ORCID Profile
0000-0002-5440-4452
Current Organisation
Nanyang Technological University
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Publisher: Wiley
Date: 30-05-2011
Publisher: Springer Science and Business Media LLC
Date: 12-07-2017
Publisher: Wiley
Date: 11-07-2023
DOI: 10.1111/CDOE.12770
Abstract: The prospective cohort design is an important research design, but a common challenge is missing data. The purpose of this study is to compare three approaches to managing missing data, the pairwise ( n = 1386 children), the partial or modified pairwise ( n = 1019) and the listwise ( n = 546), to characterize the trajectories of children's free sugars intake (FSI) across early childhood. By applying the Group‐based Trajectory Model Technique to three waves of data collected from a prospective cohort study of South Australian children, this study examined the three approaches in managing missing data to validate and discuss children's FSI trajectories. Each approach identified three distinct trajectories of child's FSI from 1 to 5 years of age: (1) ‘low and fast increasing’, (2) ‘moderate and increasing’ and (3) ‘high and increasing’. The trajectory memberships were consistent across the three approaches, and were for the pairwise scenario (1) 15.1%, (2) 68.3% and (3) 16.6% the partial or modified pairwise (1) 15.9%, (2) 64.1% and (3) 20.0% and the listwise (1) 14.9%, (2) 64.9% and (3) 20.2% of children. Given the comparability of the findings across the analytical approaches and the s les' characteristics between baseline and across different data collection waves, it is recommended that the pairwise approach be used in future analyses to optimize the s le size and statistical power when examining the relationship between FSI in the first years of life and health outcome such as dental caries.
Publisher: MDPI AG
Date: 08-10-2018
DOI: 10.3390/DJ6040056
Abstract: Oral health behaviours of children are formulated from a very young age. Formation of those behaviours among very young children is dependent on their mothers/caregivers who may themselves require support from the health profession or laypersons. The study aimed to investigate if early life visits for check-up and dental advice and perceived support improved oral health behaviours as practiced by mothers of toddlers aged 24–30 months old. Data from a population-base birth cohort study in South Australia was used. The study recruited and followed mothers of newborn children from birth to age 24–30 months. Parental questionnaires collected information about socioeconomic factors, dental visiting patterns, and oral health behaviours as practiced by the mothers for their child. Self-reported putting a child to bed with a bottle and brushing a child’s teeth were the outcome variables. The two main exposures of this study were (1) early visiting for a dental advice, and (2) layperson support that a mother received in the first two years of having the child. Data were analysed progressively from bivariate to multivariable regression models. A total of 1183 mother/child dyads had complete data. The retained s le was representative of the population. Approximately 36% of mothers put their child to bed with a bottle and 26% of mothers did not brush their child’s teeth the night before. Around 29% of children had a visit for dental check-up and 80% of mothers reported having lay support. There were gradients in the outcome variables by socioeconomic factors and the main exposures. Multivariable regression models reported that having no dental visit for advice and having no lay support were associated with 1.30 and 1.21 imes higher rates of putting a child to bed with a bottle, respectively. Having no dental visit for advice was associated with a 1.37-times higher rate of not brushing a child’s teeth, controlling for other factors. This population-based birth cohort study confirmed importance of early life dental visit for check-up and support for mothers of young children in establishing oral health behaviours of young children.
Publisher: Elsevier BV
Date: 07-2023
Publisher: Project MUSE
Date: 2016
Abstract: Dental diseases have shown to be influenced by area-level socioeconomic status. This study aims to assess the effects of change in area-level SES on the oral health of Australian Indigenous children. Data were collected from a national surveillance survey for children's dental health at two points of time (2000-2002/2007-2010). The study examines caries experienced by area-level SES and whether changes in area-level SES (stable-high, upwardly-mobile, downwardly-mobile and stable low) affects caries experience. Dental caries in both the deciduous and permanent dentition increased significantly among Indigenous children during the study period. In stable low-SES areas, the experience of decayed, missing and overall dmft/DMFT in both dentitions was highest compared with other groups at both Time 1(2.15 vs 1.61, 1.77, 1.87 and 0.86 vs 0.55, 0.67, 0.70 respectively) and Time 2 (3.23 vs 2.08, 2.17, 2.02 and 1.49 vs 1.18, 1.21 respectively). A change in area-level SES was associated with experience of dental disease among Indigenous Australian children.
Publisher: SAGE Publications
Date: 11-06-2010
Abstract: It is important that we monitor socio-economic inequality in health. Inequality in child oral health has been expected to widen because of widening socio-economic inequality. This study aimed to evaluate trends in income-related inequality in caries experience of Australian children. Cross-sectional studies in 1992/93 and 2002/03 collected data on deciduous caries experience of 5- to 10-year-olds and permanent caries experience of 6- to 12-year-olds. Household composition and income was used to calculate quartiles of equivalized income. Slope Index of Inequality (SII), Concentration Index (CI), and regression-based rate ratios were used to quantify income-related inequality and to evaluate trends. Income-related inequality in caries experience was evident regardless of time and dentition. The three indicators of inequality indicate a significant increase in income-related inequality in child deciduous caries experience during the decade. The income inequality in permanent caries experience did not change significantly. Income inequalities increased in deciduous teeth, but not in permanent teeth, among Australian children.
