Water fluoridation, dental caries and parental ratings of child oral health.

OBJECTIVES: Previous studies have identified many demographic, socioeconomic, behavioural and clinical variables associated with subjective parental ratings of child oral health. This study investigated associations between children's lifetime exposure to fluoridated drinking water (LEFW) and dental caries prevalence and parental ratings. METHODS: Australia's National Child Oral Health Study 2012-2014 conducted oral epidemiological examinations for 24 664 children aged 5-14 and investigated risk factors for child oral health and disease through questionnaires. Parents also subjectively rated their child's oral health. This cross-sectional study estimated prevalence ratios for associations between LEFW and prevalence of dental caries in the primary and permanent dentitions and parental oral health ratings for 5-8 year old and 9-14 year old children. E-value sensitivity analyses helped assess whether observed effect sizes may have arisen through unmeasured confounding. RESULTS: Children aged 5-8 with 0%-10% or 11%-89% LEFW are respectively 1.5 (95% CI 1.2-1.8) and 1.5 (95% CI 1.1-2.0) times more likely than children with 90%-100% LEFW to receive a fair or poor parental oral health rating. Children aged 9-14 with 0%-10% or 11%-89% LEFW are 1.2 (95% CI 1.0-1.4) times more likely than children with 90%-100% LEFW to receive a fair or poor parental oral health rating. Children aged 5-8 with 0%-10% or 11%-89% LEFW are respectively 1.4 (1.3-1.6) and 1.3 (95% CI 1.1-1.4) times more likely than children with 90%-100% LEFW to experience caries in their primary teeth. Children aged 9-14 with 0%-10% or 11%-89% LEFW are respectively 1.4 (95% CI 1.3-1.5) and 1.1 (95% CI 1.0-1.2) times more likely than children with 90%-100% LEFW to experience caries in their permanent teeth. CONCLUSIONS: Longer lifetime exposure to fluoridated drinking water is causally associated with a lower childhood dental caries prevalence and more positive parental ratings of child oral health. The associations are stronger for younger children.

The Medicare Chronic Disease Dental Scheme: Historical, Scientific, Socio-political Origins.

While evidence and expert opinion are the foundations of effective policy, the politics, economics, and timing of a proposal can affect outcome. Australian government involvement in the planning, funding and delivery of dental services has been minimal and inconsistent. Many believe that the hybrid dispersal model of shared constitutional power has intermittently led to poor administration of national health policy. Throughout the decade-long prelude to the introduction of the Chronic Disease Dental Scheme, a landmark health policy in Australia, Parliamentarians moved responsibility for public dental services of disadvantaged Australians into an impasse between the Federal, State, and Territorial Governments. Developments throughout the era confirm the influence of administrative intrigue, centralized authority, competing priorities, funding pressures, political strategy, public opinion, scientific evidence and the timing of a proposal on the formulation and implementation of oral health policy. Synchronized inter-governmental collaboration was also absent. Moreover, the impasse and its resolution immediately before a national election demonstrate the bipolar roles of centralized political authority and political resolve in either obstructing or implementing policy. The historical, scientific, and socio-political contexts undermining the preamble to the Chronic Disease Dental Scheme lend weight to concerns about the hybrid dispersal model of constitutional power.

Diagnosis and management of a maxillary lateral incisor exhibiting dens invaginatus and dens evaginatus.

This case report, involving an indigenous Australian, presents the diagnosis and non-surgical endodontic management of a 22 with developmental abnormalities. They include a dens evaginatus and a dens invaginatus that extends to an apical burst in a second truncated root. Cone-beam computed tomography and endodontic microscopy were not available to the clinician. This case report focuses on ambiguities appearing in the literature relating to classification and terminology associated with the abovementioned developmental anomalies. It also demonstrates the need to methodically collect and cautiously interpret available information before initiating endodontic intervention. Axial inclination, distance perception, internal demarcation and spatial awareness, together with an understanding of dental anatomy, embryology and histology and associated physiology and pathology, allowed the clinician to accurately predict the point, the angle and the depth of coronal access. Sensibility of the dentino-pulpal complex was maintained. Critical thinking, experience, innovation, problem-solving and established principles can compensate for inaccessible technologies.

Twentieth century influences on Queensland dental practice: a tangential view.

Political scientists, historians and journalists intermittently suggest that, within the Australian context, public policy and its administration in Queensland are different. Significant evidence suggests that, from colonial times, distance and decentralization have influenced Queenslanders' demographic profiles and collective identity. Using historical analysis to qualify and quantify both the alleged difference and its social significance warrants caution. Nonetheless, some developments in public dental policy and the practice of dentistry across Queensland provide intriguing contrasts. This study, a literature review, uses historical method. The authors focus on pivotal proceedings that affected both the dental profession and dental practice in the twentieth century. These events embraced the genesis and evolution of dental education and influenced fluoride politics and policies controlling the delivery of public dental services. These developments reflected not only the contemporaneous social and political fabric but also the broader influences on Queensland history, namely: area, distance, decentralization, groundwater, isolation and topography. The events and observations in this report lend some support to hypotheses concerning a Queensland difference within the Australian context of public policy and its administration.

Fluoridation advocacy in Queensland: a long and winding road.

BACKGROUND: By 1977, all Australian states and mainland territories, with the exception of Queensland, had widely implemented adjusted water fluoridation. This disparity in public health policy persisted until 2008. METHODS: This study analyses the sociopolitical and socioeconomic backgrounds that underpinned the repeal of the Fluoridation of Public Water Supplies Act (1963) and its replacement with the Water Fluoridation Act (2008). The authors used a literature review and historic method. References are in the public domain. RESULTS: The devolution, without funding, of a discretionary local authority power to fluoridate contributed to the perennial low fluoridation status in Queensland. A window of opportunity for fluoridation advocates opened between 2003 and 2008. Now that 87% of Queenslanders have access to optimally fluoridated water, Queensland premier Anna Bligh has largely delivered on a promise made in 2007 to fluoridate water supplies across the state. CONCLUSIONS: The implementation of adjusted water fluoridation requires not only political stability and resolve, but also centralised authority. The last of these factors must embrace the decision, the funding and the indemnity. State control over water-related infrastructure and water treatment enhances prospects for fluoridation. The roles of opinion polls, internal advisers and departmental figures are also confirmed. Political repercussions were minimal.