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Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE (Open Access)

Flying blind: trying to find solutions to Indigenous oral health

Andrea M. de Silva A B C , Jacqueline Martin-Kerry A , Alexandra Geale A and Deborah Cole A
+ Author Affiliations
- Author Affiliations

A Centre of Applied Oral Health Research, Dental Health Services Victoria, 720 Swanston Street, Carlton, Vic. 3053, Australia. Email: jacqueline.martin-kerry@dhsv.org.au; alexandrageale@yahoo.com.au; deborah.cole@dhsv.org.au

B Melbourne Dental School, The University of Melbourne, 720 Swanston Street, Carlton, Vic. 3053, Australia.

C Corresponding author. Email: andrea.desilva@dhsv.org.au

Australian Health Review 40(5) 570-583 https://doi.org/10.1071/AH15157
Submitted: 20 August 2015  Accepted: 29 September 2015   Published: 22 December 2015

Journal Compilation © AHHA 2016

Abstract

Objective The aim of the present study was to identify all published evidence about oral health in Indigenous children in Australia and to determine trends in Indigenous oral health over time.

Methods PubMed was used to search for published peer-reviewed articles that reported caries (decay) prevalence rates and/or caries experience (based on caries indices) in Indigenous children. Studies included in the analysis needed to report clinical oral health data (not self-reported dental experiences), and articles were excluded if they reported caries in only a select, specific or targeted sample (e.g. only children undergoing hospital admissions for dental conditions).

Results The review identified 32 studies that met the inclusion criteria. These studies reported data from the Northern Territory (n = 14), Western Australia (n = 7), South Australia (n = 7), Queensland (n = 7), New South Wales (n = 1), Australian Capital Territory (n = 1) and Tasmania (n = 1). Of the studies, 47% were in rural locations, 9% were in urban locations and 44% were in both rural and urban locations. Data are limited and predominantly for Indigenous children living in rural locations, and there are no published studies on caries in Indigenous children living in Victoria.

Conclusions The present study documents the published prevalence and severity of caries in Indigenous children living in Australia and highlights that limited oral health data are available for this priority population. Although risk factors for oral disease are well known, most of the studies did not analyse the link between these factors and oral disease present. There is also inconsistency in how caries is reported in terms of age and caries criteria used. We cannot rely on the available data to inform the development of policies and programs to address the oral health differences in Indigenous populations living contemporary lives in metropolitan areas.

What is known about the topic? Many studies report that Indigenous people have poorer general health in Australia compared with non-Indigenous people.

What does this paper add? This paper documents the available published prevalence and experience of caries for Indigenous children in Australia. It demonstrates significant limitations in the data, including no Victorian data, inconsistency with reporting methods and most data being for Indigenous children who are living in rural locations.

What are the implications for practitioners? It is important for practitioners to have access to oral health data for Indigenous children in Australia. However, the present study highlights significant knowledge gaps for this population group and identifies ways to collect data in future studies to enable more meaningful comparisons and policy development.

Additional keywords: Aboriginal and Torres Strait Islander, Australia, caries, child, decay, prevalence.


References

[1]  Jamieson LM, Parker EJ, Armfield JM. Indigenous child oral health at a regional and state level. J Paediatr Child Health 2007; 43 117–21.
Indigenous child oral health at a regional and state level.Crossref | GoogleScholarGoogle Scholar | 17316183PubMed |

[2]  Davies MJ, Spencer AJ. Dental caries among Australian Aboriginal, non-Aboriginal Australian-born, and overseas-born. Bull World Health Organ 1997; 75 197–203.
| 1:STN:280:DyaK2svit12nsw%3D%3D&md5=ee0c4d203226b95c13f7fe26e92f5ce7CAS | 9277006PubMed |

[3]  Dogar F, Kruger E, Dyson K, Tennant M. Oral health of pre-school children in rural and remote Western Australia. Rural Remote Health 2011; 11 1–7.