Publisher: MDPI AG
Date: 10-12-2020
Abstract: In the first two years of life, exposure to wholegrain foods may help establish life‑long consumption patterns associated with reduced risk of chronic disease, yet intake data are lacking for this age group. This cross‑sectional analysis aimed to determine intakes and food sources of wholegrains in a cohort of 828 Australian children aged 12–14 months, and to identify determinants of wholegrain intake. Three non‑consecutive days of dietary intake data were collected using a 24‑h recall and 2‑day estimated food record. The multiple source method was used to estimate usual wholegrain intake, and the multivariable general linear model procedure used to identify associations between usual wholegrain intake and socio‑demographic determinants. The mean wholegrain intake was 19.5 (±14) g/day, and the major food sources were ready to eat breakfast cereals (40%) breads and bread rolls (26.6%), flours and other cereal grains (9.4%), and commercial infant foods (8.3%). Lower wholegrain intakes were observed for children whose mothers were born in China (p 0.001) and other Asian countries (p 0.001), with the exception of India (p = 0.193) those with mothers aged less than 25 years (p = 0.001) and those with two or more siblings (p = 0.013). This study adds to the weight of global evidence highlighting the need to increase children’s intake of foods high in wholegrain, including in the first few years of life.
Publisher: SAGE Publications
Date: 31-07-2014
Abstract: This study aimed to (1) describe social gradients in dental caries in a population-level survey and (2) examine whether inequalities are greater in disease experience or in its treatment. Using data from Australia’s National Survey of Adult Oral Health 2004-2006, we examined absolute and relative income inequalities for DMFT and its separate components (DT, MT, FT) using adjusted proportions, means, and health disparity indices [Slope Index of Inequality (SII) and Relative Index of Inequality (RII)]. Approximately 90% of Australian adults had experienced caries, with prevalence ranging from 89.7% in the highest to 96.6% in the lowest income group. Social gradients in caries were evident across all components of DMFT, but particularly notable in Missing (SII = −15.5, RII = −0.3) and untreated Decay (SII = −23.7, RII = −0.9). Analysis of age- and gender-adjusted data indicated less variation in levels of disease experienced (DMFT) than in the health outcomes of its management (missing teeth). The findings indicate that social gradients for dental caries have a greater effect on how the disease was treated than on lifetime disease experience.
Publisher: Wiley
Date: 29-07-2015
DOI: 10.1111/ADJ.12239
Abstract: Indigenous children experience significantly more dental caries than non-Indigenous children. This study assessed if access to fluoride in the water closed the gap in dental caries between Indigenous and non-Indigenous children. Data from four states and two territories were sourced from the Child Dental Health Survey (CDHS) conducted in 2010. The outcomes were dental caries in the deciduous and permanent dentitions, and the explanatory variables were Indigenous status and access to fluoridated water (≥0.5 mg/L) prior to 2008. Dental caries prevalence and severity for Indigenous and non-Indigenous children, in both dentitions, was lower in fluoridated areas compared to non-fluoridated areas. Among non-Indigenous children, there was a 50.9% difference in mean dmft scores in fluoridated (1.70) compared to non-fluoridated (2.86) areas. The difference between Indigenous children in fluoridated (3.29) compared to non-fluoridated (4.16) areas was 23.4%. Among non-Indigenous children there was a 79.7% difference in the mean DMFT scores in fluoridated (0.68) compared to non-fluoridated (1.58) areas. The difference between Indigenous children in fluoridated (1.59) and non-fluoridated (2.23) areas was 33.5%. Water fluoridation is effective in reducing dental caries, but does not appear to close the gap between non-Indigenous children and Indigenous children.
Publisher: SAGE Publications
Date: 30-07-2020
Abstract: Our ability to address child oral health inequalities would be greatly facilitated by a more nuanced understanding of whether underlying disease experience or treatment opportunities account for a larger share of differences between social groups. This is particularly relevant in the context of population subgroups who are socially marginalized, such as Australia’s Indigenous population. The decayed, missing, and filled (dmf) surfaces index is at once a reflection of dental caries experience (d) and its management (m and f). To 1) describe socioeconomic inequalities in dental caries experience and its management among Indigenous and non-Indigenous children and 2) compare these inequalities using absolute and relative measures. Data were from the Australian National Child Oral Health Study 2012–2014. Absolute and relative income inequalities were assessed for overall dmfs and its in idual components (ds, ms, fs) using adjusted means and health disparity indices (Slope Index of Inequality [SII] and Relative Index of Inequality [RII]). Mean dmfs among Indigenous children aged 5 to 10 y was 6.4 (95% confidence interval [CI], 5.4–7.4), ranging from 2.3 in the highest to 9.1 in the lowest income group. Mean dmfs among non-Indigenous children was 2.9 (95% CI, 2.8–3.1), ranging from 1.9 in the highest to 4.2 in the lowest income group. Age- and gender-adjusted social gradients for Indigenous children were evident across all dmfs components but were particularly notable for ds (SII = −4.6, RII = −1.7) and fs (SII = −3.2, RII = −1.5). The social gradients for non-Indigenous children were much lower in magnitude: ds (SII = −1.8, RII = −1.6) and fs (SII = −0.7, RII = −0.5). Our findings suggest that socioeconomic disadvantage may translate into both higher disease experience and increased use of dental services for both Indigenous and non-Indigenous groups, with the social gradients being much more lified among Indigenous children. The findings of this study demonstrate the magnitude of disparities in dental caries among children by population groups in Australia. Our results suggest that the relationship between socioeconomic disadvantage and poor oral health is more deleterious among Indigenous than non-Indigenous children. Tackling upstream determinants of health might not only affect population patterns of health and disease but also mitigate the overwhelming racial inequalities in oral health between Indigenous and non-Indigenous Australians.
