Roy Byun

Child Dental Health Survey 2007: a snapshot of the oral health status of primary school-aged children in NSW

OBJECTIVES The Child Dental Health Survey 2007 was commissioned to establish the oral health status of school children in NSW aged 5-12 years, to provide reliable regional oral health statistics and contribute to national population-based data collections. METHODS A total of 7975 children were clinically examined at 107 public, catholic and independent schools across NSW. RESULTS Key findings from the survey include: mean dmft for 5-6-year-olds of 1.53; mean DMFT for 11-12-year-olds of 0.74; 61.2% of 5-6-year-olds and 65.4% of 11-12-year-olds have never experienced decay in their primary and permanent teeth, respectively. These figures compare favourably to national benchmarks set in 2001. CONCLUSIONS Data from the survey will be used as a baseline to measure the success of early intervention and prevention programs, for international comparisons, to provide solid evidence to support population oral health planning and for ongoing surveillance of populations of interest.

Sugary drink consumption and dental caries in New South Wales teenagers

BACKGROUND The consumption of water, milk and various sugary drinks and their relationship with the caries experience of a random sample of teenagers aged 14 to 15 years living in New South Wales, Australia was investigated. METHODS Data were obtained from both clinical and questionnaire components of the NSW Teen Dental Survey, 2010. The analyses allowed for various demographic and behavioural risk factors using caries experience (DMFT >0) and mean DMFT as the key outcome variables. RESULTS Males were more likely than females to consume large volumes of sugary drinks. Consuming two or more glasses of sugary drinks per day led to significantly increased caries experience amongst this sample of 14 and 15 year olds. Factors found to be associated with elevated sugary drink consumption included family income, gender, and mothers education level. CONCLUSIONS There is a strong correlation between increased caries experience of NSW teenagers and high levels of consumption of sugary drinks.

Neighbourhood safety and area deprivation modify the associations between parkland and psychological distress in Sydney, Australia

BackgroundThe aim of this study was to investigate how perceived neighbourhood safety and area deprivation influenced the relationship between parklands and mental health.MethodsInformation about psychological distress, perceptions of safety, demographic and socio-economic background at the individual level was extracted from New South Wales Population Health Survey. The proportion of a postcode that was parkland was used as a proxy measure for access to parklands and was calculated for each individual. Generalized Estimating Equations logistic regression analyses were performed to account for correlation between participants within postcodes, and with controls for socio-demographic characteristics and socio-economic status at the area level.ResultsIn areas where the residents reported perceiving their neighbourhood to be “safe” and controlling for area levels of socio-economic deprivation, there were no statistically significant associations between the proportion of parkland and high or very high psychological distress. In the most disadvantaged neighbourhoods which were perceived as unsafe by residents, those with greater proportions of parkland, over 20%, there was greater psychological distress, this association was statistically significant (20-40% parkland: OR=2.27, 95% CI=1.45-3.55; >40% parkland: OR=2.53, 95% CI=1.53-4.19).ConclusionOur study indicates that perceptions of neighbourhood safety and area deprivation were statistically significant effect modifiers of the association between parkland and psychological distress.

Factors associated with dental caries experience and oral health status among New South Wales adolescents.

Objective: To investigate the potential social and behavioural risk factors influencing the oral health of teenagers aged 14 and 15 years living in New South Wales Australia.

The Dental Health of primary school children living in fluoridated, pre-fluoridated and non-fluoridated communities in New South Wales, Australia.

