healthcare satisfaction scales that intended to measure general oral health care that is not restricted to specific subspecialties or interventions.nnnMETHODSnAfter preliminary searches, PUBMED and EMBASE were searched using a broad search strategy, followed by a snowball strategy using the references of the publications included from database searches. Title and abstract were screened for assessing inclusion, followed by a full-text screening of these publications. English language publications on multi-item questionnaires that report on a scale measuring patient satisfaction for oral health care were included. Publications were excluded when they did not report on any psychometric validation, or the scales were addressing specific treatments or subspecialities in oral health care.nnnRESULTSnFourteen instruments were identified from as many publications that report on their initial validation, while five more publications reported on further testing of the validity of these instruments. Number of items (range: 8-42) and dimension reported (range: 2-13) were often dissimilar between the assessed measurement instruments. There was also a lack of methodologies to incorporate patients subjective perspective. Along with a limited reporting of psychometric properties of instruments, cross-cultural adaptations were limited to translation processes.nnnCONCLUSIONSnThe extent of validity and reliability of the included instruments was largely unassessed, and appropriate instruments for populations outside of those belonging to general adult populations were not present.

Factors Influencing Early Feeding of Foods and Drinks Containing Free Sugars—A Birth Cohort Study

Early feeding of free sugars to young children can increase the preference for sweetness and the risk of consuming a cariogenic diet high in free sugars later in life. This study aimed to investigate early life factors influencing early introduction of foods/drinks containing free sugars. Data from an ongoing population-based birth cohort study in Australia were used. Mothers of newborn children completed questionnaires at birth and subsequently at ages 3, 6, 12, and 24 months. The outcome was reported feeding (Yes/No) at age 6–9 months of common foods/drinks sources of free sugars (hereafter referred as foods/drinks with free sugars). Household income quartiles, mother’s sugar-sweetened beverage (SSB) consumption, and other maternal factors were exposure variables. Analysis was conducted progressively from bivariate to multivariable log-binomial regression with robust standard error estimation to calculate prevalence ratios (PR) of being fed foods/drinks with free sugars at an early age (by 6–9 months). Models for both complete cases and with multiple imputations (MI) for missing data were generated. Of 1479 mother/child dyads, 21% of children had been fed foods/drinks with free sugars. There was a strong income gradient and a significant positive association with maternal SSB consumption. In the complete-case model, income Q1 and Q2 had PRs of 1.9 (1.2–3.1) and 1.8 (1.2–2.6) against Q4, respectively. The PR for mothers ingesting SSB everyday was 1.6 (1.2–2.3). The PR for children who had been breastfed to at least three months was 0.6 (0.5–0.8). Similar findings were observed in the MI model. Household income at birth and maternal behaviours were significant determinants of early feeding of foods/drinks with free sugars.