OBJECTIVES:The Oral Health Impact Profile (OHIP) is the most widely used instrument to measure the subjective impact of oral conditions. This study reports the shortening and psychometric evaluation of an ultra-short version (OHIP-7A) from the OHIP-14 in a large national Australian population. METHODS:Cross-sectional data included 2734 participants from Australia's National Study of Adult Oral Health (NSAOH) 2017-2018. The sample was divided into training (n = 1367) and test sample (n = 1367). Exploratory statistical procedures (redundancy analysis, Ant Colony Optimisation, dimensionality analysis) used in the establishment of ultra-short versions were employed in the training sample. Confirmatory procedures involving the examination of model fit, criterion validity and reliability were employed in the test sample. The establishment of ultra-short versions from an expert opinion ('Expert-derived OHIP-7') and exploratory ('Exploratory-derived OHIP-7') perspectives were investigated. RESULTS:Both Expert-derived and Exploratory-derived ultra-short versions displayed a unidimensional structure with good item performance based on network loadings. Both models displayed excellent model fit in terms of Comparative Fit Index (CFI ≥ 0.950) and Root Mean Square Error of Approximation (RMSEA ≤ 0.050), good criterion validity with variables such as self-rated dental health and good reliability (ω >  0.70). However, based on individual items' ability to capture 'impact' according to item content and distribution of responses across item categories, the Exploratory-derived OHIP-7 (OHIP-7A) was considered superior. CONCLUSION:The good psychometric properties of the OHIP-7A in terms of validity and reliability allow aspects of oral health that are meaningful to patients to be captured with a small number of items. This is the first and largest study to comprehensively validate an ultra-short version of the OHIP in an Australian population.

BACKGROUND:Periodontitis is a prevalent chronic inflammatory condition that frequently co-occurs with systemic chronic diseases. Although older adults experience a high burden of both periodontitis and chronic conditions, the extent to which age-specific evidence has been synthesised remains unclear. OBJECTIVES:To map and synthesise existing systematic reviews and meta-analyses examining associations between periodontitis and chronic conditions relevant to older adults and to identify evidence gaps related to age-specific analyses. METHOD:A scoping review and evidence gap map were conducted in accordance with Joanna Briggs Institute guidance and the PRISMA-ScR checklist. Seven electronic databases were searched, published between 2010 and 2024. Reviews examining associations between periodontitis and chronic conditions prevalent in older adults were included. Age focus and age-stratified analyses were extracted and mapped. RESULTS:Twenty-four studies were included. Across the studies included, periodontitis was generally reported to be associated with chronic conditions. Evidence specific to older adults was limited and mainly concentrated on cognitive impairment and dementia. Most systematic reviews included pooled general adult data without age stratification. Age-specific synthesis was largely absent for several chronic conditions and heterogeneity in disease definitions and sensitivity to confounding was common. CONCLUSION:Despite evidence suggesting associations between periodontitis and chronic conditions, age-specific evidence particularly for older adults remains limited.

Periodontitis is a chronic inflammatory disease that has been consistently linked to a range of chronic conditions, including diabetes, cardiovascular disease, and neurodegenerative disorders. Multimorbidity, defined as the co-occurrence of two or more chronic conditions in an individual, shares complex and multifactorial pathways with periodontitis, with both increasing in prevalence with age. However, the nature of their relationship, whether driven by shared risk factors or causal interactions, remains unclear. Several independent conceptual models have been developed to identify the determinants of periodontitis and multimorbidity. However, no unified frameworks currently exist to understand the interconnections between oral health, particularly periodontitis and chronic conditions. Given that oral health is an integral component of general health, developing an integrated conceptual model is essential to illustrate plausible pathways, guide future research, and support integrated prevention strategies. Therefore, this paper proposes an integrated conceptual framework to illustrate the potential association between periodontitis and multimorbidity, grounded in shared biological mechanisms and informed by the Common Risk Factor Approach and social determinants of health. The model integrates structural, behavioural, and biological factors within a single framework centred on biological pathways. This framework provides a foundation for future research and may support the development of integrated prevention and management strategies.

