ORCID Profile
0000-0002-0901-2863
Current Organisation
University of California, Irvine
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Health Policy | Health Economics | Applied Economics |
Dental Health | Health Policy Economic Outcomes | Health Policy Evaluation
Publisher: Springer Science and Business Media LLC
Date: 16-01-2015
DOI: 10.1007/S00520-015-2607-Y
Abstract: Oral health is essential to general health and well-being and is severely impacted by head and neck cancer (HNC) and its treatment. This study aimed to describe how people who have been treated for HNC cope with altered oral health and function and to identify their supportive care needs. A qualitative, descriptive approach was used. Data was collected from in idual interviews with six participants 6 months after treatment. Data analysis was performed by qualitative content analysis involving inductive and directed approaches. Directed content analysis was guided by the Stress, Appraisal and Coping Model. Three themes describing changed oral health were identified from the data: dimensions of eating, maintaining oral health after treatment and adapting to the chronic side effects of treatment. A strong use of problem-focussed coping was described, in addition to the importance of peer support in adapting to the psychosocial outcomes of treatment. Support needs identified related to increased access to specialist dental oncology services post treatment, information needs and a need for more psychological support. The study findings describe the experience of a s le of people who have received treatment for HNC. Due to a demographically homogenous s le and the strong use of positive coping strategies, the results presented may not describe the experience of the wider HNC population however, these results provide insight into factors that may influence positive coping.
Publisher: Wiley
Date: 02-03-2018
DOI: 10.1111/DAR.12691
Abstract: Reducing smoking prevalence among Indigenous Australians is a vital part of closing the health gap between Indigenous and non-Indigenous Australians. Community-controlled health clinics are an important setting for delivering smoking cessation advice and assistance. This study measured tobacco and e-cigarette use, knowledge of smoking-related health effects, motivations to quit and interest in cessation aids. Clients of Aboriginal & Torres Strait Islander Community Health Service dental clinics in Southeast Queensland (n = 421) completed a brief written questionnaire while in the waiting room. Nearly half (n = 184, 47%) of the participants currently smoked daily, of which 9% (n = 7) currently used e-cigarettes. Few smokers (8%, n = 13) had no intention to quit smoking. For current smokers, previously used quit methods were abrupt cessation (42%, n = 78), nicotine replacement therapies (NRT 25%, n = 45), prescription medications (23%, n = 43), e-cigarettes (9%, n = 17) and other methods (3%, n = 6). Current smokers were most interested in cutting down (85%, n = 110), abrupt cessation (75%, n = 98) and free NRT (72%, n = 101). Fewer (34%, n = 36) were interested in purchasing NRT for smoking cessation. Our study found there was interest in accessing smoking cessation aids among the clients of this community-controlled health clinic, particularly if provided free of charge. Embedding smoking cessation advice and assistance into a range of community-controlled health clinics could provide opportunities for addressing the high smoking prevalence among Indigenous Australians.
Publisher: Emerald
Date: 09-05-2016
Abstract: The appearance of a rapidly expanding range of ready-to-drink packaged beverages in the marketplace has been met with widespread consumer acceptance. The aim of this study is to profile the nutritional composition and dental erosive potential of a s le of beverages sold for consumption in Brisbane supermarkets. In all, 44 beverages were assessed to determine their pH and titratable acidity. Information relating to nutritional composition was also collected. Milk-based beverages had the highest energy concentration, while soft drinks, energy drinks, flavoured milk, and fruit and vegetable juice categories contained products with very high sugar concentrations ( g/100ml). All beverages, except milk-based products and still water, had a pH of less than 4.8. Titratable acidity was highest for energy drinks and fruit and vegetable juices. Energy drinks and fruit and vegetable juices had the highest sugar content and titratable acidity of all the beverage categories and so would be expected to have the greatest potential to cause oral health problems. Milk drinks had the highest energy concentration, but the lowest erosive potential. Regular consumption of many ready-to-drink pre-packaged beverages is therefore inconsistent with recommendations in current dietary and oral health guidelines. Rather than considering nutritional composition alone, this study examined both nutritional and physicochemical properties of ready-to-drink packaged beverages to reach a more holistic assessment of their health impact.
Publisher: Springer Science and Business Media LLC
Date: 25-11-2016
Publisher: Wiley
Date: 17-07-2012
DOI: 10.1111/J.1601-5037.2012.00564.X
Abstract: The aim of this report was to examine the role of the oral health therapist (OHT) in the contemporary Australian context. The original intent of the OHT role was to address unmet community oral health need in a cost-effective manner. Although it was recognized that OHTs would need to deliver clinical treatment, particularly restorative services for children, the core of their education and their knowledge and proficiency is in oral health and public health promotion. Unmet oral health need persists, and this is especially urgent for the most disadvantaged. Some may argue that this provides evidence that OHTs should provide an expanded range of clinical services, including adult restorative treatment, and that additional training should be provided to enable this to occur. This report counters that view by showing that the current health system does not avail itself of the health promotion services that OHTs are already educated to deliver. Improved health outcomes within the Australian health system are achievable by bringing oral health into the general health system, by introducing models of care aimed at the early detection of risk and disease and by recognizing the importance of public health measures designed to prevent disease.
Publisher: Elsevier BV
Date: 10-2015
DOI: 10.1053/J.AJKD.2015.04.051
Abstract: Dental disease is more extensive in adults with chronic kidney disease, but whether dental health and behaviors are associated with survival in the setting of hemodialysis is unknown. Prospective multinational cohort. 4,205 adults treated with long-term hemodialysis, 2010 to 2012 (Oral Diseases in Hemodialysis [ORAL-D] Study). Dental health as assessed by a standardized dental examination using World Health Organization guidelines and personal oral care, including edentulousness decayed, missing, and filled teeth index teeth brushing and flossing and dental health consultation. All-cause and cardiovascular mortality at 12 months after dental assessment. Multivariable-adjusted Cox proportional hazards regression models fitted with shared frailty to account for clustering of mortality risk within countries. During a mean follow-up of 22.1 months, 942 deaths occurred, including 477 cardiovascular deaths. Edentulousness (adjusted HR, 1.29 95% CI, 1.10-1.51) and decayed, missing, or filled teeth score ≥ 14 (adjusted HR, 1.70 95% CI, 1.33-2.17) were associated with early all-cause mortality, while dental flossing, using mouthwash, brushing teeth daily, spending at least 2 minutes on oral hygiene daily, changing a toothbrush at least every 3 months, and visiting a dentist within the past 6 months (adjusted HRs of 0.52 [95% CI, 0.32-0.85], 0.79 [95% CI, 0.64-0.97], 0.76 [95% CI, 0.58-0.99], 0.84 [95% CI, 0.71-0.99], 0.79 [95% CI, 0.65-0.95], and 0.79 [95% CI, 0.65-0.96], respectively) were associated with better survival. Results for cardiovascular mortality were similar. Convenience s le of clinics. In adults treated with hemodialysis, poorer dental health was associated with early death, whereas preventive dental health practices were associated with longer survival.