[4]  Vanobbergen J, De Visschere L, Daems M, Ceuppens A, Van Emelen J. Sociodemographic determinants for oral health risk profiles. Int J Dent 2010; 2010 article ID938936
Sociodemographic determinants for oral health risk profiles.Crossref | GoogleScholarGoogle Scholar |

[5]  Watt RG, Sheiham A. Integrating the common risk factor approach into a social determinants framework. Community Dent Oral Epidemiol 2012; 40 289–96.
Integrating the common risk factor approach into a social determinants framework.Crossref | GoogleScholarGoogle Scholar | 22429083PubMed |

[6]  Kramer PF, Feldens CA, Ferreira SH, Bervian J, Rodrigues PH, Peres MA. Exploring the impact of oral diseases and disorders on quality of life of preschool children. Community Dent Oral Epidemiol 2013; 41 327–35.
Exploring the impact of oral diseases and disorders on quality of life of preschool children.Crossref | GoogleScholarGoogle Scholar | 23330729PubMed |

[7]  National Advisory Committee on Oral Health. Healthy mouths healthy lives: Australia’s national oral health plan 2004–2013. Adelaide: South Australian Department of Health; 2004.

[8]  Australian Bureau of Statistics. Estimates of Aboriginal and Torres Strait Islander Australians, June 2011. 2011. Available at: http://www.abs.gov.au/ausstats/abs@.nsf/mf/3238.0.55.001 [verified 12 June 2015].

[9]  Harford JSJ, Roberts-Thomson K. Oral health. In Thomson N, editor. The health of Indigenous Australians. Melbourne: Oxford University Press; 2003. pp. 313–38.

[10]  Christian B, Blinkhorn AS. A review of dental caries in Australian Aboriginal children: the health inequalities perspective. Rural Remote Health 2012; 12 2032
| 23098560PubMed |

[11]  Kailis DG. Australian Aboriginal studies. 1. The effect of socio-economic changes on the prevalence of caries in 6–14 year-old children resident at Bathurst Island and Groote Eylandt in the Northern Territory of Australia, 1971. Aust Dent J 1979; 24 363–8.
Australian Aboriginal studies. 1. The effect of socio-economic changes on the prevalence of caries in 6–14 year-old children resident at Bathurst Island and Groote Eylandt in the Northern Territory of Australia, 1971.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL3c7gvVymsQ%3D%3D&md5=0b9d71e4ef3914b4b4dfae6ea4991013CAS | 294243PubMed |

[12]  Kailis DG. Dental conditions observed in Australian aboriginal children resident in Warburton and Cundeelee missions, Western Australia (August, 1968). Aust Dent J 1971; 16 44–52.
Dental conditions observed in Australian aboriginal children resident in Warburton and Cundeelee missions, Western Australia (August, 1968).Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaE3M7mtFOksQ%3D%3D&md5=5a7fd81d27efbe72d70acda768c910cbCAS | 4396468PubMed |

[13]  Kailis DG, Silva DG. Prevalence of dental caries in Australian aboriginal children resident in Carnarvon, Western Australia. Aust Dent J 1971; 16 109–15.
Prevalence of dental caries in Australian aboriginal children resident in Carnarvon, Western Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaE3M3jslKrsQ%3D%3D&md5=def6d78d4585cd01a40645a948da7a70CAS | 4397553PubMed |

[14]  Schamschula RG, Cooper MH, Adkins BL, Barmes DE, Agus HM. Oral conditions in Australian children of Aboriginal and Caucasian descent. Community Dent Oral Epidemiol 1980; 8 365–9.
Oral conditions in Australian children of Aboriginal and Caucasian descent.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL3M7js1yhtw%3D%3D&md5=ae8a4d4c46f6c871cca9edd384a6f9b5CAS | 6937283PubMed |

[15]  Cooper MH, Schamschula RG, Craig GG. Caries experience of Aboriginal children in the Orana region of New South Wales. Aust Dent J 1987; 32 292–4.
Caries experience of Aboriginal children in the Orana region of New South Wales.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaL1c%2Fns1Kitg%3D%3D&md5=1a6631b3ce7035c277b4cc5fbe21e701CAS | 3479968PubMed |

[16]  Pascoe L, Seow WK. Enamel hypoplasia and dental caries in Australian aboriginal children: prevalence and correlation between the two diseases. Pediatr Dent 1994; 16 193–9.
| 1:STN:280:DyaK2czjs1Cnuw%3D%3D&md5=451524fb94655d9d507c5db529001459CAS | 8058543PubMed |

[17]  Seow WK, Amaratunge A, Bennett R, Bronsch D, Lai PY. Dental health of Aboriginal pre-school children in Brisbane, Australia. Community Dent Oral Epidemiol 1996; 24 187–90.
Dental health of Aboriginal pre-school children in Brisbane, Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DyaK2s%2FisVOqsQ%3D%3D&md5=9d8976196d9f75bfe8852d01217d966eCAS | 8871017PubMed |