Good oral health is crucial for overall well-being; yet many people experience pain, discomfort, or social difficulties due to oral problems. Understanding how Australians’ oral health and quality of life have changed over time helps identify whether national dental policies and access to care have improved. The study aimed to assess temporal changes in oral health-related quality of life (OHRQoL) and identify associated risk indicators using the short Oral Health Impact Profile (OHIP-14) instrument among Australian adults. Data were sourced from the two most recent nationally representative surveys in Australia: National Survey of Adult Oral Health, NSAOH-1 (2004–06) and NSAOH-2 (2017–18). Both are population-based cross-sectional studies conducted in Australia, targeting adults aged 15 years and older. The outcome of interest was oral health–related quality of life (OHRQoL), measured using the validated short-form Oral Health Impact Profile (OHIP-14). Survey-weighted negative binomial regression models were employed to estimate both unadjusted and adjusted mean ratios (MRs) and their 95

Introduction:There is a paucity of nationwide population-based studies exploring the associations between chronic conditions and oral health. This study was conducted to describe the sociodemographic characteristics of a sample of Australian dentate adults with chronic conditions and to ascertain the associations of chronic conditions with tooth loss, dental caries and periodontal disease. Methods:Data were drawn from the National Study of Adult Oral Health (NSAOH) 2017-18, which included a random sample of Australians aged 15+ years. NSAOH used online/telephone interviews to elicit self-reported information, including sociodemographic characteristics, and oral examinations to collect clinical data. Information on chronic conditions was collected in the pre-examination questionnaire. Clinical information was ascertained in 5022 dentate adults. A 95% confidence interval (95% CI) was considered for proportions and means calculations. Results:While age was strongly associated with chronic conditions, their distribution showed a social gradient linked to education and income. Individuals with chronic obstructive pulmonary disease (COPD) (mean number of missing teeth = 11.5 [95% CI = 8.3, 14.7]) and kidney disease (mean number of missing teeth = 11.3 [95% CI = 8.5, 14.1]) had higher tooth loss whereas dental caries experience was higher in people with heart disease (mean number of decayed tooth surfaces [DS] = 2.5 [95% CI = 1.2, 3.7]) and depression (mean number of DS = 2.3 [95% CI = 1.4, 3.3]). Gingivitis was more prevalent in individuals with diabetes (40.1% [95% CI = 31.5, 49.4]) and high blood pressure (33.9% [95% CI = 29.3, 38.9]) while adults with heart disease (59.1% [95% CI = 39.3, 76.3]) and cancer (56.7% [95% CI = 43.2, 69.3]) had higher levels of periodontitis. Individuals with multimorbidity (presence of two or more concurrent chronic conditions) experienced greater tooth loss, dental caries and periodontitis. Conclusions:Australian dentate adults-particularly those with multimorbidity-exhibit significantly worse oral health statuses than healthy counterparts. These findings highlight the critical need to integrate oral care into general health services and implement targeted dental programmes for populations with chronic illnesses.

OBJECTIVES:Complete tooth loss is more common among older adults; however, its prevalence has declined significantly over time. It is currently unknown whether age and period effects act independently or whether they interact to produce differential effects by birth cohorts. This study aimed to examine temporal changes in the prevalence of complete tooth loss in Australia, examine the effects of age, period and cohort and assess life course changes within birth cohorts. METHODS:The study used data from three repeated cross-sectional waves of Australia's National Dental Telephone Interview Survey (2005, 2013 and 2021), each comprising independent samples. The prevalence of edentulism among adults aged 41 years and older was described. The independent effects of age and period and examined cohort effects were estimated using an Age-Period-Cohort Interaction (APC-I) model. RESULTS:The prevalence of complete tooth loss among adults aged 41 years and older declined from 12% in 2005 to 6% in 2021. The analysis shows that while edentulism increased with age, it decreased significantly over time across most age groups. Despite the low prevalence of edentulism, younger generations showed higher-than-expected levels of complete tooth loss. Significant cohort effects were observed, with older cohorts showing high tooth loss and younger cohorts exhibiting concerning trends. CONCLUSION:Despite overall progress in reducing edentulism, the increase in complete tooth loss among younger generations poses a threat to long-term oral health outcomes in Australia. Ongoing surveillance and targeted public health interventions are critical in preventing a resurgence in tooth loss, particularly among younger populations. Comprehensive oral health programs and equitable access to care are essential to maintaining Australia's progress in oral health and in addressing emerging challenges.