Publisher: Wiley
Date: 04-10-2013
DOI: 10.1002/HED.23417
Abstract: Cervical cancers have been shown to increase the risk of cancers at distant sites, including the head and neck region. This study investigated the relative risk of developing head and neck cancer subsequent to cervical cancer in an Australian population. Cervical cancers, head and neck cancers, and cervical dysplasias among women registered with the Queensland Oncology Repository were identified for the period 1982 to 2008. Over the 26-year period, 3328 women were diagnosed with a cervical cancer and followed up for 30,375 person-years at risk. Eighteen women (0.5%) developed head and neck cancer within a mean time of 8.1 years (SD = 5.56). The relative risk of head and neck cancer development subsequent to cervical cancer was 6.7 (95% confidence interval [CI], 4.06-10.91). This study demonstrates that women with cervical cancer were almost 7 times more likely to develop head and neck cancer compared to the general female population.
Publisher: MDPI AG
Date: 28-10-2013
Publisher: Wiley
Date: 02-03-2017
DOI: 10.1111/CDOE.12291
Abstract: Dental practitioners are able to prescribe a variety of medicines subsidized on the Pharmaceutical Benefits Schedule (PBS), the main categories of which are analgesics and antibiotics. We aimed to investigate the patterns of PBS prescribing of non-antimicrobial medicines by dental practitioners in Australia from 2001 to 2012. Data were collected from Medicare Australia on prescriptions from dental practitioners dispensed to concessional beneficiaries between 2001 and 2012. We examined patterns of use over time. There was an overall increase in number of prescriptions and in dispensed use (standardized by dose and population) of analgesic medicines for the concessional population over the 12-years period. The use of dentally prescribed analgesics increased 15%, with use of nonsteroidal anti-inflammatory drugs increasing by 41% and opioid analgesics by 12%. Prescribing of the oxycodone 5-mg tablet increased 344% between 2005 and 2012, and dental prescription of the benzodiazepines diazepam and temazepam increased by 51% and 229%, respectively, over the observation period. Injectable corticosteroid use increased by 19%. Conversely, use of carbamazepine and anti-emetics decreased by 39% and 10%, respectively. Dental prescribing of analgesics, anti-inflammatories and benzodiazepines in the concessional population has increased significantly over the past decade. These data can form the baseline to further examine appropriate medicine use in the management of dental conditions.
Publisher: Oxford University Press (OUP)
Date: 29-12-2016
DOI: 10.1093/NDT/GFV413
Abstract: Oral disease is a potentially treatable determinant of mortality and quality of life. No comprehensive multinational study to quantify oral disease burden and to identify candidate preventative strategies has been performed in the dialysis setting. The ORAL disease in hemoDialysis (ORALD) study was a prospective study in adults treated with hemodialysis in Europe (France, Hungary, Italy, Poland, Portugal and Spain) and Argentina. Oral disease was assessed using standardized WHO methods. Participants self-reported oral health practices and symptoms. Sociodemographic and clinical factors associated with oral diseases were determined and assessed within nation states. Of 4726 eligible adults, 4205 (88.9%) participated. Overall, 20.6% were edentulous [95% confidence interval (CI), 19.4-21.8]. Participants had on average 22 (95% CI 21.7-22.2) decayed, missing or filled teeth, while moderate to severe periodontitis affected 40.6% (95% CI 38.9-42.3). Oral disease patterns varied markedly across countries, independent of participant demographics, comorbidity and health practices. Participants in Spain, Poland, Italy and Hungary had the highest mean adjusted odds of edentulousness (2.31, 1.90, 1.90 and 1.54, respectively), while those in Poland, Hungary, Spain and Argentina had the highest odds of ≥14 decayed, missing or filled teeth (23.2, 12.5, 8.14 and 5.23, respectively). Compared with Argentina, adjusted odds ratios for periodontitis were 58.8, 58.3, 27.7, 12.1 and 6.30 for Portugal, Italy, Hungary, France and Poland, respectively. National levels of tobacco consumption, diabetes and child poverty were associated with edentulousness within countries. Oral disease in adults on hemodialysis is very common, frequently severe and highly variable among countries, with much of the variability unexplained by participant characteristics or healthcare. Given the national variation and high burden of disease, strategies to improve oral health in hemodialysis patients will require implementation at a country level rather than at the level of in iduals.
Publisher: Oxford University Press (OUP)
Date: 11-2022
DOI: 10.1111/BJD.21723
Abstract: There is limited evidence on the best available treatment options for capillary malformations (CMs), mainly due to the absence of uniform outcome measures in trials on therapies. A core outcome set (COS) enables standard reporting of trial outcomes, which facilitates comparison of treatment results. To develop a core outcome domain set (CDS), as part of a core outcome set (COS), for clinical research on CMs. Sixty-seven potentially relevant outcome subdomains were recognized based on the literature, focus group sessions, and input from the COSCAM working group. These outcome subdomains were presented in an online Delphi study to CM experts (medical specialists and authors of relevant literature) and (parents of) patients with CM (international patient associations). During three e-Delphi study rounds, the participants repeatedly scored the importance of these outcome subdomains on a seven-point Likert scale. Participants could also propose other relevant outcome subdomains. Consensus was defined as ≥ 80% agreement as to the importance of an outcome subdomain among both stakeholder groups. The CDS was finalized during an online consensus meeting. In total 269 participants from 45 countries participated in the first e-Delphi study round. Of these, 106 were CM experts from 32 countries, made up predominantly of dermatologists (59%) and plastic surgeons (18%). Moreover, 163 (parents of) patients with CM from 28 countries participated, of whom 58% had Sturge–Weber syndrome. During the two subsequent e-Delphi study rounds, 189 and 148 participants participated, respectively. After the entire consensus process, consensus was reached on 11 outcome subdomains: colour/redness, thickness, noticeability, distortion of anatomical structures, glaucoma, overall health-related quality of life, emotional functioning, social functioning, tolerability of intervention, patient satisfaction with treatment results, and recurrence. We recommend the CDS to be used as a minimum reporting standard in all future trials of CM therapy. Our next step will be to select suitable outcome measurement instruments to score the core outcome subdomains. What is already known about this topic? Besides physical and functional sequelae, capillary malformations (CMs) often cause emotional and social burden.The lack of uniform outcome measures obstructs proper evaluation and comparison of treatment strategies. As a result, there is limited evidence on the best available treatment options.The development of a core outcome set (COS) may improve standardized reporting of trial outcomes. What does this study add? A core outcome domain set (CDS), as part of a COS, was developed for clinical research on CMs.International consensus was reached on the recommended core outcome subdomains to be measured in CM trials: colour/redness, thickness, noticeability, distortion of anatomical structures, glaucoma, overall health-related quality of life, emotional functioning, social functioning, tolerability of intervention, patient satisfaction with treatment results, and recurrence.This CDS enables the next step in the development of a COS, namely to reach consensus on the core outcome measurement instruments to score the core outcome subdomains. What are the clinical implications of this work? The obtained CDS will facilitate standardized reporting of treatment outcomes, thereby enabling proper comparison of treatment results.This comparison is likely to provide more reliable information for patients about the best available treatment options.
