Trends in dental visiting avoidance due to cost in Australia, 1994 to 2010: an age-period-cohort analysis

Background: The cost of dental care may be a barrier to regular dental attendance with the proportion of the Australian population avoiding or delaying care due to cost increasing since 1994. This paper explores the extent to which age, period and cohort factors have contributed to the variation in avoiding or delaying visiting a dentist because of cost. Methods: Data were obtained from four national dental telephone interview surveys of Australian residents aged five years and over conducted in 1994, 1999, 2004 and 2010 (response rates 48% - 72%). The trend in the percentage of persons avoiding or delaying visiting a dentist because of cost was analysed by means of a standard cohort table and more formal age-period-cohort analyses using a nested models framework. Results: There was an overall increase in the proportion of people avoiding or delaying visiting a dentist indicating the presence of period effects. Financial barriers were also associated with age such that the likelihood of avoiding because of cost was highest for those in their mid-late twenties and lowest in both children and older adults. Cohort effects were also present although the pattern of effects differed between cohorts. Conclusion: The findings of this study suggest that, in addition to the increase in costs associated with dental care, policies targeting specific age groups and income levels may be contributing to the inequality in access to dental care.Sergio Chrisopoulos, Liana Luzzi and David S Brenna

Oral health and dental care in Australia: key facts and figures 2015

This report is the latest in the Oral health and dental care in Australia: key facts and figures suite of printed publications and web products. It presents the most recent key information on the oral health and dental care of the Australian population. Between 1994 and 2013, there was an overall increase in the proportion of people who were uncomfortable about their dental appearance, from 20% to nearly 27%. The proportion who reported experiencing a toothache over the previous 12 months increased from around 11% to 16% over the same period.Chrisopoulos S, Harford JE & Ellershaw

Oral Health of Australian Adults: Distribution and Time Trends of Dental Caries, Periodontal Disease and Tooth Loss

Published: 2 November 2021This study was conducted to describe the distribution and trends in dental caries, periodontal disease and tooth loss in Australian adults based on the findings of the National Study of Adult Oral Health 2017–18. A cross-sectional study of a random sample of Australians aged 15+ years was carried out, employing a three-stage stratified probability sampling design. Data were collected via online survey/telephone interviews using a questionnaire to elicit self-reported information about oral health and related characteristics. Participants were then invited to have an oral examination, conducted by calibrated dental practitioners following a standardised protocol in public dental clinics. A total of 15,731 Australians aged 15+ years were interviewed, of which 5022 dentate participants were orally examined. Results showed that nearly one third of Australian adults had at least one tooth surface with untreated dental caries and, on average, 29.7 decayed, missing or filled tooth surfaces per person. Almost 29% of adults presented with gingivitis while the overall prevalence of periodontitis was 30.1%. Overall, 4% of adults were edentulous while, on average, 4.4 teeth were lost due to pathology. Poorer oral health was evident in Australians from lower socioeconomic backgrounds, indicating socioeconomic inequalities in oral health. Time trends revealed that dental caries experience and tooth retention of Australian adults has improved over 30 years, while periodontal health has deteriorated between 2004–06 and 2017–18. These findings can be used to assist policy makers in planning and implementing future oral healthcare programs.Najith Amarasena, Sergio Chrisopoulos, Lisa M. Jamieson and Liana Luzz

Parenting and child behaviour as predictors of toothbrushing difficulties in young children

Background: Oral disease is one of the most prevalent chronic health conditions affecting children. Twice-daily toothbrushing is recommended to promote good oral health; however, a large proportion of Australian families are not meeting this recommendation. Aim: This study aimed to identify important barriers to regular toothbrushing for young children. Design: In this study, 239 parents of 0- to 4-year-old children completed an online survey that investigated child, family, and parent factors associated with child toothbrushing. Hierarchical linear regression was used to identify predictors of toothbrushing frequency in children and perceived difficulty of the task by parents. Results: We found that parent factors, specifically oral health knowledge, were the most significant predictors of toothbrushing frequency. Conversely, parent factors did not contribute significantly to the prediction of perceived difficulty of toothbrushing once family and child factors were taken into account. Oral health knowledge and use of routines were identified as the most important predictors of toothbrushing frequency, whereas resistant child behaviour and household organisation were found to be the most important predictors of perceived difficulty of regular toothbrushing. Conclusions: The findings of the study have implications for behavioural interventions to support parents, as well as directions for future research

Can low-income people afford life satisfaction? The modifying effect of personality traits, a cross-sectional study