Introduction and aim: In contemporary society, social inequality in tooth loss is a significant and often overlooked issue. This study aimed to describe and examine social differentials in tooth loss among Australian adults over time. Methods: This analysis used data from the National Survey of Adult Oral Health (NSAOH), which was conducted in Australia in 2 waves: NSAOH-1 (2004-2006) and NSAOH-2 (2017-2018). The study employed a population-based cross-sectional design, with adults aged 15 years and older randomly selected using a 3-stage, stratified sampling method across metropolitan and regional areas in each state and territory. The primary outcomes were self-reported edentulism and non-functional dentition (<21 teeth). Explanatory variables included socioeconomic status, assessed using equivalized household income and grouped into approximate quartiles from lowest to highest, along with sociodemographic factors, CALD (Culturally and Linguistically Diverse) status, and oral health-related behaviour. Unadjusted and adjusted absolute prevalence differences (PDs) were calculated to assess income-related inequality. Adjustments were made for age and sex using the average covariate distribution across all income groups. Results: Data were available for 14,123 participants in NSAOH-1 and 15,731 participants in NSAOH-2. The prevalence of edentulism declined from 6.4% to 4.0%, and non-functional dentition decreased from 17.1% to 13.8% over time. These reductions were observed across all household income quartiles, with lower prevalence rates for both conditions in NSAOH-2 compared to NSAOH-1. The adjusted model showed that the prevalence decreases were most marked for the lowest household income group, from 15.3 to 6.5 (PD = 8.8, 95% CI: 8.3-9.4) for edentulism and from 35.0 to 21.3 (PD = 13.7, 95% CI: 13.4-14.0) for non-functional dentition. Conclusion: Our study indicated social inequalities in both edentulism and non-functional dentition among Australian adults over time. Age, sex, place of residence, irregular dental visits, and lack of dental insurance were important factors associated with tooth loss.

Social inequality in health is a persistent and growing concern worldwide. The study aimed to describe and analyse social disparities in general and oral health among Australian adults over time. This study utilised two population-based cross-sectional survey data: the National Survey of Adult Oral Health (NSAOH) conducted in 2004-06 (NSAOH-1, n = 14,123) and 2017-18 (NSAOH-2, n = 15,731) in Australia. Representative samples of adults aged 15 years and over were recruited from metropolitan and regional areas in each state and territory using a three-stage, stratified sampling design. Outcome variables were self-rated general and oral health conditions. Explanatory variables included socioeconomic status- assessed using equivalised household income and divided into roughly equal quartile groups from lowest to highest- along with sociodemographic characteristics, culturally and linguistically diverse status, and oral health-related behaviours. Both unadjusted and adjusted absolute prevalence differences (PDs) of fair/poor general and oral health with 95