Publisher: Wiley
Date: 21-04-2017
DOI: 10.1111/PRD.12198
Abstract: In iduals with special needs are at more risk of dental disease, including periodontal diseases, and have a greater prevalence and incidence of periodontal diseases than the rest of the population. Genetic or medical conditions, and/or the use of prescription medication or recreational substances, may further increase the risk for susceptibility to periodontal disease. The success of preventing or controlling periodontal diseases amongst this group of patients has not been established. Even those in iduals who access regular and comprehensive dental care appear to develop periodontal diseases as they age, and this development occurs at a rate comparable to the natural history of the disease. The reasons behind the lack of success of interventions in reducing the incidence of periodontal diseases are complex and part of the lack of success may relate to the professional challenges in treating in iduals with special needs.
Publisher: Wiley
Date: 02-05-2018
DOI: 10.1111/INM.12465
Abstract: Provision of smoking cessation support in the form of advice and information is central to increasing quit rates, including among people with mental illness (MI), who have 3-5 times higher odds of smoking than those without MI. This study investigated the extent and perceived utility of quit smoking advice and information available to Australian smokers with MI through face-to-face, semi-structured, in-depth interviews with 29 current smokers with MI. Qualitative analysis identified four major sources of quit smoking advice and information: (i) mental health practitioners (ii) Quitline (iii) social networks and (iv) Internet and media. All identified sources, including formal sources (mental health practitioners and Quitline), were perceived as providing inadequate information about quitting smoking, particularly regarding optimal usage of nicotine replacement therapy (NRT). Social networks emerged as a substantial source of quit smoking advice and information, especially for nontraditional methods such as vaping. Participants showed high interest in receiving support from peer-led smoking cessation groups. A minority of participants reported that they had received quit smoking information from Internet and media this was largely restricted to negative reports about e-cigarettes and short advertisements for nicotine replacement therapy. Our findings suggest that more can be done to provide smokers with MI with practical smoking cessation advice and support. Comprehensive information resources tailored for smokers with MI should be developed and disseminated via multiple pathways. We also recommend a number of policy and practice reforms to promote smoking cessation among those with MI.
Publisher: Springer Science and Business Media LLC
Date: 04-08-2015
DOI: 10.1007/S11136-015-1089-1
Abstract: Although adult attachment theory has been revealed as a useful theoretical framework for understanding a range of health parameters, the associations between adult attachment patterns and a range of oral health parameters have not yet been examined. The aim of this study was to examine potential associations between attachment insecurity and: (1) oral health-related quality of life (OHRQoL), (2) oral health behaviours, and (3) self-rated oral health. In association with this aim, s le characteristics were compared with normative data. The s le in this cross-sectional study was comprised of 265 healthy adults, recruited via convenience s ling. Data were collected on attachment patterns (Experiences in Close Relationships Scale-Short Form, ECR-S), OHRQoL (Oral Health Impact Profile-14, OHIP-14), oral health behaviours (modified Dental Neglect Scale, m-DNS), and self-rated oral health (one-item global rating of oral health). Multivariate regression models were performed. Both dimensions of attachment insecurity were associated with lowered use of favourable dental visiting behaviours, as well as decreased OHRQoL for both overall well-being and specific aspects of OHRQoL. Attachment avoidance was linked with diminished self-rated oral health. This study supports the potential value of an adult attachment framework for understanding a range of oral health parameters. The assessment of a client's attachment pattern may assist in the identification of people who are at risk of diminished OHRQoL, less adaptive dental visiting behaviours, or poorer oral health. Further research in this field may inform ways in which attachment approaches can enhance oral health-related interventions.
Publisher: Wiley
Date: 30-05-2018
DOI: 10.1111/EJE.12368
Abstract: Dentistry is known to be a challenging degree and students are often under considerable academic pressure which may lead to stress and difficulties in coping. Personality influences coping ability, yet very little is known about the personality traits of dentistry students. This study aimed to describe the personality profiles of students enrolled in an Australian undergraduate dental degree. Students enrolled in year one and two of the undergraduate dental programme at The University of Queensland were invited to complete an online survey which included the Temperament and Character Inventory (TCI). Personality was measured by four dimensions of temperament: Novelty Seeking, Harm Avoidance, Reward Dependence and Persistence and three-character traits: Self-Directedness, Cooperativeness and Self-Transcendence. Data analysis was mostly descriptive, and t tests and univariate statistics compared groups. Participants (n = 134 97% response rate females = 51%) were generally single, spoke another language at home and lived in shared accommodation. The majority (55%) were 20-29 years old, and 40% were international students. The s le had average levels of all TCI traits, except for Cooperativeness which was high. This s le of dentistry students portrayed a profile of temperament and character similar to profiles of other health profession students with the intellectual ability and drives to undertake a competitive and challenging degree. Longitudinal studies are needed to track changes in personality throughout the degree. This would provide insight into how and when to best support students.
Publisher: Wiley
Date: 12-08-2022
DOI: 10.1111/EOS.12890
Abstract: Glass ionomer (GI) cements and self‐etch (SE) or universal adhesives after etching (ER) adapt variably with dentine. Dentine characteristics vary with depth (deep/shallow), location (central eripheral), and microscopic site (intertubular eritubular). To directly compare adhesion to dentine, non‐destructive imaging and testing are required. Here, GI, ER, and SE adapted at different dentine depths, locations, and sites were investigated using micro‐CT, xenon plasma focused ion beam scanning electron microscopy (Xe PFIB‐SEM), and energy dispersive X‐ray spectroscopy (EDS). Extracted molars were prepared to deep or shallow slices and treated with the three adhesives. Micro‐CT was used to compare changes to air volume gaps, following thermocycling, and statistically analysed using a quantile regression model and Fisher's exact test. The three adhesives performed similarly across dentine depths and locations, yet no change or overall increases and decreases in gaps at all dentine depths and locations were measured. The Xe PFIB‐SEM‐milled dentine‐adhesive interfaces facilitated high‐resolution characterization, and element profiling revealed variations across the tooth‐material interfaces. Dentine depth and location had no impact on adhesive durability, although microscopic differences were observed. Here we demonstrate how micro‐CT and Xe PFIB‐SEM can be used to compare variable dental materials without complex multi‐stage specimen preparation to minimize artefacts.
