Investing in professional advocacy: a case study of a successful fluoridation campaign in rural New South Wales, Australia.

UNLABELLED: In New South Wales (NSW), Australia, the responsibility to implement water fluoridation rests with local government Councils, partly accounting for the hindrance in its statewide implementation. Since 2003, the NSW Health Department has been actively promoting water fluoridation to the remaining unfluoridated rural communities. OBJECTIVES: To describe the community education and consultation strategies which led to the implementation of fluoridation in two rural NSW towns. METHODS: In February 2005, the Mid-Western Regional Council and the NSW Health Department undertook a comprehensive community education process followed by a consultation process. The education process included the organization of public forums; distribution of fluoridation information packs; building rapport with the local media; and the use of local disease and treatment data to demonstrate oral health disparities with neighbouring fluoridated towns. The consultation process to determine support for fluoridation included seeking written submissions from the community and conducting interviews on a random sample of households by an independent research organization. RESULTS: A total of 502 (N = 1,012) interviews to determine support for fluoridation were completed, achieving a response rate of 49.6%. 54% of respondents wanted their water supplies fluoridated, 25% did not and the remaining 21% were unsure. In June 2005, the Mid-Western Regional Council resolved to implement water fluoridation and fluoride was added to the towns' water supplies in November 2007. CONCLUSIONS: This case study demonstrates that it is possible to garner community support for water fluoridation with the use of a multifaceted approach in educating and consulting communities and stakeholders.

Parental support for water fluoridation in Lithgow, New South Wales.

BACKGROUND: The objective of this paper was to report on the level of support for water fluoridation among parents of primary school children in Lithgow and on the socio-demographic and oral health factors that may have influenced this support. METHODS: As part of a survey in Lithgow of the oral health status of school children, their parents were asked to complete an oral health-related questionnaire. Questions on support for fluoridation and socio-demographics were included. Descriptive statistics and logistic regression analysis were used to examine associations between variables. RESULTS: Seventy per cent of the responding parents supported water fluoridation. However, this support was significantly higher among those from a higher socio-economic background. Nearly half the parents thought that health authorities or the government should take on the responsibility for matters related to water fluoridation. No statistically significant differences in caries experience were observed amongst children whether or not their parents supported fluoridation, except for 5-6 year olds (p < 0.01). CONCLUSIONS: Lithgow parents strongly supported the introduction of water fluoridation but suggested that governments and health authorities should adopt a more proactive role in relation to fluoridation implementation.

Profile of orthodontic services provided in private practice by general practitioners and specialist orthodontists for an insured population.

In Australia, the proportion, volume and type of orthodontic care provided by general practitioners and orthodontists are largely unknown. The overall objective of this study was to create a profile of orthodontic services provided by general practitioners and orthodontists for a cohort of insured patients using private practices in New South Wales, Australia, from 1st January 1992 to 31st December 1995. Data were derived from claims records submitted by members of a health insurance fund for rebates for fees paid to private practitioners for orthodontic services they received during the study period. Distribution of the volume and type of service provided by general practitioners and orthodontists was compared using the Chi-squared test. Statistical significance was taken at the 5 per cent level. Orthodontic services were provided predominantly by orthodontists (80%). Fixed orthodontic treatment was provided almost exclusively (91%) by orthodontists. The majority of removable appliance services was provided by general practitioners. Orthodontists provided more orthodontic services in the capital city and other metropolitan areas, whereas general practitioners provided more orthodontic services in rural areas. Orthodontists provided more services to members in the highest socio-economic group, whereas general practitioners provided more services to members in the lowest socio-economic group.

Cost of dental services provided in private general practice for an insured population in New South Wales, Australia.