Publisher: Elsevier BV
Date: 04-2020
DOI: 10.1093/AJCN/NQAA012
Publisher: Elsevier BV
Date: 06-2017
Publisher: MDPI AG
Date: 19-11-2019
DOI: 10.3390/NU11112828
Abstract: We examined associations between dietary patterns at 12 months, characterised using multiple methodologies, and risk of obesity and early childhood caries (ECC) at 24–36 months. Participants were Australian toddlers (n = 1170) from the Study of Mothers’ and Infants’ Life Events affecting oral health (SMILE) birth cohort. Principal Components Analysis (PCA) and the Dietary Guideline Index for Children and Adolescents (DGI-CA) were applied to dietary intake data (1, 2 or 3-days) at 12 months, and regression analysis used to examine associations of dietary patterns with body mass index Z-score and presence of ECC at 24–36 months. Two dietary patterns were extracted using PCA: family diet and cow’s milk and discretionary combination. The mean DGI-CA score was 56 ± 13 (out of a possible 100). No statistically significant or clinically meaningful associations were found between dietary pattern or DGI-CA scores, and BMI Z-scores or ECC (n = 680). Higher cow’s milk and discretionary combination pattern scores were associated with higher energy and free sugars intakes, and higher family diet pattern scores and DGI-CA scores with lower free sugars intakes. The association between dietary patterns and intermediate outcomes of free sugars and energy intakes suggests that obesity and/or ECC may not yet have manifested, and thus longitudinal investigation beyond two years of age is warranted.
Publisher: Wiley
Date: 07-02-2016
DOI: 10.1111/JACE.14146
Publisher: Elsevier BV
Date: 12-2016
Abstract: This paper describes and compares magnitudes of socioeconomic (SES) inequalities in oral health among Indigenous and non-Indigenous children over a 10-year period. We analysed annual oral health survey data from NSW, NT and SA. Data were extracted for time period 1 (2000-2002, N=215,317) and time period 2 (2007-2010, N=34,495). Oral health outcomes were untreated decayed deciduous teeth (dt) and cumulative dental caries experience (dmft). Postcode-level Socioeconomic Index for Areas was used to assess SES. Age standardisation and complex survey weights were used. Indices of socioeconomic inequality in health (Slope Index of Inequality, Relative Index of Inequality, Absolute and Relative Concentration Index) were used to quantify inequality in dental caries and its changes over time. Oral health outcomes deteriorated in both Indigenous and non-Indigenous populations over time. Indigenous children experienced higher levels of disease at both times. Untreated dt increased in both populations. The cummulative disease (dmft) increased at higher rate among children in low-SES areas in both populations. Over time, there was an increase in socioecononomic inequalities in dmft in all children and in dt in non-Indigenous children. Area-level socioeconomic inequality in child oral health has widened due to deterioration in low-SES children.
Publisher: MDPI AG
Date: 30-10-2020
DOI: 10.3390/NU12113343
Abstract: Understanding the determinants of early introduction of sugar sweetened beverages (SSBs) may assist in designing effective public health interventions to prevent childhood weight related conditions (obesity). This study explores the relationship between family/infant characteristics and the early introduction of SSBs among infants in Sydney, Australia. Mothers (n = 934) from an ongoing birth cohort study were interviewed at 8, 17, 34, and 52 weeks postpartum. Multivariable logistic regression analysis was used to identify family/infant factors independently associated with the likelihood of early introduction of SSBs ( weeks of age). Of the 934 mothers interviewed, 42.7% (n = 399) of infants were introduced to SSBs before 52 weeks. Mothers who were born in Vietnam (adjusted Odds Ratio (AOR) = 2.14 95% confidence interval (CI) 1.33, 3.47), other Asian countries (AOR = 1.62 95% CI 1.02, 2.58) as well as single mothers (AOR = 3.72 95% CI 2.46, 5.62) had higher odds of introducing SSBs early to their infants. Mothers from highly advantaged socioeconomic background (AOR = 0.43 95% CI 0.28, 0.68), those who breastfed their baby for 17–25 weeks (AOR = 0.60 95% CI 0.37, 0.99), 26–51 weeks (AOR = 0.65 95% CI 0.45, 0.94), and 52 weeks or more (AOR = 0.62 95% CI 0.43, 0.90) and those who introduced solids between 17–25 weeks (AOR = 0.58 95% CI 0.36, 0.91) and 26 weeks or more (AOR = 0.55 95% CI 0.34, 0.91) had reduced odds of introducing SSBs early. Tailoring health promotion programs for these vulnerable groups may delay the introduction of SSBs.
Publisher: S. Karger AG
Date: 2009
DOI: 10.1159/000235580
Abstract: There is an ongoing debate whether early exposure to fluoride is necessary. The effect of early exposure to fluoride needs to be understood to inform the appropriate population oral health policy. This study aimed to evaluate the effects of systemic fluoride intake in early childhood on caries experience of the permanent dentition observed at the age of 8 or 9 years, controlling for the effects of topical exposures to fluoride at the age of 5 years. The fluorosis experience of children was used as a proxy indicator for early exposure to fluoride, while exposures to fluoride at the age of 5 years, which were collected retrospectively, were used to control for the topical effect on permanent caries experience of the same children. Caries experience recorded at 8 or 9 years of age of 571 children was compared between groups with or without fluorosis. Bivariate analysis and multivariate analysis controlling for exposures to fluoride at the age of 5 years and other potential contributory factors were conducted. A quarter of the s le had very mild to mild fluorosis, while 15% had caries experience in the permanent dentition. Multivariate models showed that children who did not have fluorosis had a higher prevalence and severity of caries compared to those with fluorosis after controlling for other factors. In conclusion, there was a significant negative association between fluorosis status and caries experience in the permanent dentition.
