Risk indicators for untreated dental decay among Indigenous Australian children

Abstract

Objective: To investigate risk indicators for untreated dental decay among Indigenous Australian children using a national representative sample.

Methods: Data were from the National Child Oral Health Study 2012-2014, which included a nationally representative sample of Indigenous Australian children aged 5-14 years. Outcomes were the prevalence (% ds/DS >0) and severity (mean ds/DS) of untreated dental decay at the tooth surface level. Caries of the primary dentition was estimated among 5- to 10-year-olds, while that of the permanent dentition was among 8- to 14-year-olds. Independent variables included residential location, household income, frequency and age commencement of toothbrushing, sugar-sweetened beverages (SSB) consumption, dental visiting and residential fluoridation status. Multivariable log-Poisson regression models with robust standard error estimation were used to identify risk indicators for untreated decay. The complex sampling design was taken into account in all analyses.

Results: There were 720 5- to 10-year-old and 736 8- to 14-year-old Indigenous children. Indigenous children experienced significant amount of untreated dental caries. Among 5- to 10-year-olds, % ds >0 was 43.1 (95% CI: 36.8-49.6) and mean ds was 3.4 (95% CI: 2.4-4.4). Among 8- to 14-year-olds, % DS >0 was 27.3 (22.3-32.9), while mean DS was 0.8 (0.6-1.0). In multivariable modelling, risk indicators for % ds >0 among 5- to 10-year-olds were low household income, commencing toothbrushing after 30 months of age, consuming 2+ cups of SSB per day and not residing in fluoridated areas. Risk indicators for mean ds among 5- to 10-year-olds included infrequent toothbrushing and consuming 2+ cups of SSB per day. Risk indicators for % DS >0 among 8- to 14-year-olds were low household income, while risk indicators for mean DS among 8- to 14-year-olds were residing in non-capital city, low household income, consuming 2+ cups of SSB per day and not residing in fluoridated areas.

Conclusion: Indigenous Australian children experienced significant amount of untreated dental caries. Risk indicators for untreated decay included demographic factors, socioeconomic factors, oral hygiene behaviours, dietary behaviours and environmental factors.

Keywords: indigenous children oral health; national child oral health study; risk indicator; untreated dental decay.