OBJECTIVE: To determine cost of dental services provided to a cohort of insured population 18 years and over, who used private general dental practice in New South Wales, Australia. BASIC RESEARCH DESIGN: This cohort study used the person-years method and Weibull regression for analysis. Setting Data were derived from claims records submitted for rebates by members of a health insurance fund for services they received in private general dental practice during 1 January 1992-31 December 1995. PARTICIPANTS: 75,501 members from New South Wales. MAIN OUTCOME MEASURES: To determine, by age groups, the cost per item of dental service, cost of services received at a visit and cost of services received per year. RESULTS: The median cost per item of dental service received for all ages was A$36.7; with cost increasing with age until 55-64 year age group where an apparent plateau occurred. The median cost of services received at a visit for all ages was Australian dollars 93.5. Cost of services received at a visit increased with age, reaching a plateau in the middle aged groups. The median cost of providing services for all age groups per year was Australian dollar 183.6. The cost of services per year when compared with the youngest age group (18-24 years) increased by about 20% for each successive age group up to the 45-54 year age group. From 55 years onwards the cost levelled off at approximately 70% more than the youngest age group. CONCLUSION: The cost of providing dental services increased with age to reach a plateau in the middle age groups.

Dental service provision in private general practice for an insured population in New South Wales, Australia.

OBJECTIVE: To determine patterns of dental services provided to a cohort of the insured population 18 years and over, in private general practice in New South Wales, Australia. BASIC RESEARCH DESIGN: A cohort study using the person-years method and Poisson regression for analysis. SETTING: Data were derived from claims records submitted by members of a health insurance fund (Government Employees Health Fund-GEHF) for rebates during the study period 1 January 1992-31 December 1995. PARTICIPANTS: There were 133,467 members aged 18 years and over from New South Wales. MAIN OUTCOME MEASURES: To determine, by age group, for those members who used private general practice and made a claim (referred to as 'patients') the annual number of visits, total number of services received per year and number of services received at a visit. RESULTS: The mean number of visits per patient was 2.4 per year with patients under 45 years making fewer visits than the 45-54 age group reference category. Mean number of services utilised per patient-year was 5.9, with services provided increasing from 3.5 for the 18-24-year-old group, reaching a plateau of approximately 6.2 for those aged 45 years or more. The number of services received per visit was 2.4 and there were no differences by age. Service mix was dominated by restorative (35%), diagnostic (27%), and preventive services (18%); with age specific variations observed. CONCLUSIONS: Age was found to be an important determinant in the use of dental services, independent of membership duration and gender.

Changes in the pattern of sugar (sucrose) consumption in Australia 1958-1988.

The study reports on data relating to the apparent consumption, food content, and contribution of different food groups to the sugar (sucrose) intake in Australia. The trends and patterns of sugar (sucrose) usage have been summarised. The apparent annual sugar consumption has remained very high (up to 50 kg per person) for the last three decades with an increase in sugar consumed in manufactured foods. There has been some decrease in sugar consumed in confectionery, bakeries and vegetable products and as refined sugar. The greatest increase in sugar intake has been through non-alcoholic beverages, ice-cream and frozen confectionery, and cereals. The prevalence of dental caries in Australia has dropped dramatically over the past three decades while the consumption of sugar remains very high.

Some social characteristics and background of first-year dental students, University of Sydney, 1976-85.

This paper presents some information, derived by questionnaire, on the social characteristics and background of 1148 first-year dental students at the University of Sydney for the years 1976-1985. Student entry age was 19.4 years; 27 per cent were female; 36 per cent of fathers and 24 per cent of mothers were professionals and 37 per cent of fathers and 11 per cent of mothers had attended university; parents of female students had higher educational levels than parents of male students; 55 per cent had medicine as the course of first preference. Eighty-five per cent of students entered dentistry from high school with 78 per cent from Sydney. Characteristics of students showed little change over the period 1976-1985. Some changes noted were an increase in the number of female students with fewer living in their parents' home; increase in number of students from government schools; decrease in foreign students but an increase in students (Australian citizens, or residents) born overseas, and of different ethnic backgrounds.