OBJECTIVES:This study was conducted to describe the dental visiting patterns and ascertain their associations with clinically assessed dental caries and periodontal disease levels of dentate Australian adults. MATERIALS AND METHODS:A three-stage stratified probability sampling design was used to randomly select a cross-section of Australians aged 15+ years. Self-reported oral health and related information was obtained using questionnaire-based interviews. Dental visiting patterns studied were usual frequency of dental visits, usual reason for dental visit, and use of a regular dentist. Oral examinations were conducted following a standardized protocol in public dental clinics. A total of 5022 dentate adults aged 15+ years who were interviewed and orally examined were included in the current analysis. RESULTS:Higher proportions of adults with lower education levels and no dental insurance usually visited for a dental problem, made dental visits less frequently, and did not use a regular dentist. Individuals who were usually visiting for a dental problem, making dental visits less frequently, and not using a regular dentist had higher levels of dental caries and periodontal diseases. CONCLUSIONS:Dental visiting patterns of Australian adults were associated with their socioeconomic backgrounds. Usually visiting for a dental problem, making dental visits less frequently, and not using a regular dentist were more likely to be associated with higher levels of dental caries and periodontal diseases. These findings may help clinicians to recognize patients at increased risk for dental caries and periodontal diseases while apprising policy makers to plan and implement programs for dental service provision.

OBJECTIVE:To investigate whether a stronger Sense of Coherence (SOC) modifies the association between low household income and poor self-rated dental and general health measures (SRDH and SRGH, respectively). METHODS:Cross-sectional analyses were performed using data from the Dental Care and Oral Health Study (DCOHS, 2015-2016) in South Australia (n = 3664). In multivariate Poisson regression models, the main effects, interactions and effect modifications of SOC in the association between income and SRDH and SRGH were estimated using prevalence ratios (PRs) for poor self-rated health. RESULTS:In the low-income group, among those with stronger SOC, the prevalence of poor SRDH (16.0%) and SRGH (8.1%) was lower than that of those with weaker SOC (25.0% and 18.9%). Lower coherence (weak SOC) was associated with poor SRGH (PR = 4.8, 95% CI [1.8-13.1]). The interaction between lower coherence and low- and middle-income strata was not associated with the prevalence of poor SRDH and SRGH. CONCLUSIONS:Although interactions between SOC and income were not statistically significant, findings suggest a potential modifying role of strong SOC on the association between low income and poor health. These results should be interpreted with caution, as they are exploratory.

Objectives: To examine the associations between oral health behaviours, quality of life, and caries experience, and to assess the extent to which these behaviours account for oral health disparities across socioeconomic groups. Participants: 879 adults aged 45–54 years from metropolitan Adelaide, South Australia. Research design: Data on socioeconomic status (SES, via household income), oral health behaviours (toothbrushing, mouth rinsing, interdental cleaning, dental visiting, and self-care) and quality of life were collected via questionnaire. Clinical examinations were completed for 709 participants to assess caries experience. Outcome measures: Quality of life, assessed via the 14-item Oral Health Impact Profile (OHIP-14), and caries experience via DMFT scores. Results: An inverse SES gradient was recognised for quality of life and caries experience. Lower-income participants had reduced dental visiting scores [17.5 (95% CI: 17.1–18.0)] than higher-income groups [20.0 (95% CI: 19.6–20.4)], and higher dental self-care scores [17.7 (95% CI: 17.3–18.0)] than mid-income participants [17.6 (95% CI: 17.2–18.0)]. Higher-income individuals were likelier to have visited a dentist in the last 12 months (39.5%) and brush daily (36.9%) than lower-income individuals (29.7% and 30.0%). Full behavioural adjustment attenuated SES disparities in quality of life (unadjusted β = −2.7, 95% CI: −3.4 to −2.1; adjusted β = −2.0, 95% CI: −2.7 to −1.3), but not caries experience (unadjusted β = −0.8, 95% CI: −1.3 to −0.3; adjusted β = −0.7, 95% CI: −1.2 to −0.1). Conclusions: Oral health behaviours were associated with reduced socioeconomic inequalities in quality of life. Insignificant associations were observed between oral health behaviours and caries experience, even after adjustment for SES.