OnlinePublThe aim was to investigate whether the "Big Five" personality traits modify the association between household income and life satisfaction (LF); and to evaluate the interaction and main effects of personality traits and income on LF. Data from the Dental Care and Oral Health Study (DCOHS, 2015–2016) was used for the cross-sectional study (n=3,475). Multivariable Poisson regression models (adjusted for demographics and health behaviours) assessed the effect of personality traits (measured using the Ten-Item Personality Inventory) on the association between income and LF (measured by the Satisfaction With Life Scale) using prevalence ratios (PRs). The Relative Excess Risk due to Interaction (RERI) was calculated to assess the direction of effect modification. Among low-income respondents, low LF was less prevalent in those with high personality trait scores than those with low scores. The difference in the prevalence of low LF by personality traits was greater between low versus high income for openness (11.4% vs 7.7%), agreeableness (12.3% vs 9.4%) and emotional stability (26.1% vs 20.2%) categories. The combined effects of low income and low scores for these traits on LF also exceeded the sum of their individual effects, as shown by their positive RERIs. The association between low income and low LF was modified by high openness, agreeableness and emotional stability scores. Findings suggest that psychological interventions for improving LF would be most beneficial in low-income groups.Mehrsa Zakershahrak Sergio Chrisopoulos, Liana Luzzi, Dandara Haag, David Brenna

A longitudinal assessment of chronic periodontitis in Australian adults

Aim: The study aimed to estimate the incidence/progression and reversal of chronic periodontitis and to identify factors associated with chronic periodontitis in Australian adults over a 12-year period. Materials and Methods: Data were obtained from the longitudinal component of the National Study of Adult Oral Health (NSAOH) in 2004–2006, and repeated data, among the same adults, in 2017–2018. NSAOH 2004–2006 was a population-based study of Australian adults aged 15+ years. The American Academy of Periodontology/European Federation of Periodontology case definitions were used, and then compared with two other case definitions. Multivariable Poisson regression models were used to estimate incidence rate ratios (IRRs) and reversal rate ratio (RRRs) of periodontitis. Results: A total of 775 dentate Australian adults had dental examinations at both times. The proportion of incidence/progression and reversal among Australian adults was 56.4% and 11.0%, respectively. Tobacco smokers presented with more than three times higher incidence (IRR: 3.32, 95% CI: 1.50–7.60) and lower reversals (RRR: 0.94, 95% CI: 0.39–0.98) than those who had never smoked. Cessation of smoking was positively associated with periodontitis reversal. The total incidence/progression was 471.7/10,000 person-years, with reversal being 107.5/10,000 person-years. The average number of teeth lost due to periodontal disease was 1.9 in 2017–2018. Being male and not having periodontal treatment were significant risk markers for the incidence/progression of periodontitis. Conclusion: Smoking is a risk factor for periodontitis. Cessation of smoking is an effective means of reducing the incidence and progression of chronic periodontitis, to reduce the risk of tooth loss, and to improve overall periodontal health.Xiangqun Ju | Gloria Mejia | Sergio Chrisopoulos | Liana Luzzi | Lisa M. Jamieso

Barriers and enablers to delivery of the Healthy Kids Check: An analysis informed by the Theoretical Domains Framework and COM-B model

Background: More than a fifth of Australian children arrive at school developmentally vulnerable. To counteract this, the Healthy Kids Check (HKC), a one-off health assessment aimed at preschool children, was introduced in 2008 into Australian general practice. Delivery of services has, however, remained low. The Theoretical Domains Framework, which provides a method to understand behaviours theoretically, can be condensed into three core components: capability, opportunity and motivation, and the COM-B model. Utilising this system, this study aimed to determine the barriers and enablers to delivery of the HKC, to inform the design of an intervention to promote provision of HKC services in Australian general practice. Methods: Data from 6 focus group discussions with 40 practitioners from general practices in socio-culturally diverse areas of Melbourne, Victoria, were analysed using thematic analysis. Results: Many practitioners expressed uncertainty regarding their capabilities and the practicalities of delivering HKCs, but in some cases HKCs had acted as a catalyst for professional development. Key connections between immunisation services and delivery of HKCs prompted practices to have systems of recall and reminder in place. Standardisation of methods for developmental assessment and streamlined referral pathways affected practitioners' confidence and motivation to perform HKCs. Conclusion: Application of a systematic framework effectively demonstrated how a number of behaviours could be targeted to increase delivery of HKCs. Interventions need to target practice systems, the support of office staff and referral options, as well as practitioners' training. Many behavioural changes could be applied through a single intervention programme delivered by the primary healthcare organisations charged with local healthcare needs (Medicare Locals) providing vital links between general practice, community and the health of young children. © 2014 Alexander et al.; licensee BioMed Central Ltd

Job Resources and Matching Active Coping Styles as Moderators of the Longitudinal Relation Between Job Demands and Job Strain

Background: Only in a few longitudinal studies it has been examined whether job resources should be matched to job demands to show stress-buffering effects of job resources (matching hypothesis), while there are no empirical studies in which the moderating effect of matching personal characteristics on the stress-buffering effect of job resources has been examined. Purpose: In this study, both the matching hypothesis and the moderating effect of matching active coping styles were examined with respect to the longitudinal relation between job demands, job resources, and job strain.Method: The study group consisted of 317 beginning teachers from Belgium. The two-wave survey data with a 1-year time lag were analyzed by means of structural equation modeling and multiple group analyses. Results: Data did not support the matching hypothesis. In addition, no support was found for the moderating effect of specific active coping styles, irrespective of the level of match. Conclusion: To show stress-buffering effects of job resources, it seems to make no difference whether or not specific types of job demands and job resources are matched, and whether or not individual differences in specific active coping styles are taken into account