BackgroundThe Local Government Area of Gosford implemented a water fluoridation scheme in 2008. Therefore the opportunity was taken to record the dental health of primary school children aged 5–7 years prior to the fluoridation and compare the results with other communities in NSW with different access to fluoridated water. The aim was to compare the oral health of New South Wales (Australia)s 5–7 year olds living in fluoridated, and non- fluoridated communities. One of the areas was due to implement water fluoridation and is termed the pre-fluoridation site.MethodsPupils in the first year of Public and Catholic Schools in three areas of NSW were recruited. Class lists were used to draw a sample of approximately 900 per area. This number allowed for a non-response rate of up to 30 per cent and would give a sample sufficient numbers to allow statistical inferences to be drawn. Children whose parents consented received a dental examination and the clinical data was collected on mark sense cards.ResultsIn the 3 areas the proportion of children who received a dental examination varied; 77.5% (n = 825) for the fluoridated area, 80.1% (n = 781) for the pre-fluoridated area and 55.3% (n = 523) for the non-fluoridated area. The mean dmft was 1.40 for the fluoridated area, 2.02 for the pre-fluoridated area and 2.09 for the non-fluoridated area. These differences were statistically significant (p < 0.01). Differences were also noted in the proportion of children who were caries free, 62.6% fluoridated area, 50.8% for the pre-fluoride area and 48.6% for the non-fluoride location.ConclusionThe children living in the well-established fluoridated area had less dental caries and a higher proportion free from disease when compared with the other two areas which were not fluoridated. Fluoridation demonstrated a clear benefit in terms of better oral health for young children.

A 4-year assessment of a new water-fluoridation scheme in New South Wales, Australia.

OBJECTIVE To monitor the changes in dental caries prevalence of 5- to 7-year-old children living in a fluoridated area, a newly fluoridated area and in an area without water fluoridation, in NSW, Australia. METHODS Dental caries prevalence was recorded for 5- to 7-year-old children, living in the three study locations, by six trained and calibrated examiners in 2008, 2010 and 2012. A questionnaire recorded demographic data, toothbrushing behaviour and sugary drink consumption. Caries experience was measured using the decayed, missing, and filled teeth (dmft) index for primary teeth, the percentage of children who were caries free and the significant caries index. Univariate analysis was undertaken to determine independent predictors of caries. RESULTS The caries prevalence changed over time. In 2008, the mean dmft index was 1.40 for the fluoridated area, 2.02 for the area about to fluoridate and 2.09 for the unfluoridated control. By 2012, these mean dmft scores were 0.69, 0.72 and 1.21, respectively. In the two areas where children received fluoridated water, the significant caries index was 2.30 for the fluoridated area and 2.40 for the newly fluoridated area. The significant caries score for children in the unfluoridated location was 3.93. Multivariate analysis showed that over time the differences in dental caries prevalence between the established fluoride area and the newly fluoridated area diminished. However, children in the unfluoridated control area continued to demonstrate significant differences in the mean number of decayed teeth compared with children in the fluoridated comparator sites, and the proportions of children free from decay were significantly higher in the fluoridated areas than in the unfluoridated area. CONCLUSION Fluoridation of public water supplies in Gosford and Wyong offers young children better dental health than those children who do not have access to this public health measure.

Lifestyle Changes After a Diagnosis of Type 2 Diabetes

Objective. Whether patients with type 2 diabetes change their lifestyle in response to their diagnosis and maintain behavior changes is unclear. This study aimed to 1) compare changes in lifestyle behaviors among participants who were newly diagnosed with type 2 diabetes and those never diagnosed with type 2 diabetes and 2) investigate changes in lifestyle behaviors in relation to the duration of newly diagnosed type 2 diabetes. Methods. We used self-reported information from the New South Wales 45 and Up Study and a follow-up study. Changes in body weight; amount of walking, moderate to vigorous physical activity (MVPA), and sitting; fruit and vegetable consumption; and smoking status and number of cigarettes smoked were used as measures of health behavior change. These variables were compared between participants in a “new type 2 diabetes” group and a “no type 2 diabetes” group. Results. The new type 2 diabetes group had a smaller decrease in vegetable consumption, lost more weight, and were more likely to quit smoking than the no type 2 diabetes group. MVPA, fruit consumption, and number of cigarettes smoked did not change significantly for either group. Although no significant changes were found in any of the health behaviors based on time since diagnosis, the magnitude of changes in weight and walking increased as duration of diagnosis increased, whereas changes in MVPA, number of cigarettes smoked, and proportion of participants who quit smoking decreased. Conclusion. In this population-based study, participants with incident type 2 diabetes reported only minimal changes in their lifestyle factors after receiving their diagnosis.