Introduction: Social inequities in dental caries are reflected by both inequities in the social structures that contribute to disease severity and inequities in the provision of dental care. This study aimed to describe social differentials in the dental caries experience among Australian adults across a 13-y period and to examine if the highest magnitude of oral health inequities persisted across dental caries prevalence (decayed teeth [DT]) or its management (missing teeth [MT], filled teeth [FT]). Methods: Data were from 2 population-based cross-sectional surveys of Australian adult oral health conducted in 2004-2006 (National Survey of Adult Oral Health-1 [NSAOH-1], n = 5,505) and 2017-2018 (NSAOH-2, n = 5,022). In each survey, representative samples of adults were obtained through a 3-stage, stratified sample design within metropolitan and regional areas in each state/territory. Clinical outcomes included the prevalence and mean of DT, MT, FT, and DMFT. Equivalized household income was grouped into approximately quartiles from low to high. Results: Across all income quartiles, the mean DT and % DT >0 was higher in NSAOH-2 than in NSAOH-1. The increase in prevalence was highest in the third highest income group (prevalence difference [PD] = 8.4, from 24.1 to 32.5). Similarly, % MT >0 was lower in NSAOH-2 than in NSAOH-1 across all income groups, with the decrease most marked for the lowest income group (PD = -6.5, from 74.1 to 67.8). Across all income quartiles, % FT >0 was lower in NSAOH-2 than in NSAOH-1. The decrease was the most marked for the lowest income group (PD = -8.9, from 81.1 to 72.2). Conclusion: The findings confirm that although oral health inequities decreased for the most extreme management outcome of dental caries (MT), inequities increased for experience of that disease (DT) and the more conservative management of dental caries (FT). For all D, M, and F components (DMFT), inequities between the lowest and highest household income groups increased from 2004-2006 to 2017-2018. Knowledge Transfer Statement: This study found that social inequities in oral health (experience of untreated dental caries and missing teeth) increased between the most socially advantaged and disadvantaged groups between 2004-2006 and 2017-2018. This suggests that models of dental service provision in Australia are increasingly benefitting those who can afford and access the care and who arguably need the services less than their less socially advantaged counterparts do.

Abstract Background ‘Culturally And Linguistically Diverse (CALD)’ populations have diverse languages, ethnic backgrounds, societal structures and religions. CALD populations have not experienced the same oral health benefits as non-CALD groups in Australia. However, the socio-demographic profile of Australian CALD populations is changing. This study examined how household income modifies the oral health of CALD and non-CALD adults in Australia. Methods Data were from two National Surveys of Adult Oral Health (NSAOH) conducted in 2004-06 (NSAOH 2004-06) and 2017-18 (NSAOH 2017-18). The outcome was self-reported number of missing teeth. CALD status was identified based on English not the primary language spoken at home and country of birth not being Australia. Social disadvantage was defined by total annual household income. Effect-measure modification was used to verify differences on effect sizes per strata of CALD status and household income. The presence of modification was indicated by Relative Excess Risk due to Interactions (RERIs). Results A total of 14,123 participants took part in NSAOH 2004-06. The proportion identifying as CALD was 11.7% and 56.7% were in the low-income group, and the mean number of missing teeth was 6.9. A total of 15,731 participants took part in NSAOH 2017-18. The proportion identifying as CALD was 18.5% and 38.0% were in the low-income group, and the mean number of missing teeth was 6.2. In multivariable modelling, the mean ratio (MR) for CALD participants with low household income in 2004-06 was 2% lower than the MR among non-CALD participants with high household income, with the RERI being − 0.23. Non-CALD participants from lower income households had a higher risk of having a higher number of missing teeth than low income CALD individuals (MR = 1.66, 95%CI 1.57–1.74 vs. MR = 1.43 95%CI 1.34–1.52, respectively). In 2017-18, the MR for CALD participants with low household income was 3% lower than the MR among non-CALD participants with high household income, with the RERI being − 0.11. Low income CALD participants had a lower risk of missing teeth compared to their non-CALD counterparts (MR = 1.43, 95% CI 1.34–1.52 vs. MR = 1.57, 95% CI 1.50–1.64). Conclusions The negative RERI values indicate that the effect-measure modification operates in a negative direction, that is, there is a protective element to being CALD among low income groups with respect to mean number of missing teeth.