[18]  Seow WK, Amaratunge A, Sim R, Wan A. Prevalence of caries in urban Australian aborigines aged 1–3.5 years. Pediatr Dent 1999; 21 91–6.
| 1:STN:280:DyaK1M3htlSrsw%3D%3D&md5=1528862c706d64389945c8aabb6c7bdbCAS | 10197332PubMed |

[19]  Hallett KB, O’Rourke PK. Early childhood caries and infant feeding practice. Community Dent Health 2002; 19 237–42.
| 12489838PubMed |

[20]  Roberts-Thomson K. Oral health of Aboriginal Australians. Aust Dent J 2004; 49 151–3.
Oral health of Aboriginal Australians.Crossref | GoogleScholarGoogle Scholar | 15497360PubMed |

[21]  Endean C, Roberts-Thomson K, Wooley S. Anangu oral health: the status of the Indigenous population of the Anangu Pitjantjatjara lands. Aust J Rural Health 2004; 12 99–103.
Anangu oral health: the status of the Indigenous population of the Anangu Pitjantjatjara lands.Crossref | GoogleScholarGoogle Scholar | 15200519PubMed |

[22]  Armfield JM. Public water fluoridation and dental health in New South Wales. Aust N Z J Public Health 2005; 29 477–83.
Public water fluoridation and dental health in New South Wales.Crossref | GoogleScholarGoogle Scholar | 16255452PubMed |

[23]  Blair EM, Zubrick SR, Cox AH. The Western Australian Aboriginal Child Health Survey: findings to date on adolescents. Med J Aust 2005; 183 433–5.
| 16225453PubMed |

[24]  Kruger E, Dyson K, Tennant M. Pre-school child oral health in rural Western Australia. Aust Dent J 2005; 50 258–62.
Pre-school child oral health in rural Western Australia.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD28roslSisQ%3D%3D&md5=1f444ab59af6be0fa9e582165276daf7CAS | 17016892PubMed |

[25]  Jamieson LM, Armfield JM, Roberts-Thomson KF. Oral health inequalities among Indigenous and nonindigenous children in the Northern Territory of Australia. Community Dent Oral Epidemiol 2006; 34 267–76.
Oral health inequalities among Indigenous and nonindigenous children in the Northern Territory of Australia.Crossref | GoogleScholarGoogle Scholar | 16856947PubMed |

[26]  Jamieson LM, Armfield JM, Roberts-Thomson KF. The role of location in Indigenous and non-Indigenous child oral health. J Public Health Dent 2006; 66 123–30.
The role of location in Indigenous and non-Indigenous child oral health.Crossref | GoogleScholarGoogle Scholar | 16711632PubMed |

[27]  Jamieson LM, Armfield JM, Roberts-Thomson KF. Dental caries trends among Indigenous and non-Indigenous Australian children. Community Dent Health 2007; 24 238–46.
| 1:STN:280:DC%2BD1c%2FptVWrtg%3D%3D&md5=d85a3f2f9429c3a06b6c9a0d1b78789eCAS | 18246842PubMed |

[28]  Jamieson LM, Armfield JM, Roberts-Thomson KF. Indigenous and non-Indigenous child oral health in three Australian states and territories. Ethn Health 2007; 12 89–107.
Indigenous and non-Indigenous child oral health in three Australian states and territories.Crossref | GoogleScholarGoogle Scholar | 17132586PubMed |

[29]  Hopcraft M, Chow W. Dental caries experience in Aboriginal and Torres Strait Islanders in the Northern Peninsula Area, Queensland. Aust Dent J 2007; 52 300–4.
Dental caries experience in Aboriginal and Torres Strait Islanders in the Northern Peninsula Area, Queensland.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BD1c7gvVaiuw%3D%3D&md5=415c906908547cebc533ff977b4ebf22CAS | 18265686PubMed |

[30]  Parker EJ, Jamieson LM. Oral health comparisons between children attending an Aboriginal health service and a government school dental service in a regional location. Rural Remote Health 2007; 7 625
| 17474830PubMed |

[31]  Bailie RS, Stevens M, Armfield JM, Ehsani JP, Beneforti M, Spencer J. Association of natural fluoride in community water supplies with dental health of children in remote Indigenous communities: implications for policy. Aust N Z J Public Health 2009; 33 205–11.
Association of natural fluoride in community water supplies with dental health of children in remote Indigenous communities: implications for policy.Crossref | GoogleScholarGoogle Scholar | 19630837PubMed |