Publisher: SAGE Publications
Date: 31-08-2017
Abstract: To review the quality of current smoking cessation guidelines that include recommendations for people with severe mental illness. A systematic search of scientific databases, central government health authority websites, psychiatry peak bodies, guideline clearing houses and Google was undertaken for relevant smoking cessation guidelines. Three reviewers independently assessed guideline quality using the AGREE II (Appraisal of Guidelines for REsearch and Evaluation II) instrument. Two reviewers extracted recommendations specific to smokers with severe mental illness. Thirteen guidelines met the inclusion criteria. Seven guidelines scored ⩾60% in at least four domains. Median scores for ‘Editorial independence’, ‘Rigour of development’, ‘Stakeholder Involvement’ and ‘Applicability’ were less than 60%. The highest median scores were for ‘Scope and purpose’ (87%, 69–96%) and ‘Clarity of presentation’ (87%, 56–98%). ‘Editorial independence’ (33.3%, 0–86%) and ‘Rigour of development’ (54%, 11–92%) had the lowest median domain scores. The guidelines varied greatly in their recommendations but the majority recommended nicotine replacement therapy, bupropion or varenicline as first-line pharmacotherapy, along with behavioural support. Many guidelines did not adequately report their methods or the competing interests of the authors. Future guidelines development may benefit from more specifically addressing AGREE II criteria and the needs of smokers with severe mental illness.
Publisher: Wiley
Date: 24-05-2021
DOI: 10.1111/EJE.12689
Abstract: Dental therapists, hygienists and oral health therapists constitute up to a third of the dental workforce in Australia and New Zealand. Personality is often explored in health professions to provide insights into traits that are conducive to workforce retention and to assist in planning and training. This study aimed to investigate the current demographic and personality characteristics of oral health students in Australia and New Zealand. Students in years one to three of all eight undergraduate Bachelor of Oral Health programs in Australia and New Zealand were invited to complete an online survey. The survey measured activities prior to entering into oral health, career intentions and included a personality questionnaire, the Temperament and Character Inventory (TCI). Three quarters of participants ( n = 336 30% response rate females = 90%) were single, from an urban area and 20–29 years of age. Oral health students overall portrayed high trait levels of Persistence and Cooperativeness. Cluster analysis of TCI traits identified three groups. Groups of students with high Persistence and Cooperativeness tended to be older, were working in non‐dental and dental careers prior to their degree and were interested in working in regional areas after graduation. Students with high levels of persistence and cooperativeness were interested in working in regional areas after graduation, highlighting the importance of industriousness and persistence in overcoming barriers to practicing in regional areas. Further research is warranted to investigate barriers and enablers in recruitment and retention of males in a primarily female dominated profession.
Publisher: Elsevier BV
Date: 03-2014
DOI: 10.1016/J.OOOO.2013.09.017
Abstract: This study describes the predictive value of oral epithelial dysplasia (OED) grading as an indicator for malignant transformation and progression. The records of an Australian-based pathology laboratory were searched for oral mucosal biopsies with a dysplastic or malignant diagnosis. Examination for an association with progression and malignant transformation without reinterpretation was performed. Analysis was undertaken using hazard ratios and the Fisher exact test. A total of 368 patients with a diagnosis of OED were included. Twenty-six patients (7.1%) underwent progression or malignant transformation the annual malignant transformation rate was 1%. No other characteristics were associated with a heightened risk of progression or transformation. The severity of OED was not associated with risk of malignant transformation, suggesting that the current OED grading system is not useful for predicting patient outcomes or for determining management strategies. Definitive treatment of all OED is recommended, until a more reliable progression/transformation system is developed.
Publisher: Hindawi Limited
Date: 02-01-1970
DOI: 10.1111/HSC.12423
Abstract: Social factors, health behaviours and the direct effects of substances contribute to the poor oral health and restricted access to dental services experienced by people who are dependent on drugs and/or alcohol. Admission for inpatient withdrawal management provides an opportunity for intervention to promote oral health but to be effective it must be acceptable to patients. To support intervention design, we examined patients' views about oral health, practices and treatment access, and appropriateness of health-promoting intervention in this context. Given paucity of knowledge in the area we employed a qualitative approach, data were collected in semi-structured interviews with inpatients of a public specialist alcohol and drug unit in Australia in September 2014. Analysis employed the framework approach. All 14 participants wanted 'good teeth' but few diligently attended to oral healthcare most sought assistance only in emergencies. Participants' knowledge of services was limited and practical and affective barriers hindered access. With none recalling attention to oral health during admission, support was strong for incorporation of oral health in inpatient assessments. Participants wanted information about the impact of substances on oral health and oral hygiene practices provided in various formats, and facilitated referral to non-judgemental, affordable treatment. Patients regarded promotion of oral health in the inpatient context as important, relevant and acceptable. Support should respect the different knowledge, practices and motivations for oral health and recovery, of patients. Addressing practical and affective barriers to dental services will require collaboration between drug and alcohol and dental services, and this should be the focus of further research.
Publisher: Elsevier BV
Date: 03-2013
Publisher: Springer Science and Business Media LLC
Date: 19-04-2013
Publisher: Wiley
Date: 07-01-2019
DOI: 10.1111/CDOE.12445
Abstract: The literature describing the oral health of people with Multiple Sclerosis (MS) is scant and the findings equivocal. The aim of this study was to describe the oral health and oral self-care behaviours of people living with MS and compare it to the Australian population. Participants enrolled with the Australian MS Longitudinal Study (AMSLS) were invited to participate in the survey using an online or paper-based questionnaire. Data were collected on level of disability, oral health, oral self-care and factors influencing attendance for oral health care. Completed questionnaires were received for 1523 respondents. Over one-fifth (n = 320 22%) rated their oral health as fair or poor, and more than half (n = 840 57%) reported toothache in the last 12 months. These proportions were higher than those for the general Australian adult population (oral health prevalence ratio (PR) = 1.25 [1.12, 1.40] toothache PR = 3.63 [3.39, 3.88]), and this is despite comparable or better self-maintenance habits and dental attendance reported by respondents. People with MS reported high rates of mouth dryness (68.4%), teeth sensitivity (64.7%), change of taste (40.5%) and orofacial pain (39.0%) fewer than 10% experienced none of these. There was a lower prevalence of self-reported need for treatment (extraction or filling) than in the Australian adult population (15.8% vs 32.9%). People with MS have a greater oral health burden, demonstrated by their poorer self-reported oral health than the Australian adult population. Furthermore, they experience high rates of toothache, mouth dryness, teeth sensitivity, change of taste and orofacial pain. These findings are contrary to their self-reported good oral self-care and dental attendance habits and suggest some of the oral health impacts are due to MS rather than dental behaviours.
Publisher: Wiley
Date: 23-12-2016
DOI: 10.1111/ADJ.12427
Abstract: The development of antibiotic resistance by bacteria is of global concern. Inappropriate prescribing has the potential to exacerbate this issue. We aimed to examine the patterns of prescribing of antimicrobial medicines by dental practitioners in Australia from 2001 to 2012. Data were collected from Medicare Australia on prescriptions from dental practitioners dispensed to concessional beneficiaries between 2001 and 2012. We examined patterns of use over time. There was an overall increase in number of prescriptions and in dispensed use (standardized by dose and population) of antibiotics and antifungals for the concessional population over the 12-year period. The use of dentally prescribed antibiotics increased 50%. Amoxicillin was the most commonly prescribed antibiotic accounting for 66% of all prescriptions in 2012. Generally, there was preferential prescribing of the highest dose formulations. The use of the two antifungals increased 30% over the study period with a preference for hotericin B (74%) rather than nystatin. These data show a concerning increase in prescribing of antibiotics and antifungals by dentists in Australia. It would appear that Australian dentists may not be prescribing these medicines appropriately however, further research is needed to understand prescribing behaviours and decision-making by dentists.
