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ABSTRACT: To determine income inequalities in both perceived oral health and oral health-related behaviours and the role oral health-related behaviours in explaining income inequalities in perceived oral health among Sri Lankan adolescents.
The sample included 1,218 fifteen-year-olds selected from 48 schools in the Colombo district using a stratified cluster sampling technique. Data were collected by means of questionnaires to both adolescents and their parents. Perceived oral health status was the oral health outcome considered while oral health-related behaviours included brushing frequency, use of dental services in the preceding year and consumption of sugary food/drinks and fruit/vegetables.
Tooth brushing frequency, use of dental services in the preceding year and consumption of fruit/vegetables were associated with perceived oral health status. Also, the trends in perceived oral health and all oral health behaviours across ordered income groups were statistically significant. However, it was evident from the Poisson regression models that the effect of income on perceived oral health did not attenuate significantly following adjustment for oral health behaviours.
This study demonstrated that oral health behaviours were associated with perceived oral health and also the existence of income gradients in perceived oral health and oral health behaviours. However, oral health behaviours were not accountable for the observed income gradients in perceived oral health.
Community Dentistry And Oral Epidemiology 01/2011; 39(4):345-51. · 1.89 Impact Factor
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ABSTRACT: The aim of the study was to assess the value of different indicators of socioeconomic status for oral health research among Sri Lankan adolescents. Six indicators of socioeconomic status were assessed in terms of their relationship to 2 oral health outcomes. The sample consisted of 15-year-old students (n = 1218) selected from 48 schools in the Colombo district using a stratified cluster sampling technique. Data collection included oral examinations of students and questionnaires to both students and their parents. The correlations between the 6 indicators were low to moderate. The indicators of household material assets and parental educational status emerged as significant predictors of the 2 oral health outcomes. Therefore, it is concluded that indicators of material assets-namely, the family affluence scale and the asset index-could be used as optimal measures of socioeconomic status in oral health research among adolescents in Sri Lanka.
Asia-Pacific Journal of Public Health 10/2010; 22(4):407-14. · 1.06 Impact Factor
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ABSTRACT: While Australians are one of the healthiest populations in the world, inequalities in access to health care and health outcomes exist for Indigenous Australians and Australians living in rural or urban areas of the country. Hence, the purpose of this study was to develop an innovative methodological approach for predicting the incidence rates of jaw fractures and estimating the demand for oral health services within Australia.
Population data were obtained from the Australian Bureau of Statistics and was divided across Australia by statistical local area and related to a validated remoteness index. Every episode of discharge from all hospitals in Western Australia for the financial years 1999/2000 to 2004/2005 indicating a jaw fracture as the principle oral condition, as classified by the International Classification of Disease (ICD-10AM), was the inclusion criterion for the study. Hospitalization data were obtained from the Western Australian Hospital Morbidity Data System.
The model estimated almost 10 times higher jaw fracture rates for Indigenous populations than their non-Indigenous counterparts. Moreover, incidence of jaw fractures was higher among Indigenous people living in rural and remote areas compared with their urban and semi-urban counterparts. In contrast, in the non-Indigenous population, higher rates of jaw fractures were estimated for urban and semi-urban inhabitants compared with their rural and remote counterparts.
This geographic modelling technique could be improved by methodological refinements and further research. It will be useful in developing strategies for health management and reducing the burden of jaw fractures and the cost of treatment within Australia. This model will also have direct implications for strategic planning for prevention and management policies in Australia aimed at reducing the inequalities gap both in terms of geography as well as Aboriginality.
Dental Traumatology 06/2010; 26(3):217-22. · 1.20 Impact Factor
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ABSTRACT: This study aimed to assess the temporal and spatial changes in the demand for general anaesthesia, relative to disease incidence, in 0-19-year-olds.
Hospitalisation data were obtained from the Western Australian Morbidity Data System for the financial years 1999/2000 to 2004/2005, and principal diagnosis was obtained from every patient discharged from a public or private hospital. Hospitalisation data was correlated with socioeconomic status and the geographical location of primary residence.
In the public hospital sector, there were greater rates of people residing in Statistical Local Areas (SLAs) with decreasing accessibility to healthcare services utilising the option of treatment of dental caries under general anaesthetic (GA) compared to people living within highly accessible areas. In the private sector, children who resided in SLAs with the greatest access to healthcare facilities had a greater rate of being hospitalised for the treatment of dental caries under GA.
The results demonstrated distinct patterns of trends in demand for general anaesthetic care among different SES groups and geographical location of primary residence. There was an overall emerging trend of increasing demand placed on public sector both among dental care users among high and low SES. Moreover, the results demonstrated the potential application of geographic modelling as a service planning tool for estimating the future demand for GA care for dental caries in addition to the timely need for focused attention on preventive services for early identification, prevention and control of dental caries among children.