[32]  Spencer AJ, Bailie R, Jamieson L. The Strong Teeth Study; background, rationale and feasibility of fluoridating remote Indigenous communities. Int Dent J 2010; 60 250–6.
| 1:STN:280:DC%2BC3cjlvVejsg%3D%3D&md5=eed1dca6b79309b9a1c6ba5db982bf4cCAS | 20718312PubMed |

[33]  Jamieson LM, Armfield JM, Roberts-Thomson KF, Sayers SM. A retrospective longitudinal study of caries development in an Australian Aboriginal birth cohort. Caries Res 2010; 44 415–20.
A retrospective longitudinal study of caries development in an Australian Aboriginal birth cohort.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC3cjpsFSrsg%3D%3D&md5=ff16cd6c28c3bebd2aa1bb71b7684519CAS | 20720421PubMed |

[34]  Slade GD, Bailie RS, Roberts-Thomson K, Leach AJ, Raye I, Endean C, Simmons B, Morris PS. Effect of health promotion and fluoride varnish on dental caries among Australian Aboriginal children: results from a community-randomized controlled trial. Community Dent Oral Epidemiol 2011; 39 29–43.
Effect of health promotion and fluoride varnish on dental caries among Australian Aboriginal children: results from a community-randomized controlled trial.Crossref | GoogleScholarGoogle Scholar | 20707872PubMed |

[35]  Divaris K, Preisser JS, Slade GD. Surface-specific efficacy of fluoride varnish in caries prevention in the primary dentition: results of a community randomized clinical trial. Caries Res 2013; 47 78–87.
Surface-specific efficacy of fluoride varnish in caries prevention in the primary dentition: results of a community randomized clinical trial.Crossref | GoogleScholarGoogle Scholar | 1:CAS:528:DC%2BC3sXhslWisr0%3D&md5=cc1d06f2994d9d77ce607750a6d5214dCAS | 23207237PubMed |

[36]  Zander A, Sivaneswaran S, Skinner J, Byun R, Jalaludin B. Risk factors for dental caries in small rural and regional Australian communities. Rural Remote Health 2013; 13 1–9.

[37]  Ha D, Australian Research Centre for Population Oral Health Oral health of Australian Indigenous children compared to non-Indigenous children enrolled in school dental services. Aust Dent J 2014; 59 395–400.
Oral health of Australian Indigenous children compared to non-Indigenous children enrolled in school dental services.Crossref | GoogleScholarGoogle Scholar | 25040876PubMed |

[38]  Johnson N, Lalloo R, Kroon J, Fernando S, Tut O. Effectiveness of water fluoridation in caries reduction in a remote Indigenous community in Far North Queensland. Aust Dent J 2014; 59 366–71.
Effectiveness of water fluoridation in caries reduction in a remote Indigenous community in Far North Queensland.Crossref | GoogleScholarGoogle Scholar | 1:STN:280:DC%2BC2cjitVSjsw%3D%3D&md5=9597f59f154d8c67a09fd73b3d57e53dCAS | 24820049PubMed |

[39]  Lalloo R, Jamieson LM, Ha D, Ellershaw A, Luzzi L. Does fluoride in the water close the dental caries gap between Indigenous and non-Indigenous children? Aust Dent J 2014; 60 390–6.
Does fluoride in the water close the dental caries gap between Indigenous and non-Indigenous children?Crossref | GoogleScholarGoogle Scholar |

[40]  World Health Organization. Oral health surveys – basic methods, 5th edition. Geneva: WHO; 2012.

[41]  Blinkhorn F, Brown N, Freeman R, Humphris G, Martin A, Blinkhorn A. A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries. BMC Public Health 2012; 12 681
A phase II clinical trial of a dental health education program delivered by aboriginal health workers to prevent early childhood caries.Crossref | GoogleScholarGoogle Scholar | 22909327PubMed |

[42]  Merrick J, Chong A, Parker E, Roberts-Thomson K, Misan G, Spencer J, Broughton J, Lawrence H, Jamieson L. Reducing disease burden and health inequalities arising from chronic disease among Indigenous children: an early childhood caries intervention. BMC Public Health 2012; 12 323
Reducing disease burden and health inequalities arising from chronic disease among Indigenous children: an early childhood caries intervention.Crossref | GoogleScholarGoogle Scholar | 22551058PubMed |