Publisher: MDPI AG
Date: 09-01-2019
Abstract: The first two years of life is a period of rapid growth and development. During this time a lack of key nutrients, including iron, can have long-lasting effects on motor and cognitive performance. The purpose of this cross-sectional study was to determine intake and sources of iron in a cohort of 828 toddlers (mean age 13.1 mo) participating in the Adelaide-based Study of Mothers’ and Infants’ Life Events affecting oral health (SMILE), and to identify determinants of iron intake. At approximately 12 months of age, 3 non-consecutive days of dietary intake data were collected using a 24-h recall and 2-days food record. The Multiple Source Method was used to combine data from the 24-h recall and each day of the food record to estimate usual iron intake and descriptive statistics were used to report sources of iron. Linear regression was used to identify associations between iron intake and non-dietary determinants (maternal age, education, country of birth, BMI, socioeconomic position, parity, toddler sex) and primary milk feeding method at 12 months. The mean intake of iron was 7.0 (95% CI 6.7–7.2) mg/day and 18.2% of children had usual intakes below the estimated average requirement of 4 mg/day. The main sources of iron included infant and toddler cereals and formulas. Milk feeding method and parity were significantly associated with iron intake. Toddlers with siblings and those who received breast milk as their primary milk feed had significantly lower iron intakes than only children and those who received formula, respectively. The Australian Infant Feeding Guidelines promote the importance of iron-iron-rich complementary foods such as meat and meat alternatives. However, low intakes of this food group suggest that parents do not recognize the importance of these foods or understand the specific foods that toddlers should be eating.
Publisher: Wiley
Date: 12-2020
DOI: 10.1111/CDOE.12606
Abstract: Evidence suggests there are geographical variations in child oral health and this has prompted research into determinants of that variation. This study aimed to investigate factors attributable to the difference in child oral health between urban and rural areas in Australia. Data were from the National Child Oral Health Study 2012‐14, a population‐based study of 5‐ to 14‐year‐old children, who underwent oral epidemiological examinations by trained examiners. Caries prevalence (dmfs/DMFS 0) and experience (dmfs/DMFS count) in the primary dentition (5‐ to 8‐year‐old) and permanent dentition (9‐ to 14‐year‐old) were calculated. Children were grouped by residential location (urban or rural areas). A parental questionnaire collected information on family socio‐economic factors, and in idual health behaviours (dental access, sugar consumption and toothbrushing). Residential history was used to calculate lifetime exposure to water fluoridation (WF). Analyses were weighted to produce population‐representative estimates. The primary outcomes were assessed separately for the two groups in regression models with robust standard error estimation to estimate prevalence ratios and mean ratios and their 95% confidence intervals. Population Attributable Fractions were calculated using the population distribution of the exposures and their adjusted estimates. 10 581 5‐ to 8‐year‐old and 14 041 9‐ to 14‐year‐old children were included. Caries prevalence was higher in rural than in urban areas. In multivariable models, exposure to fluoridation, reason for dental visit and consumption of sugary beverages were consistently associated with caries prevalence and experience. WF coverage attributed to differences in caries prevalence (10% vs 21%) and experience (14% vs 35%) in the permanent dentition. High consumption of sugary beverages attributed to a higher primary and permanent dental caries experience in rural than in urban areas. Dental access was also attributed to the differences between the two areas. Factors at both community and in idual levels attributed to the observed differences in child caries prevalence and experience between urban and rural areas.
Publisher: Elsevier BV
Date: 07-2022
DOI: 10.1016/J.JDENT.2022.104113
Abstract: To investigate the trajectory of maternal intake of sugar-sweetened beverages (SSB) during the first five years of their child's life and its effect on the child's dental caries at five years-of-age. This is an ongoing prospective population-based birth cohort study in Adelaide, Australia. Mothers completed questionnaires on their SSB intake, socioeconomic factors and health behaviors at the birth of their child and at the ages of one, two and five years. Child dental caries measured as decayed, missing, or filled tooth surfaces was collected by oral examination. Maternal SSB intake was used to estimate the trajectory of SSB intake. The trajectories then became the main exposure of the study. Dental caries at age five years were the primary outcomes. Adjusted mean- and prevalence-ratios were estimated for dental caries, controlling for confounders. 879 children had dental examinations at five years-of-age. Group-based trajectory modeling identified three trajectories of maternal SSB intake: 'Stable low' (40.8%), 'Moderate but increasing' (13.6%), and 'High early' trajectory (45.6%). Multivariable regression analysis found children of mothers in the 'High early' and 'Moderate but increasing' groups to have greater experience of dental caries (MR: 1.37 (95%CI 1.01-1.67), and 1.24 (95%CI 0.96-1.60) than those in the 'Stable low' trajectory, respectively. Maternal consumption of SSB during pregnancy and in the early postnatal period influenced their offspring's oral health. It is important to create a low-sugar environment from early childhood. The results suggest that health promotion activities need to be delivered to expecting women or soon after childbirth.
Publisher: Wiley
Date: 12-2014
DOI: 10.1111/AJR.12107
Abstract: To examine the association between children's clinical oral health status and their residential location using the latest available data (2009) and to ascertain whether poor oral health among rural children is related to being Indigenous, having less access to fluoridated water or being of lower socioeconomic status (SES), than children from urban areas. Cross-sectional survey. Data were collected on 74, 467 children aged 5-12 years attending school dental services in Australia (data were not available for Victoria or New South Wales). Clinical oral health was determined by the mean number of permanent teeth with untreated caries, missing and filled permanent teeth, and the mean decayed, missing and filled permanent teeth index (DMFT) of 8 to 12-year-old-children and the mean number deciduous teeth with untreated caries, missing and filled deciduous teeth, and the mean decayed, missing and filled deciduous teeth index (dmft) of 5-10-year-olds. The multivariable models that included coefficients on whether the child was Indigenous, from an area with fluoridated water and SES, were controlled for age and sex. The mean DMFT of 8-12-year-old children and the mean dmft of 5-10-year-old-children were significantly higher in rural areas compared with urban centres after accounting for Indigenous status, fluoridated water and SES. Children's oral health was poorer in rural areas than in major city areas.