Although the prevalence of poor oral health among older populations in Australia and the United States is higher, the contribution of ethnicity status is unknown. We aimed to estimate the contribution of social inequalities in oral health among older populations in Australia and the United States. Cross-sectional study design using data from Australia’s National Survey of Adult Oral Health (NSAOH 2004–06 and 2017–18) and the United States’ National Health and Nutrition Examination Survey (NHANES 2003–04 and 2011–16). Participants included in the analysis were aged 65 + years. Oaxaca-Blinder type decomposition analysis was used to assess the contribution of demographic (age, sex), socioeconomic position (educational attainment, household income) and dental behaviors (last dental visit) to changes in prevalence of edentulism and non-functional dentition, and mean number of missing teeth by ethnicity status over time in Australia and the United States. The number of participants aged 65 + years who provided clinical and sociodemographic/dental behaviour data was 1043 and 1269 in NSAOH 2004–06 and 2017–18, and 1372 and 1328 in NHANES 2003–04 and 2011–16 respectively. The prevalence of edentulism was from 13 percent (NHANES 2011–16) to 28 percent (NSAOH 2004–06), while the prevalence of non-functional dentition was from 41 percent (NSAOH 2017–18 and NHANES 2011–16) to 61 percent (NHANES 2003–04). The mean number of missing teeth was from 11 (NSAOH 2017–18) to 18 (NHANES 2003–04). The prevalence of edentulism and non-functional dentition, and the mean number of missing teeth were higher among older Australians identifying as White and the opposite results were observed among older Americans identifying as Non-White. For older adults in Australia, risk factors with the greatest impact on oral health outcomes by ethnicity status were educational attainment and household income. For older adults in the United States, the most dominant risk factor for non-optimal oral health outcomes by ethnicity status was last dental visit. There are important policy translation implications from our findings, as they indicate that social and structural systems in Australia and the United States operate differently in the context of oral health over time among culturally diverse older citizens. This information will help inform initiatives that both target effective oral health promotion for older, culturally-diverse populations and provide evidence for the distribution of resources in the public dental health setting for this age group and cultural demographic.

Recommending dental visits every six months is commonplace among dental practitioners worldwide. A scoping review was conducted by electronically searching PubMed, Scopus and Embase to identify and map the nature of evidence for the effect of different frequencies of dental visits on dental caries and periodontal disease. Studies were written in English on the frequency of dental visits and published between January 2008 and April 2023. Three systematic reviews that evaluated the risk of bias, strength of studies and certainty of evidence were included from the 4537 articles yielded through the search strategy. The available evidence was weak and of low quality for the currently recommended frequencies of dental visits, whether these are fixed or universal. For adults, there was little to no effect of making biannual, biennial or risk-based dental visits on dental caries and periodontal disease, which was supported by moderate- to high-certainty evidence. Accordingly, it is suggested that dental professionals and dental insurance providers make individually tailored, customised and risk-based recommendations for dental visits, rather than encouraging fixed or universal frequencies of dental visits. For children and adolescents, further research on this issue warrants well-designed randomised controlled trials (RCTs) and cohort studies of sufficient duration with an adequate number of participants.

