Distribution and determinants of oral health

Oral diseases and disorders remain widespread and extensive in the population. There is a fundamental requirement for important research in documenting and exploring the trends in oral diseases and their distribution in the population. Research that seeks to understand the determinants of changes over time or variation between sub-groups in the population is fundamental to the process of improving oral health.

Child Dental Health Survey

This survey reports annually on the state of oral health in Australia’s school-age children using data provided by State and Territory School Dental Services.

Adult Dental Programs Survey

The Adult Dental Programs Survey monitors the oral health of cardholders as they attend for public‑funded dental treatment. The survey evaluates the oral health status of patients attending for care, their demographic and utilization characteristics, and profiles of services provided throughout the courses of care.

Indigenous Oral Health

ARCPOH is developing an Indigenous oral health collection with the assistance of State and Territory dental services and Aboriginal community-controlled health organisations. Memoranda of Understanding have been negotiated with some remote communities.

Aboriginal Birth Cohort Study – Wave 3 (NHMRC)

An SA community-owned Indigenous oral health promotion initiative (AIATSIS)

Caries Risk Assessment for South Australian Children (The University of Adelaide Scholarship and ADRF grant)

This study aims to explore factors that might affect the accuracy of clinicians’ judgement of caries risk level for South Australian children in school dental clinic.

Fluoride exposure, dental fluorosis and caries among South Australian children (Adelaide International Scholarship, The University of Adelaide)

The aim of this study is to determine risk factors for dental fluorosis among children of different age cohorts.

A cognitive theory of the etiology of fear

This research looks at understanding the bases of anxiety and fear, including dental fear, by employing a new cognitive model and will form the body of a PhD. It is proposed that fear is a direct result of perceptions of stimulus characteristics.

Child Fluoride Study Mark II (NHMRC)

The extent to which water fluoridation has contributed to the considerable reduction of dental decay in children in recent times in Australia is unclear, due perhaps to the increasing availability of fluoride in other sources such as toothpaste, drops, tablets, and professional applications. It is proposed to monitor for approximately three years a sample of 30,000 primary and secondary school children to examine the precise contribution of consuming fluoridated water to tooth decay. The project also aims to examine the comparative role of diet, toothbrushing, socioeconomic status, and other factors in tooth decay.

The Child Fluoride Study (CFS Mark II) investigates the effectiveness of consuming fluoridated water in reducing children’s caries experience’ and extends the previous CFS in 1991. New methodological issues are being dealt with, which will lead to the improved precision of both exposure and disease variables in the study.

The objectives of the CFS Mark II are to establish the prevalence of dental caries among 5–15‑year‑old children and analyse their association with differing exposure to fluoridated water supplies and other sources of fluoride. The duration of the study is 3 years (±12 months) and involves at least 30,000 children in South Australia, Tasmania, Victoria and Queensland.

The South Australian Dental Longitudinal Study (NHMRC)

The South Australian Dental Longitudinal Study (SADLS) has been the first comprehensive dental longitudinal study of older adults to be conducted in Australia. Participants were aged 60+ years at the 1991 baseline data collection, and were a random sample of community-dwelling older adults in urban Adelaide and rural Mount Gambier. The 11-year follow-up data collection builds upon the previous study findings to provide important and new information about the onset and progression of oral diseases in older Australians.

Social determinants of oral health (University of Adelaide Scholarship; ADRF)

The strong relationship between socioeconomic status (SES) and oral health parallels similar relationships between socioeconomic status and a wide variety of chronic health conditions with common risk factor. However little research has attempted to explain this phenomenon. This study will draw together a comprehensive range of social factors impacting on people’s daily lives to develop an evidence-based explanation for the SES-based differences in oral health. Because most Australian adults have experienced dental disease or disorder, oral health is uniquely suited in social survey for explaining wider health inequalities and as a platform from which to subsequently develop effective interventions.

Explaining social inequality in population oral health using a multilevel approach (NHMRC)

This research builds on the social determinants of oral health project. The objectives of this project are to evaluate the area (contextual) influences of neighbourhood on oral health and to determine the relative importance of both individual-level (compositional) and contextual characteristics in explaining variation in adult oral health.

Life course influences on dental caries in 5-year-olds

This project was funded in July 2004 by Channel 7 Children’s Research Foundation of SA Inc. A prospective cohort study of 550 children involves collaboration with Departments of Public Health and Obstetrics and Gynaecology as well as the SA Dental Service.

Juvenile justice – oral health of juveniles in detention

As part of a major health survey of juveniles in detention in NSW, ARCPOH staff were involved in training and calibrating examiners.

Determinants of oral health of adults entering the 4th decade of life (NHMRC)

The purpose of this research is to document the nature, distribution and determinants of oral health among 29‑year‑olds in South Australia so as to identify points of intervention to maintain Australia’s improved oral health further into adulthood. Adults who participated in earlier research as 13-year-olds in 1988–89 will be followed-up with a social survey and oral examination to provide a range of key outcome measures on oral health status and explanatory factors from when they were 13 years old, their dental history and circumstances as 29-year-olds.