Publisher: Wiley
Date: 20-03-2023
Abstract: Efficient methods for labeling aryl trifluoromethyl groups to provide novel radiotracers for use in biomedical research with positron emission tomography (PET) are keenly sought. We report a broad‐scope method for labeling trifluoromethylarenes with either carbon‐11 ( t 1/2 =20.4 min) or fluorine‐18 ( t 1/2 =109.8 min) from readily accessible aryl(mesityl)iodonium salts. In this method, the aryl(mesityl)iodonium salt is treated rapidly with no‐carrier‐added [ 11 C]CuCF 3 or [ 18 F]CuCF 3 . The mesityl group acts as a spectator allowing radiolabeled trifluoromethylarenes to be obtained with very high chemoselectivity. Radiochemical yields from aryl(mesityl)iodonium salts bearing either electron‐donating or electron‐withdrawing groups at meta ‐ or para ‐ position are good to excellent (67–96 %). Ortho ‐substituted and otherwise sterically hindered trifluoromethylarenes still give good yields (15–34 %). Substituted heteroaryl(mesityl)iodonium salts are also viable substrates. The broad scope of this method was further exemplified by labeling a previously inaccessible target, [ 11 C] p ‐trifluoromethylphenyl boronic acid, as a potentially useful labeling synthon. In addition, fluoxetine, leflunomide, and 3‐trifluoromethyl‐4‐aminopyridine, as ex les of small drug‐like molecules and candidate PET radioligands, were successfully labeled in high yields (69–81 %).
Publisher: MDPI AG
Date: 13-01-2019
DOI: 10.3390/NU11010161
Abstract: In the first 2 years of life, it is important to limit exposure to foods high in free sugars, in order to lay foundations for lifelong eating patterns associated with a reduced risk of chronic disease. Intake data at this age is limited, so compliance with recommendations is not known. This analysis describes free sugars intakes, food sources and determinants of high consumption among Australian children at 2 years of age. Free sugars intakes were estimated using a customized Food Frequency Questionnaire, and median usual free sugars intake at 2 years was 22.5 (Interquartile Range (IQR) 12.8–37.7) g/day, contributing a median 8% of the estimated energy requirement (EER). Based on the EER, most children (71.1%) exceeded the World Health Organization recommendation that % of energy should come from free sugars, with 38% of participants exceeding the % recommendation. Children from households with the greatest socioeconomic disadvantage were more likely to exceed the 10% recommendation (Prevalence Ratio (PR) 1.44, 95% Confidence Interval (95% CI) 1.13–1.84), and be in the top tertile for free sugars intake (PR 1.58, 95% CI 1.19–2.10) than the least disadvantaged. Main sources of free sugars were non-core foods, such as fruit juice, biscuits, cakes, desserts and confectionery with yogurt and non-dairy milk alternatives the two notable exceptions. Improved efforts to reduce free sugars are needed from the introduction of solid food, with a particular focus on fruit juice and non-core foods.
Publisher: Wiley
Date: 11-11-2003
DOI: 10.1046/J.1600-0528.2003.00009.X
Abstract: Studies from developed countries have found smoking a significant risk indicator for periodontitis. However, few such studies have been conducted in developing populations, where the natural history of the disease is rarely confounded by treatment and smoking is highly prevalent. The present study aimed to confirm the consistency, strength and dose-response of the association of smoking with periodontitis measured by loss of attachment (LOA) in a representative middle-aged adult s le from a developing country. A cross-sectional study with a multistage stratified random s le was conducted in two provinces of Vietnam. A total of 575 (response: 84.6%) 35-44-year-old subjects were interviewed and periodontally examined. Data were re-weighted to represent the population of the provinces. 28.9% were current smokers (CS), 8.6% former smokers (FS) and 62.5% never-smokers (NS). Number of cigarette pack-years was calculated to ide CS into light smokers, LS < or = 5 pack-years, and heavy smokers, HS 5+ pack-years. The US NIDR protocol was employed for LOA measurement at two sites per tooth for every tooth. HS presented with the highest prevalence of LOA exceeding various thresholds followed by LS (chi2, P or = 4 mm and LOA > or = 6 mm was significantly higher among HS and LS compared to NS (ANOVA P < 0.001). The severity scores of LOA for NS, FS, LS and HS were 2.42, 2.50, 2.64 and 3.05 mm respectively (ANOVA P or = 5 mm and 1+ site with PD > or = 4 mm. Compared to NS, the odds ratio for periodontitis among heavy smokers was 7.17 (CI: 2.87-17.92, P < 0.001). Smoking is a risk indicator for periodontitis among the middle-aged Vietnamese population. To pursue a population prevention approach for periodontitis, dentistry in Vietnam needs to be part of antismoking and smoking cessation programs.