Publisher: Wiley
Date: 24-01-2016
Publisher: Wiley
Date: 07-03-2017
DOI: 10.1002/PON.4392
Publisher: Wiley
Date: 26-07-2019
DOI: 10.1111/ADJ.12706
Abstract: Social determinants of oral health are complex and have been described by conceptual frameworks. A widely embraced model of children's oral health was published by Fisher-Owens et al. (2007), identifying theoretical constructs influencing oral health. The current study aimed to investigate community-level constructs described in the conceptual model. The Longitudinal Study of Australian Children is a cross-sequential dual cohort study, with a representative s le (n = 10090) of Australian children. Generalized estimating equations were applied to model seven waves of carer-reported oral health and community measures. In the final model, children living in Queensland had a 1.48 (CI 1.35-1.62) increased odds of dental caries over time. Children in low socio-economic status (SES) areas (OR 1.32 CI 1.20-1.44) had an increased odds of caries. The state of Queensland (OR 1.24 CI 1.05-1.46) and poor neighbourhood liveability (OR 1.17 CI 1.05-1.31) were predictors of dental injury. By modelling available community measures, this study found SES and rurality were predictors of caries over childhood. Our results highlight the difficulty of applying conceptual models to oral health. The use of qualitative studies and realist reviews should be considered to complement statistical models to provide contextualized insights into funding, policy and service delivery on children's oral health.
Publisher: Springer Science and Business Media LLC
Date: 30-11-2018
DOI: 10.1038/S41430-017-0021-X
Abstract: While beverages are an important dietary source of water and some essential nutrients, consumption of sweet beverages has increasingly been linked to adverse health outcomes. Currently there is a paucity of longitudinal consumption data on beverage consumption in Australian children. The Longitudinal Study of Australian Children has run biennially since 2004. Twenty four-hour recall data collected over 6 waves from the birth cohort (aged 0-1 year at baseline) was analysed and demographics were assessed for associations. Five thousand one hundred and seven children participated at baseline, with a 71-90% retention of participants at each wave. Water consumption remained consistent with age over time, with more than 90% consuming more than one glass in the last 24-h. Proportions of fruit juice consumers decreased overall. Soft drink and cordial consumer proportions increased from 1% (0-1 year), to 28% (2 years) and 43% (10 years). Between 2 and 10 years, proportions of consumption of full-cream milk decreased by 8% and for skim milk this proportion increased by 51%. High proportions of consumers of soft drink/cordial was significantly associated with older children, males, children with a medical condition, living in a rural area, low socio-economic status and Indigenous Australians. Water consumption remained consistently high across the ages, while fruit juice was commonly introduced into the diet early childhood. While proportions of fruit juice consumers decreased after the age of 2 years, proportions of soft drink consumers increased. The findings from this study should assist with surveillance data and inform policy and interventions aimed at reducing consumption of sweet beverages.
Publisher: Wiley
Date: 16-06-2021
DOI: 10.1111/JDV.17376
Abstract: Due to a large variety in treatment outcomes reported in therapeutic trials and lacking patient‐relevant outcomes, it is hard to adequately compare and improve current therapies for patients with capillary malformations (CMs). The Core Outcome Set for Capillary Malformations (COSCAM) project aims to develop a core outcome set (COS) for use in future CM trials, in which we will first develop a core outcome (sub)domain set (CDS). Here, we describe the methods for the development of a CDS and present the results of the first development stage. The COSCAM project is carried out according to the recommendations of the Cochrane Skin Core OUtcomes Set INitiative (CS‐COUSIN) and the Core Outcome Measures in Effectiveness Trials (COMET) initiative. During the first stage, we identified all potentially relevant outcome subdomains based on a systematic review, two focus group sessions and input from patient representatives of Dutch patient organizations and the COSCAM‐founding group. In stage two, we will present the subdomains in a three‐round e‐Delphi study and online consensus meeting, in which CM patients, parents/caregivers and CM experts worldwide rate the importance of the proposed subdomains, hereby finalizing the core outcome (sub)domains of the CDS. A total of 67 potential outcome subdomains were included sixteen were previously used in the literature, 20 were proposed by Dutch patients and their parents/caregivers ( n = 13) in focus group sessions and 38 were suggested by the experts of the COSCAM‐founding group. Seven were excluded because of overlap. The final CDS may serve as a minimum standard in future CM trials, thereby facilitating adequate comparison of treatment outcomes. After this CDS development, we will select appropriate outcome measurement instruments to measure the core outcome subdomains.
Publisher: Wiley
Date: 27-05-2016
DOI: 10.1111/ADJ.12345
Abstract: Smoking cessation interventions delivered by dental practitioners can be as effective as those delivered by general medical practitioners. However, concern that addressing smoking may cause offence to their patients is a reason cited by dental practitioners for not regularly addressing patient smoking behaviours, despite believing they should play a role in smoking cessation. This study aimed to elicit the smoking behaviour and smoking cessation preferences of dental patients to determine if these concerns accurately reflect patient attitudes. We surveyed 726 adult dental patients attending The University of Queensland's School of Dentistry dental clinics, Brisbane Dental Hospital and four private dental practices in South-East Queensland. Most (80%) current daily smokers had tried to quit smoking. Smokers and non-smokers both agreed that dentists should screen for smoking behaviour and are qualified to offer smoking cessation advice (99% and 96% respectively). Almost all participants (96%) said they would be comfortable with their dentist asking about their smoking and that if their smoking was affecting their oral health their dentist should advise them to quit. Patients are receptive to dental practitioners inquiring about smoking behaviour and offering advice on quitting. Smoking patients showed considerable motivation and interest in quitting smoking, particularly in the context of health problems related to smoking being identified. These results should encourage dentists to raise the issue with their patients.
Publisher: Elsevier BV
Date: 12-2017
DOI: 10.1016/J.JAD.2017.07.037
Abstract: Many psychotropic medications affect oral health. This review identified oral side effects for antidepressant, antipsychotic, anticonvulsant, antianxiety and sedative drugs that are recommended in Australia for the management of common mental illnesses and provides recommendations to manage these side-effects. The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat common mental health conditions. For each medication, the generic name, class, and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (eMIMs) and UpToDate databases. Meyler's Side Effect of Drugs Encyclopaedia was used to identify additional oral adverse reactions to these medications. Fifty-seven drugs were identified: 23 antidepressants, 22 antipsychotics or mood stabilisers, and 12 anxiolytic or sedative medications. Xerostomia (91%) the most commonly reported side effect among all classes of medications of the 28 identified symptoms. Other commonly reported adverse effects included dysguesia (65%) for antidepressants, and tar e dyskinesia (94%) or increased salivation (78%) for antipsychotic medications. While xerostomia has often been reported as a common adverse effect of psychotropic drugs, this review has identified additional side effects including dysguesia from antidepressants and tar e dyskinesia and increased salivation from antipsychotics. Clinicians should consider oral consequences of psychotropic medication in addition to other side-effects when prescribing. For antidepressants, this would mean choosing duloxetine, agomelatine and any of the serotonin re-uptake inhibitors except sertraline. In the case of antipsychotics and mood stabilisers, atypical agents have less oral side effects than older alternatives.