National Survey of Adult Oral Health (NHMRC, AIHW, ADA, CDC, Colgate, States/Territories)

The 2004–06 National Survey of Adult Oral Health (NSAOH) interviewed a nationally-representative sample of 14,123 people aged 15–97 years and dentally examined 5,505 of them. It represented Australia’s second oral health examination survey, occurring 17 years after the 1987–88 National Oral Health Survey of Australia. The NSAOH was directed by a team of researchers from ARCPOH who worked in collaboration with health departments in each state/territory to collect the data. The first report from the survey, entitled “Australia’s dental generations: The National Survey of Adult Oral Health 2004–06”, was launched on March 17, 2007, by the Hon Tony Abbott, federal minister for health. The report demonstrates how historical influences on oral health through the 20th century have created four distinct “dental generations” that now constitute the Australian adult population. State and Territory reports was released on 7th August 2008. Additional analyses are underway and further reports will be published to address a range of research questions regarding oral health in Australia’s adult population.

A life course epidemiological approach to understanding oral health inequalities (NHMRC Project Grant)

Life course epidemiology is gaining interest as a means to understand the impact of exposures in early life on health outcomes in adulthood. 15-year follow-up study of children recruited and examined in 1991/92.

Periodontal disease and cardiovascular disease (NHMRC)

Tracking cardiovascular disease mortality and morbidity among NSAOH subjects using AIHW’s National Death Index and National Hospital Morbidity Database to determine whether periodontitis is associated with elevated risk of cardiovascular disease.

Dentine sensitivity in Australia

This study aims to investigate the occurrence, nature and management of dentine sensitivity in Australia.

Oral care for adults with physical and intellectual disability

This study aims to investigate how carers can contribute to improve oral health of disabled people.

Home for Oral Health (ADRF)

The aim of this study is to provide insight into factors that contribute to the oral health and oral health-related quality of life among homeless adults in Australia.

Factors associated with water fluoridation support in Australia (ADRF)

This study aimed to look at the association between beliefs, attitudes and perceptions of risk associated with water fluoridation support and opposition in a national study.

National Dental Anxiety and Fear Survey (ADRF)

This study aims to (i) determine the prevalence of dental fear and phobia in Australia through a national data collection using a number of measures of dental fear; (ii) develop a new measure of dental fear; and (iii) to provide additional information informing the Cognitive Vulnerability Model of the etiology of fear. The study comprises a questionnaire follow-up to the National Dental Telephone Interview Survey.

Oral health literacy among carers of people with disabilities

Chronic heart failure project (in collaboration with SA Dental Service)

Social gradients in child oral health status and access to services

The aim of the project is to examine the oral health status of children aged 5–12 years in NSW and relate these to the socioeconomic characteristics of the individual school and area.

Factors contributing to socio-economic gradients in children’s oral health between 1993 and 2003 (NHMRC)

Diabetes and Periodontal Health (Bartold, Slade, Phillips, Kapellas)

This study will evaluate a method to screen for gum disease (periodontitis) among diabetic patients in a medical setting. 200 diabetic patients at the Queen Elizabeth Hospital will complete a questionnaire and dental radiographs will be taken. A standardised oral epidemiological examination will be conducted to provide a ‘gold-standard’ designation of periodontitis. A statistical formula will combine questionnaire and radiographic data, and its accuracy in predicting gold-standard periodontitis will be measured. If successful, the study would provide the justification for a trial in which periodontal care would be tested for its impact on dental and medical management of diabetics.

Risk indicators for periodontal disease in an urban Aboriginal population (NHMRC project grant)

This study based at Redfern Aboriginal Medical Service will examine the relative association of smoking, chronic medical conditions, stress, drug abuse and dietary factors in a case control study of periodontal disease among Aboriginal adults.

NSW Teen Survey

Collaboration between Centre for Oral Health Strategy NSW and ARCPOH. Survey of teenagers aged 14–15 years enrolled in secondary schools across NSW. Information collected will include an oral health examination and self‑complete questionnaire.

Association between telomere length and periodontitis among middle-aged males (Sanders, McNamara, Hughes, Slade, Bartold)

Periodontitis is an age-related disease affecting one in five Australian adults and a major cause of tooth loss. This study will investigate whether adults with periodontitis have shorter telomere lengths than adults without this disease. Telomeres, the protective caps on the ends of chromosomes, shorten with each cell division. However shortening occurs at different rates under different conditions. This study will provide evidence on whether cellular ageing is associated with periodontitis. Findings will open opportunities to investigate risk factors for accelerated cellular ageing and early onset of periodontitis and related chronic inflammatory diseases that share risk factors with periodontitis.