Publisher: Wiley
Date: 10-08-2020
DOI: 10.1111/CDOE.12568
Publisher: American Medical Association (AMA)
Date: 27-11-2019
Publisher: Wiley
Date: 04-12-2016
DOI: 10.1111/JPHD.12134
Abstract: To assess dental caries trends in indigenous children in South Australia, 2001-2010 and contribution by area-level socioeconomic status (SES), remoteness and water fluoridation status. This study is a part of the Child Dental Health Survey (CDHS) is an ongoing national surveillance survey in Australia including children enrolled in the School Dental Services (SDS). Postcode-level adjusted mean deciduous and permanent caries experience was estimated at each year. Time trend of dental caries experience was estimated using mixed effect models. Area-level socioeconomic status, remoteness, water fluoridation status were independent variables in the models. There was a significant upward trend of dental caries experience over the 10 years. Dental caries experience of indigenous children living in low SES areas had nearly one more deciduous tooth and a half permanent tooth with caries than indigenous children living in higher SES areas. The remote postcodes showed higher levels of decay in deciduous dentition (+1.25 teeth) compared with others regions. The dental caries trend increased in South Australian indigenous children over the study period, and was associated with area-level SES and remoteness. The increasing trend in dental caries in indigenous children is important evidence to inform policies to improve oral health.
Publisher: Project MUSE
Date: 2016
Abstract: Tooth decay is related to poverty, measured at in idual and neighbourhood levels. It is however uncertain if living in an advantaged neighbourhood reduces tooth decay similarly in Australian Indigenous and non-Indigenous children. This study describes tooth decay by neighbourhood characteristics and Indigenous status, and examines inequalities by Indigenous status. In deciduous dentition the percentage of children with tooth decay and untreated decay decreased on average 26% and 20% respectively in the non-Indigenous s le from poor to affluent neighbourhoods. In Indigenous children tooth decay and untreated decay decreased on average 6% and 8%, respectively, from poor to affluent neighbourhoods. While all children from affluent areas had less tooth decay, the gap between non-Indigenous and Indigenous children remained significant across neighbourhood characteristics. This suggests that both universal and targeted prevention programs should be considered for all Indigenous children irrespective of where they live.
Publisher: AMPCo
Date: 2016
DOI: 10.5694/MJA15.00703
Abstract: The study assessed longitudinal changes in the presentation of dental fluorosis and evaluated the impact of fluorosis on the perception of oral health among young adults. Prospective follow-up study during 2011-12 of a population-based study in South Australia conducted between 2003 and 2004. 8-13-year-old children initially examined in 2003 and 2004. Dental fluorosis was assessed with the Thylstrup and Fejerskov (TF) Index. The impact on perceptions of oral health by the study participants and their parents was assessed with the Global Rating of Oral Health (GROH). Pairwise comparative analysis of the presentation of fluorosis was conducted at the in idual and tooth levels. Multivariable models of changes in fluorosis were generated. An ordinal logistic regression model was used to evaluate the association between GROH with dental fluorosis, caries and other factors. A total of 314 participants completed the follow-up questionnaires and dental examination. Over 60% of teeth scored as TF 1 at baseline were scored as TF 0 at follow-up 66% of teeth scored as TF 2 or 3 at baseline were scored as TF 0 or 1 at follow-up. In multivariable models, changes in fluorosis were not significantly associated with socio-economic factors or oral health behaviours, confirming that they were the result of a natural process. Perceptions of poor oral health were significantly associated with the number of untreated decayed tooth surfaces at follow-up, but not with fluorosis. Very mild and mild dental fluorosis diminished with time. Dental fluorosis did not have a negative impact on perceptions of oral health.
Publisher: Wiley
Date: 16-01-2017
DOI: 10.1111/CDOE.12280
Abstract: Lifetime access to fluoridated water (FW) is associated with lower caries experience. However, assessing this association in adults is likely affected by age. Cohort stratification and categorization of per cent lifetime access to fluoridated water (% LAFW) within cohorts are current approaches to this assessment. These approaches require an examination of the % LAFW and caries experience variation within and across age groups and their association to inform future analyses. This secondary analysis aimed to examine the age group variation in % LAFW and caries experience and the association of % LAFW with caries within and across age groups of adults. A secondary analysis was undertaken using the Australian National Survey of Adult Oral Health 2004-2006 data on 4090 persons aged 15-91 years randomly s led by a stratified, multistage probability method. Study participants underwent an interview, an oral examination by trained and standardized dentists to determine decayed, missing or filled tooth surfaces (DMFS) and a mailed self-complete questionnaire which collected residential history to calculate % LAFW. Variations in % LAFW and DMFS across age groups (15-34 35-44 45-54 55+) were examined. Multivariable regression log-link models were generated for DMFS score within each age group. The age groups varied in values and distribution of % LAFW. Caries experience was strongly associated with age. % LAFW was significantly associated with DMFS score in the two younger age groups, but not in the others. Multivariable regression models showed that the highest % LAFW quartile had significantly lower DMFS count than the lowest quartile in the two younger age groups (mean ratios: 0.67 and 0.78, respectively), controlling for other covariates. Access to FW was associated with caries experience in Australian adults. The magnitude of associations varied between age groups, dependent on the natural history of caries and its measurement by DMFS.
Publisher: MDPI AG
Date: 20-12-2019
Abstract: Despite recommendations to the contrary, consumption of discretionary (energy-dense, nutrient-poor) foods begins for some children early in the weaning period, and the proportion of children consuming discretionary foods increases markedly in the second year of life. The purpose of this study was to determine intake and sources of discretionary foods in a cohort of 828 Australian toddlers (mean age: 13.1mo), and to identify determinants of discretionary food intake. At approximately 12 months of age, 3 non-consecutive days of dietary intake data were collected using a 24-h recall and 2-day food record, and the percentage total energy derived from discretionary foods was estimated. Linear regression was used to identify associations between discretionary food intake and socio-demographic determinants (mother’s age, level of education, country of birth, pre-pregnancy body mass index, socioeconomic position, parity, age of child when mother returned to work, and child’s sex) and age at which complementary foods were introduced. The average energy intake of children in this cohort was 4040 (±954.7 SD) kJ with discretionary foods contributing an average of 11.2% of total energy. Sweet biscuits, and cakes, muffins, scones and cake-type desserts contributed 10.8% and 10.2% of energy intake from discretionary foods, respectively. Other key contributors to energy intake from discretionary foods included sausages, frankfurters and saveloys (8.3%), vegetable products and dishes where frying was the main cooking technique (8.6%), butter (7.3%), and finally manufactured infant sweet or savory snack foods (9.3%). Higher intakes of discretionary food were associated with children having two or more siblings (p = 0.002), and being born to younger mothers ( years) (p = 0.008) and mothers born in Australia or the United Kingdom (p 0.001). Parents, in particular young mothers and those with larger families, need practical guidance on how much of, and how often, these foods should be eaten by their children.