Publisher: Wiley
Date: 24-03-2019
DOI: 10.1111/IPD.12485
Abstract: Oral health policy and funding must be informed by well-designed studies which monitor oral health and the factors which influence it. This study aimed to analyse the oral health of the Longitudinal Study of Australia Children (LSAC). The LSAC is a dual-cohort cross-sequential study run biennially since 2004. Carer-report measures for oral health were measured across six biennial waves and included frequency of tooth brushing, dental service use, and dental problems since the previous wave. A total of 10 090 Australian children participated at baseline (birth [B] n = 5017 and kindergarten [K] n = 4983). Most carers reported that children brushed daily and had regular access to dental care. Increasing age was a significant predictor of dental caries, whereas no differences were observed between time periods and cohorts. Dental caries was more frequently reported than dental injuries. Caries was highest at age eight for the B (n = 1234, 30.5%) and K (n = 1355, 31.5%) cohorts. By the age of six, caries prevalence had already begun to climb despite the majority of carers reporting good oral health behaviours for their children. Early intervention in the prevention of dental caries is essential, as children appear to attend dental services when caries is already occurring.
Publisher: Wiley
Date: 03-12-2018
DOI: 10.1111/CDOE.12438
Abstract: Research into dental diseases in children is no longer primarily focussed on biological and dietary factors, with social determinants an important influence. The aim of this study was to systematically review the focus of research on influences on children's oral health in Australia. Relevant databases were searched for English language publications between 2008 and 2017. Included studies were original research articles with a focus on influences of oral health for Australian children. A thematic synthesis approach was adopted, and included studies were coded using the Fisher-Owens et al (2007) framework which included child-, family- and community level influences. A total of 252 studies were included in this review. The focus of the included studies was most frequently on child level influences (n = 200, 79.4%), followed by community level (n = 175, 69.4%) and family (n = 86, 38.1%)-level influences. Overall, the highest proportion of included studies were on the child level influences of physical attributes (n = 86, 34.1%) and child maturing (n = 83, 32.9%). The influences with the least number of studies were social environment (n = 2, 0.8%), social support (n = 3, 1.2%) and physical safety on both a family and community levels (n = 3, 1.2% and n = 1, 0.4%, respectively). Monitoring child level influences of oral health has consistently occurred in national surveys and epidemiological studies. Family level influences are comparatively underinvestigated and should be a focus of future research in Australia. This study has helped to identify area gaps in the literature and can guide future studies.
Publisher: Informa UK Limited
Date: 10-2010
DOI: 10.1586/ERC.10.109
Abstract: Oral health has been implicated in systemic disease throughout the ages however, the understanding of the relationship between oral disease and systemic diseases such as cardiovascular disease and Type 2 diabetes mellitus is still emerging today. Chronic periodontal disease is widespread in the general population and a significant proportion of adults suffer from the most severe form of the disease. Dental plaque biofilm is necessary for the development of chronic periodontal disease with genetic and environmental factors contributing towards the pathogenesis. The putative biological mechanisms of the association between oral disease and atherogenesis are discussed, although there is insufficient evidence to establish causality at this time. Regardless of a direct causal relationship between oral disease and cardiovascular disease, treatment of oral disease leads to both a reduction in the systemic inflammatory burden as reflected in inflammatory markers and an improvement in endothelial function and hence improved overall health outcomes. A brief overview of periodontal disease including etiology, pathogenesis, screening and therapeutic implications is presented.
Publisher: SAGE Publications
Date: 2007
DOI: 10.1177/154405910708600105
Abstract: Significant associations between atherosclerosis and both Porphyromonas gingivalis, a major periodontopathogen, and the respiratory pathogen, Chlamydia pneumoniae, have been shown. Many in iduals with evidence of atherosclerosis demonstrate seropositivity to these pathogens. The aim of the present study was to examine the atherogenic effect of repeated immunizations with either or both of these agents, and to determine if molecular mimicry of bacterial heat-shock protein (HSP), termed GroEL, and host (h) HSP60 was involved. Atherogenesis was examined in apolipoprotein-E-deficient (−/−) mice following intraperitoneal immunizations with P. gingivalis, C. pneumoniae, P. gingivalis, and C. pneumoniae or vehicle. Lesion area in the proximal aorta and levels of serum antibodies to P. gingivalis, C. pneumoniae, and GroEL were measured. The increased pathogen burden of P. gingivalis, but not of C. pneumoniae, enhanced atherosclerosis. hHSP60 was detected in lesions, and in P. gingivalis-immunized mice, lesion development was correlated with anti-GroEL antibody levels, supporting the involvement of molecular mimicry between GroEL and hHSP60.
Publisher: Wiley
Date: 26-08-2014
DOI: 10.1111/IDH.12103
Abstract: The aim of this study was to describe oral mucosal screening and referral attitudes of Australian oral health therapists (OHTs) and dental hygienists (DHs). Questionnaires were distributed to participants who attended dental hygiene courses run in both regional and metropolitan Queensland. One hundred and two participants comprised 58 OHTs and 44 DHs, with a mean of 8.9 years since graduation. Thirty-four participants worked in regional locations, while 68 were from metropolitan areas. 97% of participants agreed that mucosal screening should be performed for all new and recall patients, while a minority (5%) agreed that patients will detect an oral mucosal change themselves. The majority (77%) agreed that oral cancer would be encountered in their practising career. Most participants (81%) felt comfortable discussing the presence of a suspicious lesion with patients and 88% agreed that it was their role to screen. In terms of barriers to oral cancer screening, lack of training was seen as the most prevalent barrier (56%) followed by lack of confidence (51%). Lack of time was seen as the third most prevalent barrier (40%), and lack of financial incentives was the least prevalent barrier (16%). Oral health therapists and DHs understand the importance of oral mucosal screening and are likely to be alert to oral mucosal changes. While lack of time and financial incentives was perceived to be impediments to mucosal screening, lack of confidence and training was the most prevalent barriers. This issue should be addressed through implementation of effective continuing education courses targeting oral cancer screening and referral practices.