Objectives To investigate whether a strong sense of coherence (SOC) modifies the association between low-income and oral and general health-related quality of life (OHRQoL and HRQoL, respectively) among a South Australian population sample; and to explore the main and interaction effects of income and SOC on OHRQoL and HRQoL. Methods Baseline data from the Dental Care and Oral Health Study (DCOHS, a South Australian representative study, 2015–2016) were used for cross-sectional analysis (n = 3,786). Four multivariable factorial ANOVA models were applied to assess the effect measure modification, main effects, and interaction of income and SOC on OHRQoL (measured using the OHIP-14) and HRQoL (measured using the EQ-5D-3L). Results Income and SOC had small main effects on OHRQoL. Income had a small effect and SOC had an intermediate effect on HRQoL, meaning that individuals with strong SOC had better OHRQoL and HRQoL in all income categories. Also, high-income participants had better OHRQoL and HRQoL. The interaction between income and SOC was statistically significant on HRQoL. Among participants from low-income group, those with strong SOC had better OHRQoL (mean = 8.8, 95% CI[7.9, 9.7]) and HRQoL (mean = 1.1, 95% CI[1.0, 1.3]) than others with weak SOC (OHIP-14 mean = 12.7, 95% CI[11.7, 13.6]) and (EQ-5D-3L mean = 2.0, 95% CI[1.9, 2.2]). Conclusion The findings showed the main effects and interaction between SOC and income on OHRQoL and HRQoL. Income had different effects on OHRQoL and HRQoL depending on whether SOC was strong or weak. Findings suggested that strong SOC modified the association between low-income and OHRQoL and HRQoL.

Background: Among Australia’s older population, the burden of oral disease is disproportionality borne by culturally and linguistically diverse (CALD) communities. This study aims to examine changes in untreated decay surfaces (DS) between 2004–2006 and 2017–2018 among older CALD and non-CALD Australians. Methods: Data were sourced Australian national oral health surveys conducted in 2004–2006 and 2017–2018. An Oaxaca–Blinder decomposition analysis was used to assess the contribution of socio-demographics and dental behaviours. Results: A total of 246 CALD and 2853 non-CALD dentate participants aged 60+ years took part in 2004–2006, and 363 and 4278 in 2017–2018, respectively. There were increases in mean DS for both CALD (0.74 to 1.42) and non-CALD (0.72 to 1.50) groups between 2004–2006 and 2017–2018. The decomposition model showed that, for CALD participants in 2004–2006 with untreated DS, 40% of the contribution was from not having dental insurance; nearly three-quarters of the contribution was from last dental visit being over one year ago (72.9%) in 2017–2018. Among non-CALD participants in 2017–2018 with untreated DS, 42.5% of the contribution was from the last dental visit being over one year ago. Conclusions: Our findings suggest that social determinants, including increased access to dental insurance, could mitigate the oral health inequities observed.

BackgroundGiven the significant investment of governments and families into the provision of child dental care services in Australia, continued population oral health surveillance through national oral health surveys is imperative. ObjectiveThe aims of this study are to conduct a second National Child Oral Health Survey (NCOHS-2) to (1) describe the prevalence, extent, and impact of oral diseases in contemporary Australian children; (2) evaluate changes in the prevalence and extent of oral diseases in the Australian child population and socioeconomic subgroups since the first National Child Oral Health Study (NCOHS-1) in 2012-2013; and (3) use economic modeling to evaluate the burden of child oral disease from the NCOHS-1 and NCOHS-2 and to estimate the cost-effectiveness of targeted programs for high-risk child groups. MethodsThe NCOHS-2 will closely mimic the NCOHS-1 in being a cross-sectional survey of a representative sample of Australian children aged 5-14 years. The survey will comprise oral epidemiological examinations and questionnaires to elucidate associations between dental disease in a range of outcomes, including social and emotional well-being. The information will be analyzed within the context of dental service organization and delivery at national and jurisdictional levels. Information from the NCOHS-1 and NCOHS-2 will be used to simulate oral disease and its economic burden using both health system and household costs of childhood oral health disease. ResultsParticipant recruitment for the NCOHS-2 will commence in February 2024. The first results are expected to be submitted for publication 6 months after NCOHS-2 data collection has been completed. Thematic workshops with key partners and stakeholders will also occur at this time. ConclusionsRegular surveillance of child oral health at an Australian level facilitates timely policy and planning of each state and territory’s dental public health sector. This is imperative to enable the most equitable distribution of scarce public monies, especially for socially disadvantaged children who bear the greatest dental disease burden. The last NCOHS was conducted in 2012-2014, meaning that these data need to be updated to better inform effective dental health policy and planning. The NCOHS-2 will enable more up-to-date estimates of dental disease prevalence and severity among Australian children, with cost-effective analysis being useful to determine the economic burden of poor child dental health on social and emotional well-being and other health indicators. International Registered Report Identifier (IRRID)PRR1-10.2196/52233