Publisher: Springer Science and Business Media LLC
Date: 02-02-2018
DOI: 10.1007/S10995-018-2431-3
Abstract: Objective The association between and commonality of risk factors for poor self-rated oral health (SROH) and general health (SRGH) among new mothers has not been reported. The purpose of this paper is to assess the commonality of risk factors for poor SROH and SRGH, and self-reported obesity and dental pain, among a population-based s le of new mothers in Australia. It also investigated health conditions affecting new mothers' general health. Methods Data collected at baseline of a population-based birth cohort was used. Mothers of newborns in Adelaide were approached to participate. Mothers completed a questionnaire collecting data on socioeconomic status (SES), health behaviours, dental pain, SROH, self-reported height and weight and SRGH. Analysis was conducted sequentially from bivariate to multivariable regression to estimate prevalence rate (PR) of reporting poor/fair SROH and SRGH. Results of the 1895 new mothers, some 21 and 6% rated their SROH and SRGH as poor/fair respectively. Dental pain was associated with low income and smoking status, while being obese was associated with low SES, low education and infrequent tooth brushing. SROH and SRGH was associated with low SES, smoking, and dental pain. SROH was also associated with SRGH [PR: 3.06 (2.42-3.88)]. Conclusion for practice There was a commonality of factors associated with self-rated oral health and general health. Strong associations between OH and GH were also observed. Given the importance of maternal health for future generations, there would be long-term societal benefit from addressing common risk factors for OH and GH in integrated programs.
Publisher: Wiley
Date: 29-04-2019
DOI: 10.1111/CDOE.12460
Abstract: To investigate risk indicators for untreated dental decay among Indigenous Australian children using a national representative s le. Data were from the National Child Oral Health Study 2012-2014, which included a nationally representative s le 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 s ling design was taken into account in all analyses. 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. 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.
Publisher: Wiley
Date: 05-06-2018
DOI: 10.1111/CDOE.12384
Abstract: Water fluoridation's effectiveness has been reaffirmed by systematic reviews. However, most of the included nonrandomised controlled before and after studies were conducted pre-1975. Opportunity for such studies is limited in a steady state of community fluoridation programmes. As an alternative for evidence to support or refute the effectiveness of water fluoridation, this study used data from a recent national child oral health study to examine associations between lifetime exposure to fluoridated water (%LEFW) and childhood caries. A population-based study of child oral health in Australia was conducted in 2012-2014, using complex s ling and weighting procedures. Parents provided detailed household information and children underwent oral epidemiological examination by trained examiners. Residential history from birth was used to calculate %LEFW. Caries prevalence (dmfs/DMFS>0) and experience (dmfs/DMFS) in both primary (age 5-8) and permanent dentitions (age 9-14) were estimated. Socioeconomic factors that were significantly different by %LEFW were then used as covariates in multivariable log-Poisson regression models for each caries outcome by %LEFW. A total of 24 664 children had complete data. Caries prevalence and experience were higher among 5-8-year-old children with lower %LEFW (46.9% 4.27 surfaces) than those with 100%LEFW (31.5% 1.98 surfaces) and for the 9-14-year-old children with lower %LEFW (37.0% 1.34 surfaces) than those with 100%LEFW (25.0% 0.67 surfaces). In the multivariable models, the prevalence ratios for primary and permanent caries were significant for the two lower exposure groups against the 100%LEFW group. Similarly, the mean ratios for primary dmfs were significant for all three lower exposure groups and for permanent DMFS were significant for the two lower exposure groups against the 100%LEFW group. Mean ratios for the 0%LEFW compared to the 100%LEFW group were 2.10 (1.83-2.40) for dmfs and 1.82 (1.57-2.10) for DMFS. Analysis of contemporary data representative of the Australian child population found consistent associations between %LEFW and childhood caries, which persisted when socioeconomic differences were adjusted across exposure groups, supporting the continued effectiveness of water fluoridation.
Publisher: MDPI AG
Date: 18-10-2019
Abstract: Breastfeeding to 12 months and beyond offers considerable health benefits to both infants and mothers. Despite these recognized benefits, relatively few women in high income countries breastfeed for 12 months, and rarely breastfeed to 24 months. The aim of this study was to identify the prevalence and determinants of continued breastfeeding to 12 and 24 months amongst a cohort of Australian women participating in the Adelaide-based Study of Mothers’ and Infants’ Life Events affecting oral health (SMILE). Duration of breastfeeding was known for 1450 participants and was derived from feeding related data collected at birth, 3, 6, 12 and 24 months. Multivariable logistic regression analysis was used to investigate the relationship between explanatory variables and continued breastfeeding to 12 and 24 months. In total, 31.8% of women breastfed to 12 months and 7.5% to 24 months. Women who were multiparous, university educated, had not returned to work by 12 months and whose partners preferred breastfeeding over bottle feeding were more likely to be breastfeeding at 12 months. While women who had introduced complementary foods before 17 weeks and formula at any age were less likely to be breastfeeding at 12 months. Mothers who were born in Asian countries other than India and China, had not returned to work by 12 months and had not introduced formula were more likely to be breastfeeding at 24 months. The majority of the determinants of continued breastfeeding are either modifiable or could be used to identify women who would benefit from additional breastfeeding support and encouragement.
