Community trial of silver fluoride treatment for deciduous dentition caries in remote Indigenous communities.

BACKGROUND: Silver fluoride 40% followed by 10% stannous fluoride (AgF) has been used in dental practice in some parts of Australia for many years. This study compared the effectiveness of application of AgF with atraumatic restorative technique (ART) in managing cavitated carious primary molars. METHODS: The study was a community effectiveness trial in two remote Aboriginal communities where AgF has been used for some time. Children between 4 and 8 years of age with caries on primary molars were randomized by birth date to receive AgF or ART. There were 210 children who were included in the study with 384 eligible teeth. Children were followed up for periods between 9 months and 4 years. Negative outcomes such as dental pain, extraction, use of antibiotics and more extensive restorative treatment were considered as the primary outcomes of the study. RESULTS: Those negative outcomes were infrequent in both treatment groups. The prevalence ratio of negative sequelae for children treated with AgF compared with those treated with ART was lower at 0.18. CONCLUSIONS: Silver fluoride was well accepted, easy to use and at least as effective a treatment as ART for dental caries in primary molars in young Aboriginal children in remote areas.

Prevalence, extent and severity of severe periodontal destruction in an urban Aboriginal and Torres Strait Islander population.

BACKGROUND: The aim of this study was to document the three main indicators of severe periodontal destruction and to evaluate factors associated with those indicators in an urban Indigenous population in Australia. METHODS: A cross-sectional survey of a convenience sample of Aboriginal adults from an Australian urban area was undertaken. Socio-demographic data and smoking status were collected by interview and health status by a medical record audit. Clinical attachment loss (CAL) was used to determine prevalence, extent and severity of severe periodontitis. Factors with significant association with periodontal indicators at bivariate level were further included in multivariable analysis controlling for age and gender. RESULTS: A total of 251 Aboriginal adults participated in the study. The proportion with severe periodontitis was 11.9% (95% CI: 7.6-16.3), extent: 5.0% (95% CI: 3.3-6.7) and severity: 5.3 mm (95% CI: 5.0-5.6). These estimates are significantly higher than that of other Australians. Current smokers had significantly higher prevalence rate (PR) of severe periodontitis: PR = 2.8 (95% CI: 1.3-6.0). People with diabetes and current smokers had significantly higher extent of sites with CAL 6+ mm: 1.9 (1.1-3.3) and 2.1 (1.2-3.6) respectively. Having diabetes was associated with significantly higher severity score (ß: 0.96 (SE: 0.47)). CONCLUSIONS: A high proportion of this urban Aboriginal population had severe periodontal disease related to smoking and diabetes.

Blood-borne virus-related discrimination in dental services.

While the risk of infection through occupational exposure to blood-borne viruses is a major concern of dental health care workers, the National HIV/AIDS Strategy and many health, AIDS and discrimination-related agencies have identified discrimination related to HIV/AIDS as a priority area for action. In 1995 the Commonwealth Department of Health and Family Services selected the School of Medical Education at the University of New South Wales to conduct a national project to reduce discrimination related to blood-borne viruses within dental services (Godwin, Meihubers & Rotem 1997). This paper provides an overview of the study and its major findings. The study focused on quality of care issues which may cause or manifest discrimination. Key stakeholders were invited to review policies, procedures, organisational arrangements and other systemic issues which influence the quality of oral health services to populations within selected geographical regions.