Publisher: University of Otago Library
Date: 30-06-2022
Abstract: Introduction: The Doctor of Medicine (MD) and the Bachelor of Dental Science Honours (BDSc) degrees are challenging, with similar prerequisites regarding the scope of prior knowledge and academic performance. Studies have previously explored personality traits of students within each degree, but few have compared traits between the MD and BDSc cohorts. Methods: Successive first-year cohorts of MD and BDSc students (2015 to 2018) completed a survey including demographic questions and the Temperament and Character Inventory (TCI). Generalised estimating equations comparedTCI traits of students in the programs. Results: MD students comprised a higher proportion of students who were male, older and married artnered compared to BDSc students. Profiles of temperament and character were similar. After adjusting for sex, age and marital status, the mean scores of harm avoidance were higher, and persistence, self-directedness and cooperativeness significantly lower inBDSc compared to MD students. Conclusions: Students pursuing medicine and dentistry demonstrate some differences in trait scores, however they are not meaningfully different when interpreting their profiles. Both groups have similar personalities, indicative of coping with their challenging degrees. A supportive learning environment is paramount to that coping success.
Publisher: Wiley
Date: 10-04-2017
DOI: 10.1111/JRE.12460
Abstract: Periodontal disease has been associated with cardiovascular disease in the general population. It is unknown whether IgG antibody levels for periodontal pathogens are associated with the diagnosis of coronary artery disease (CAD) in HIV-positive in iduals. Twenty-four HIV-positive in iduals (cases) with stored plasma available in the 12 months before CAD diagnosis were age- and sex-matched 1:2 with 46 HIV-positive in iduals without CAD (controls). Antibody levels to whole cell extracts from periodontal pathogens Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans and Fusobacterium nucleatum, as well as markers of inflammation sCD14, CXCL10 and high-sensitivity C-reactive protein, were compared between cases and controls using enzyme-linked immunosorbent assays. P. gingivalis-specific IgG levels (μg/mL) were significantly higher in in iduals with CAD (median 1.48 [IQR 1.06-2.05]) compared to controls (0.70 [IQR 0.35-1.24], P<.001), and remained significantly higher following adjustment for traditional cardiovascular risk factors and HIV viral load (OR 21.6 [95% CI 3.73-125.63] P=.001). There was a borderline association between A. actinomycetemcomitans IgG antibody levels (cases, median 3.86 [IQR 3.19-4.72] controls, 3.34 [IQR 2.59-4.07], P=.050) and no association found between F. nucleatum antibody levels and CAD. sCD14 levels (μg/mL) were higher in cases compared with controls (median 3.45 [IQR 3.03-4.11] vs 2.65 [IQR 2.32-2.99] P<.001), while CXCL10 (median 127 pg/mL [IQR 88-157] vs 153 [IQR 90-244] P=.321) and high-sensitivity C-reactive protein (median 3.44 mg/L [1.98-5.32] vs 1.85 [1.13-6.88] P=.203) levels were not different between cases and controls. Periodontal bacteria may be contributing to CAD risk in HIV-positive in iduals.
Publisher: Elsevier BV
Date: 08-2023
Publisher: BMJ
Date: 12-01-2016
DOI: 10.1136/TOBACCOCONTROL-2015-052713
Abstract: YouTube is the most popular video sharing website, and is increasingly used to broadcast health information including smoking cessation advice. This study examines the quality and quantity of YouTube quit smoking videos targeted at people living with mental illness (MI). We systematically searched YouTube using selected relevant search terms. The first 50 videos obtained for each search term were screened for relevance and further videos screened through snowball s ling. Forty unique, English language videos focussing on people with MI were included in the assessment and evaluated for general video characteristics, themes, format, targeted smoking cessation and harm reduction information. Most videos either discussed the problem of high smoking rates among people with MI (n=12) or smoking cessation programmes and policies at an institutional level (n=13). Only nine videos were aimed at providing quit smoking advice to this population. One video recommended higher doses of nicotine replacement therapy (NRT) for people with MI while six videos referred to possible changes in medication dosage on quitting smoking. Four videos suggested cutting down smoking for harm reduction. Very few YouTube videos specifically focus on the problem of high smoking rates among people with MI and even fewer provide targeted smoking cessation and harm reduction advice for this priority population. There is a need to develop comprehensive, evidence based, quit smoking video resources for smokers with a MI.
Publisher: MDPI AG
Date: 23-11-2016
Publisher: Oxford University Press (OUP)
Date: 25-01-2016
DOI: 10.1111/IJPP.12241
Abstract: To investigate community pharmacist's attitudes, beliefs and practices towards oral health in the Australian setting, describe the frequency and nature of consumer enquiries relating to oral health, and gain insight regarding smoking cessation support for people experiencing oral health problems. An online questionnaire was developed based on previous research, validated to ensure accuracy and reliability, and convenience s ling used to advertise across major pharmacy organisational websites and newsletters to maximise community pharmacist responses. One hundred and forty-four valid community pharmacist responses were descriptively analysed. The majority of pharmacists (93%) believed it was their role to deliver oral health advice in the community and almost all (97%) pharmacists believed further education would benefit their practice. The top four consumer enquiries pharmacists reported confidence in handling related to analgesic medication to relieve oral-related pain (95.8%), mouth ulcers (95.1%), oral thrush (94.4%) and toothache (93.8%) and the most frequently reported consumer enquires were those where the majority of pharmacists reported high confidence in handling. A small proportion of pharmacists (8%) always enquired about patient smoking status, and nearly all pharmacists (97%) desired further education and training to benefit their practice in oral healthcare. This study highlights that Australian pharmacists have an important role in oral health and there is opportunity to enhance this role, and address risk factors such as smoking with further training, support and education. The findings from this study can guide future research into the development of appropriate training programmes, standards, and best oral healthcare practices for Australian pharmacists.
Publisher: Wiley
Date: 02-2021
DOI: 10.1111/EJE.12666
Abstract: The transactional model of stress is a framework describing the process for coping with stressful events as a relationship between the in idual person and environment. This study aimed to investigate the associations between personality, learning environment and experiences of mental health for a cohort of Australian dentistry students. Students were invited in 2017 to complete an online questionnaire including the Depression, Anxiety and Stress Scale (DASS‐21), The Dundee Ready Education Environment Measure (DREEM) and Cloninger’s Temperament and Character Inventory (TCIR‐140). Students were followed‐up one year later, and generalised estimating equations were used. A total of 219 (response 73.5%) students participated in the study. Two personality profiles of dentistry students were identified. Group 1 were significantly higher in the traits persistence, self‐directedness, cooperativeness and reward dependence, whereas Group 2 were significantly higher in harm avoidance. Students with Group 2 personality had a 3.12 (CI:1.72‐5.65) increased odds of depression compared to Group 1 students. Compared to students with positive perceptions of the learning environment, students with negative perceptions had increased odds of stress (3.48, CI: 1.85‐6.53), depression (2.71, CI: 1.57‐ 4.65) and anxiety (2.59, CI: 1.56‐4.28). Students with personalities high in levels of self‐directedness, cooperativeness and persistence and low in harm avoidance, as found in Group 1, demonstrate high levels of general well‐being. Positive perceptions of the dentistry learning environment were found to be an important influence on students stress. This study highlighted a number of factors important to student well‐being and provides direction for further investigation of interventions aimed at enhancing student well‐being.