Publisher: Wiley
Date: 21-04-2015
DOI: 10.1111/CDOE.12162
Abstract: Dental caries is a multifactorial condition, prevention of which requires comprehensive understanding of both contextual and compositional determinants and their population impact. To investigate contextual and compositional factors associated with the prevalence of dental caries in children and to estimate the population impact of those factors. Children in one Australian state were selected through stratified random s ling selection in 2010-2011. Oral epidemiological examinations provided in idual-level outcomes: prevalence of dental caries in the primary (among 5- to 8-year-olds) and permanent dentitions (9- to 14-year-olds). Socioeconomic status, oral health behaviours and practices and dietary patterns were explanatory factors at the in idual-level, school-level and area-level fluoridation status. Three-level multilevel multivariable models were sequentially specified for the prevalence of dental caries to estimate prevalence ratios (PR) associated with explanatory factors, adjusting for covariates and between- and within-group variances. Population attributable fraction (PAF) was estimated as the population impact of the statistically significant explanatory factors. Data from 2214 5- to 8-year-olds and 3186 9- to 14-year-olds from 207 schools in 16 areas were analysed. The prevalence of dental caries in the primary and the permanent dentitions was 47.1% (43.9-50.4) and 38.8% (36.1-41.6), respectively. The highest prevalence of dental caries was observed in the nonfluoridated areas. In bivariate associations, factors at three levels were associated with prevalence of dental caries. In the full models, children in the nonfluoridated areas had significantly higher prevalence of dental caries [PR for the primary: 1.29 (1.11-1.50) PR for the permanent 1.49 (1.01-2.21)] compared with children in fluoridated areas, controlling for other factors. PAF estimates indicated that lack of water fluoridation attributed to 21% and 31% of primary and permanent dental caries, respectively in this child population. A multitude of factors had significant population impact on the prevalence of dental caries in children. Water fluoridation has a significant population impact on dental caries experience in this child population.
Publisher: MDPI AG
Date: 23-10-2017
Publisher: BMJ
Date: 10-2020
DOI: 10.1136/BMJOPEN-2020-041185
Abstract: The long-term goal of the Study of Mothers’ and Infants’ Life Events Affecting Oral Health (SMILE) birth cohort study is to identify and evaluate the relative importance and timing of critical factors that shape the oral health of young children. It will then evaluate those factors in their inter-relationship with socioeconomic influences. SMILE is a single-centre study conducted in Adelaide, Australia. All newborns at the main three public hospitals between July 2013 and August 2014 were eligible for inclusion. The final recruited s le at birth was 2181 mother/infant dyads. Participants were followed up with questionnaires when the child was 3 and 6 months of age, and 1, 2 and 5 years of age. Oral epidemiological examinations and anthropometric assessments were conducted at age 2 and 5 years. SMILE has contributed comprehensive data on dietary patterns of young children. Intakes of free sugars, core and discretionary foods and drinks have been detailed. There was a sharp increase in free sugars intake with age. Determinants of dietary patterns, oral health status and body weight during the first 5 years of life have been evaluated. Socioeconomic characteristics such as maternal education and household income and area-level socioeconomic profile influenced dietary patterns and oral health behaviours and status. Funding has been obtained to conduct oral epidemiological examinations and anthropometric assessments at age 7–8 years. Plans are being developed to follow the cohort into adolescent years.
Publisher: Wiley
Date: 28-11-2022
DOI: 10.1111/CDOE.12819
Abstract: Child oral health is a result of interactions between multilevel influences within a complex system. Understanding those interactions informs conceptualizing a socioecological framework of important influences on oral health. This paper aimed to present a scoping review on the determinants of dental caries and their interactions in childhood and adolescence. The two review questions were as follows: Which factors are determinants of child dental caries ? and, How do determinants interact within and across socioecological levels ? The three main electronic databases for biomedical records, PubMed, Web of Science and Scopus were searched, followed by reference check. The search and screening/selection procedures followed an a priori strategy and inclusion/exclusion criteria were specified in advance. The main components of the strategy were participants, concept and context. Following the final selection, eligible studies were assessed with quality appraisal tools for the risk of methodologic biases. Determinants reported in the included studies were then assigned to the micro‐, meso‐, exo‐ or macro‐systems levels in a socioecological framework. Interactions between determinants were also identified and reported. A total of 100 studies were included after removal of duplicates, screening on the title/abstracts and full‐text assessment among 3313 records initially identified. A higher number of studies included were cross‐sectional studies published in recent years. The majority of determinants found to influence child dental health were assigned to microsystem level within the framework. However, determinants were found at all levels and interactions were reported within and between socioecological levels. Determinants identified in the scoping review represent factors at different socioecological levels that influence child oral health. Application of a socioecological model through a complex systems approach should lead to valid and robust progress towards practical solutions for better child oral health globally.
Publisher: Springer Science and Business Media LLC
Date: 06-05-2014
Publisher: MDPI AG
Date: 26-03-2018
Publisher: American Association for the Advancement of Science (AAAS)
Date: 13-05-2020
DOI: 10.1126/SCITRANSLMED.AAU2939
Abstract: Two radioligands, [ 18 F]LSN3316612 and [ 11 C]LSN3316612, image and quantify brain O -linked-β- N -acetyl-glucosamine hydrolase in vivo.
Publisher: MDPI AG
Date: 16-08-2016
DOI: 10.3390/NU8080501
No related grants have been discovered for Diep Ha.