International Dental Journal 06/2010; 60(3):190-6. · 0.96 Impact Factor
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ABSTRACT: The aim of the present study was to assess the relationship between dental caries and dietary patterns in Sri Lankan adolescents.
The sample consisted of 1218, 15-year-olds who were selected from 48 schools in the Colombo district of Sri Lanka using a stratified cluster sampling technique. Data were collected by distributing questionnaires among both adolescents and their parents and by conducting an oral examination of all adolescents. A validated 13 foods/food groups food frequency questionnaire was used to obtain dietary information.
Factor analysis extracted three dietary patterns from the 13 foods/food groups, and these patterns accounted for 41.44% of variation in the dietary intake. They were labelled as sweet, healthy and affluent dietary patterns. From the multiple logistic regression analysis, the sweet dietary pattern, household income and oral hygiene status emerged as significant predictors of dental caries.
It was concluded that dietary pattern labelled as sweet emerged as a significant predictor of dental caries.
Oral health & preventive dentistry 01/2010; 8(2):165-72. · 0.55 Impact Factor
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ABSTRACT: Australians living in rural and remote areas have poorer access to dental care. This situation is attributed to workforce shortages, limited facilities and large distances to care centres. Against this backdrop, rural and remote Indigenous (Aboriginal) communities in Western Australia seem to be more disadvantaged because evidence suggests they have poorer oral health than non-Indigenous people. Hence, provision of dental care for Aboriginal populations in culturally appropriate settings in rural and remote Western Australia is an important public health issue. The aim of this research was to compare services between the Aboriginal Medical Services (AMS)-based clinics and a typical rural community clinic. A retrospective analysis of patient demographics and clinical treatment data was undertaken among patients who attended the dental clinics over a period of 6 years from 1999 to 2004. The majority of patients who received dental care at AMS dental clinics were Aboriginal (95.3%), compared with 8% at the non-AMS clinic. The rate of emergency at the non-AMS clinic was 33.5%, compared with 79.2% at the AMS clinics. The present study confirmed that more Indigenous patients were treated in AMS dental clinics and the mix of dental care provided was dominated by emergency care and oral surgery. This indicated a higher burden of oral disease and late utilisation of dental care services (more focus on tooth extraction) among rural and remote Indigenous people in Western Australia.
Australian Journal of Primary Health 01/2010; 16(4):291-5. · 0.50 Impact Factor
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ABSTRACT: To determine factors associated with perceived oral health status among adolescents in Sri Lanka.
A descriptive, cross-sectional study where the data were collected by means of an oral examination and questionnaires to both children and their parents.
Schools in the Colombo district, Sri Lanka.
1,218, 15-year-old adolescents who were selected from 48 schools using a stratified cluster sampling techniques.
Nearly 21% of the sample rated their oral health as poor. According to the hierarchical logistic regression models the percentage of variance in perceived oral health explained by the four groups of independent variables namely: socio-demographic variables, oral health behaviours, clinical oral health indicators and subjective measures of oral health status were 3, 1, 4 and 7% respectively. The final model indicated that poor perceived oral health was significantly associated with low household income, not using dental services, presence of gingivitis, being aware about the presence of oral disease, presence of toothache and other oral symptoms and perceived need for dental care. It accounted for 15% of the variation in perceived oral health.
Subjective measures of oral health contributed most to the single-item perceived oral health rating of adolescents. Socio-demographic variables and normative measures of untreated caries, missing teeth and gingivitis had a limited role in explaining perceived oral health in Sri Lankan adolescents.
International Dental Journal 01/2009; 58(6):349-55. · 0.96 Impact Factor
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ABSTRACT: The authors assessed the perceived need for dental care among 585 older individuals, of whom 235 received a clinical oral examination. Of the 235 participants, only 171 were dentate. The present analysis is limited to this group. Of these 171 dentate adults, 43 percent perceived a need for dental care. Of this sample section, 53 percent perceived a need for dentures. Age, perceived oral health status, presence of mobile teeth, three impact items of the Oral Health Impact Profile-14 (OHIP-14) scale--namely "had a painful aching in the mouth, had difficulty in eating and that the diet had been unsatisfactory due problems with teeth, mouth or dentures"--and the total OHIP-14 score showed significant associations with perceived need for dental care in bi-variate analysis. Poor perceived oral health status emerged as the strongest predictor of perceived need for dental care in logistic regression.
Special Care in Dentistry 25(4):199-205.