Effectiveness of water fluoridation in the prevention of dental caries across adult age groups

BACKGROUND Lifetime access to fluoridated water (FW) is associated with lower caries experience. However, assessing this association in adults is likely affected by age. Cohort stratification and categorization of per cent lifetime access to fluoridated water (% LAFW) within cohorts are current approaches to this assessment. These approaches require an examination of the % LAFW and caries experience variation within and across age groups and their association to inform future analyses. OBJECTIVE This secondary analysis aimed to examine the age group variation in % LAFW and caries experience; and the association of % LAFW with caries within and across age groups of adults. METHODS A secondary analysis was undertaken using the Australian National Survey of Adult Oral Health 2004-2006 data on 4090 persons aged 15-91 years randomly sampled by a stratified, multistage probability method. Study participants underwent an interview, an oral examination by trained and standardized dentists to determine decayed, missing or filled tooth surfaces (DMFS) and a mailed self-complete questionnaire which collected residential history to calculate % LAFW. Variations in % LAFW and DMFS across age groups (15-34; 35-44; 45-54; 55+) were examined. Multivariable regression log-link models were generated for DMFS score within each age group. RESULTS The age groups varied in values and distribution of % LAFW. Caries experience was strongly associated with age. % LAFW was significantly associated with DMFS score in the two younger age groups, but not in the others. Multivariable regression models showed that the highest % LAFW quartile had significantly lower DMFS count than the lowest quartile in the two younger age groups (mean ratios: 0.67 and 0.78, respectively), controlling for other covariates. CONCLUSION Access to FW was associated with caries experience in Australian adults. The magnitude of associations varied between age groups, dependent on the natural history of caries and its measurement by DMFS.

Seeking fresh food and supporting local producers: perceptions and motivations of farmers’ market customers

ABSTRACT Farmers’ markets revitalise public spaces. They create a place of diversity and interest and provide consumers with an opportunity to purchase fresh, local and seasonal foods in a social and community-focused environment. In this study, we aimed to investigate the backgrounds, attitudes and motivations of 633 customers at 17 farmers’ markets in Sydney. We found that shoppers were motivated by a variety of social, ethical, health and environmental factors. Customers looked to purchase high quality, fresh, nutritious and locally produced foods that had been grown or made using sustainable and environmentally friendly farming and food production methods. Forming direct relationships with producers and fostering community connections were also seen as important benefits of farmers’ markets. A collaborative approach involving market managers, community and government groups, planners, developers, health organisations, producers and consumers is required to identify, trial and fund strategies to promote farmers’ markets as an affordable, beneficial and convenient shopping option for all members of the community.

Assessment of the Use of an Intra-Oral Camera for Epidemiological Caries Research

Technological innovations have played an important role in dental care. These have brought about significant changes in the way dental diseases have been diagnosed and treated. Such examples as the prevention of dental caries through the use of fluoride toothpaste [1], and digital radiography [2,3] have all impacted on patient care. Another area of technology which has changed dramatically over the recent years is dental photography [4]. Digital technology, linking photographic data to computers and the miniaturization of sophisticated high magnification cameras has resulted in many dental practitioners recommending use of photography as an educational tool, for facilitating medicolegal records and assisting with the diagnosis of clinical problems [5]. The versatility of intra-oral cameras might be the reason for which they have become extremely popular in private dental practice [6]. However, the use of this multifaceted tool has not been utilized a great deal in the field of dental research. Intra-oral cameras have been found valuable in the field of forensic dentistry [7]. They have also been used for scoring dental plaque [8], deciduous molar hypomineralization [9] and have shown to have effectively augmented oral hygiene instruction and improved patient compliance [10]. Also a number of researchers [11-13] have found the small intra-oral cameras to be a useful tool for teledentistry offering a potentially efficient and reliable means for screening caries in children in remote or under-serviced areas. Other studies have been reported using them for scoring caries [14]. However these studies were either limited to posterior teeth or were conducted on extracted teeth [15,16]. To date published scientific literature on epidemiological projects utilizing the ability of modern light weight intra-oral cameras to record the oral health of individual patients is very limited.