Abstract Background Psychosocial factors and dentist-patient relationships (DPR) have been suggested to be associated with oral health outcomes. This study aimed to test a conceptual model which hypothesised relationships among psychosocial factors, DPR variables, and oral health-related quality of life (OHRQoL) in the ‘distal-to-proximal’ framework. Methods A total of 12,245 adults aged 18 years or over living in South Australia were randomly sampled for the study. Data were collected from self-complete questionnaires in 2015–2016. The outcome variable of Oral Health Impact Profile was used to measure OHRQoL. Psychosocial domain consisted of psychological well-being, social support, and health self-efficacy. DPR domain included trust in dentists, satisfaction with dental care, and dental fear. The hypothesised model was tested using the two-step approach in structural equation modelling. Results Data were analysed from 3767 respondents after the screening/preparing process (adjusted valid response rate 37.4%). In the first step of the analysis, confirmatory factor analyses produced acceptable measurement models for each of the six latent variables (GFI = 0.95, CFI = 0.98, RMSEA = 0.04). The final structural model indicated that better well-being, higher self-efficacy, and more satisfaction were associated with lower oral health impact (β = − 0.12, − 0.07, − 0.14, respectively) whereas fear was positively associated (β = 0.19). Among intermediates, support was positively associated with satisfaction within a small effect size (β = 0.06) as compared to self-efficacy with trust (β = 0.22). The invariance of the final model was also confirmed on participants’ SES and dental service characteristics except the variable of ‘last dental visit’. Conclusions Psychosocial factors and DPR variables were associated with oral health impact in both direct and indirect paths. The framework of ‘distal-to-proximal’ actions is empirically supported from psychosocial factors via DPR variables to OHRQoL.

This study investigated population impact of sugar-sweetened beverage (SSB) intake on overweight and obesity and dental caries in Australian children. The National Child Oral Health Study collected parent-completed data (socioeconomic status, health behaviors, SSB consumption) and dental caries in the primary dentition of children aged 5 to 8 years. The outcomes (prevalence of caries and overweight and obesity) were assessed in multivariable regression models to estimate prevalence ratios (PRs) with SSB intake as the main exposure. Population attributable fraction (PAF) was calculated using population distribution of the exposure and adjusted PRs. Among 7,021 children, some 15.2% children consumed 2+ SSBs per day. Prevalence of caries and overweight and obesity was 35.8% and 28.7%, respectively, and strongly associated with SSB consumption. Adjusted PRs for 2+ SSB intake/d for having dental caries and overweight and obesity was 1.45 (95% confidence interval [CI], 1.27–1.66) and 1.49 (95% CI, 1.28–1.74), respectively. PAF of SSB consumption was 11% (95% CI, 18–35) for dental caries and 9% (95% CI, 11–34) for overweight and obesity. The reported findings consolidated evidence of detrimental effects of sugars intake on population health. Public health policy and advocacy initiatives such as a sugar tax and banning junk food advertisements should be prioritized to potentially reduce a significant proportion of cases with either condition. Knowledge Transfer Statement: The reported findings greatly consolidated evidence of detrimental effects of sugars intake on child oral health and overweight and obesity, some of the most prevalent chronic conditions in children. Evidence on population impact of sugars intake is directly informative to policy makers and the public about the potential impact of population-based programs targeting sugars intake to prevent dental caries and overweight and obesity.