Publisher: Wiley
Date: 05-01-2016
DOI: 10.1111/ADD.13253
Abstract: To explore how smoking and smoking cessation is perceived within the context of disadvantage, across a broad cross-section of defined populations vulnerable to social disadvantage. Qualitative focus groups with participants recruited through community service organizations (CSO). Metropolitan and regional settings in Queensland, Australia. Focus groups were held at the respective CSO facilities. Fifty-six participants across nine focus groups, including people living with mental illness, people experiencing or at risk of homelessness (adult and youth populations), people living with HIV, people living in a low-income area and Indigenous Australians. Thematic, in-depth analysis of focus group discussions. Participant demographic information and smoking history was recorded. Smoking behaviour, smoking identity and feelings about smoking were reflective of in idual circumstances and social and environmental context. Participants felt 'trapped' in smoking because they felt unable to control the stressful life circumstances that triggered and sustained their smoking. Smoking cessation was viewed as an in idual's responsibility, which was at odds with participants' statements about the broader factors outside of their own control that were responsible for their smoking. Highly disadvantaged smokers' views on smoking involve contradictions between feeling that smoking cessation involves personal responsibility, while at the same time feeling trapped by stressful life circumstances. Tobacco control programmes aiming to reduce smoking among disadvantaged groups are unlikely to be successful unless the complex interplay of social factors is carefully considered.
Publisher: Wiley
Date: 18-07-2018
DOI: 10.1111/EJE.12384
Abstract: Continuous evaluation and improvement of the learning environment are required to respond to the changing nature of dental practice and dental education. This study aimed to describe a cohort of undergraduate dentistry students' perceptions of their learning environment. Students enrolled in years 1-4 of the Bachelor of Dental Science (Honours) programme at The University of Queensland were invited to complete an online survey which included demographics and the Dundee Ready Education Environment Measure (DREEM). This scale measures students' perception of the educational environment overall, and for five domains: Learning, Teaching, Academic self-perception, Atmosphere and Social self-perception. Data analysis was mostly descriptive, t tests and univariate statistics compared groups. Participants (N = 192 females = 57%) were generally positive about their learning environment, with a total DREEM score of 127 of 200. Overall, Academic and Social self-perception domain scores were ranked lower than others. Students in preclinical years of study and/or had dentistry as a first career preference were more positive across all domains, except Social self-perception. Differences between the preclinical and clinical phases of the curriculum point to the structure of teaching and learning in health professional degrees. Further research should investigate how each environmental domain more specifically correlates with other aspects of the curriculum and student progression, including well-being. This could include logistical factors such as timetabling and its effect on physical well-being, to less tangible factors that may impact on mental well-being.
Publisher: Wiley
Date: 31-05-2017
DOI: 10.1111/ADJ.12510
Abstract: Many medications used to manage multiple sclerosis (MS) affect oral health. This review aimed to identify the oral side-effects of the current drugs recommended in Australia to treat MS and make dental practitioners aware of the range of symptoms. The Australian Therapeutic Guidelines and the Australian Medicines Handbook were searched for medications used to treat MS. For each medication, the generic name, class, route of administration, dosage and drug company reported side-effects were extracted from the online Monthly Index of Medical Specialties (MIMs) database. Meyler's Side-effect of Drugs Encyclopaedia was used to identify any additional oral adverse reactions to medications used to treat MS. Fourteen drugs were identified for the treatment of MS progression and 13 drugs for the treatment of MS symptoms. For these medications, 18 oral side-effects were documented: xerostomia was the most common, followed by dysgeusia, dysphagia, mouth ulceration and sinusitis. Anticholinergic drugs caused xerostomia while immunosuppressants resulted in more infection-related side-effects. Dental practitioners should be aware of the range of symptoms likely to be reported by this population. Clinicians are encouraged to continue providing dental care for their patients who develop MS and refer complex cases to specialists.
Publisher: Wiley
Date: 10-05-2017
DOI: 10.1111/DAR.12549
Abstract: Indigenous Australians experience a significant gap in life expectancy compared with non-Indigenous Australians. Indigenous communities have high-smoking prevalence and low engagement with cessation therapies. This qualitative research, conducted in an urban Australian Indigenous community, explored smokers' views on smoking, quitting and engagement with current nicotine replacement therapies. Opinions on acceptability of tobacco harm reduction were sought. We explored the acceptability of novel nicotine products, that is, new or unfamiliar products, including non-therapeutic options, such as e-cigarettes. Focus groups and in idual interviews with adult Indigenous daily smokers (n = 27) were used. Current and novel nicotine products were displayed and demonstrated. Discussions were audio-recorded, transcribed and analysed thematically. Participants expressed interest in trying existing and novel nicotine products. Short-to-medium term use of nicotine replacement therapy for quitting was generally acceptable views on long-term use were mixed. Interest in use of tobacco substitutes depended on their perceived effectiveness, providing a 'kick' and 'relieving stress'. Desirable qualities for tobacco substitutes were identified with gender differences and product preferences noted. The unpleasant taste of existing products is a barrier to both short-term and long-term use. We found substantial interest in trying some existing and novel nicotine products, mostly for short-term use. A number of attributes were identified that would make nicotine products potentially acceptable as a long-term substitute. Some participants were interested in long-term substitution if acceptable products were available. Improvements in current products and access to novel products are needed if tobacco harm reduction is to be acceptable. [Yuke K, Ford P, Foley W, Mutch A, Fitzgerald L, Gartner C. Australian urban Indigenous smokers' perspectives on nicotine products and tobacco harm reduction. Drug Alcohol Rev 2018 :87-96].
Publisher: Wiley
Date: 26-02-2015
DOI: 10.1111/ADJ.12270
Abstract: Smoking is a significant health and economic burden in Australia. Studies of smoking cessation practices in dental settings have primarily concentrated on dentists rather than other oral health practitioner (OHP) groups (dental hygienists, dental therapists and oral health therapists). The aim of this study was to measure Australian OHPs' attitudes, behaviours, interest and barriers to delivering smoking cessation interventions. Members of the two peak professional bodies representing Australian OHPs were invited to participate in an anonymous online questionnaire. There were discrepancies between practitioner attitudes and current smoking cessation practices. While the majority of practitioners (90.1%) frequently screened for smoking behaviour, fewer (51.1%) assisted patients to quit smoking. The principal form of assistance was referral to Quitline (45.7%) or to a general medical practitioner (44.4%). The most prevalent barriers identified were lack of knowledge of pharmacological treatments (45.8%) and lack of access to smoking cessation resources (44.2%). Contrary to international studies, time and financial incentive were not commonly cited barriers to delivering smoking cessation interventions. This survey identifies a need for continuing education in smoking cessation practice. Dissemination of policies, guidelines and resources may assist OHPs to become more engaged and confident in delivering smoking cessation interventions as part of their routine practice.
Publisher: Elsevier BV
Date: 12-2018
DOI: 10.1016/J.EVALPROGPLAN.2018.08.002
Abstract: Access to dental care is poorer for people experiencing homelessness and disadvantage due to barriers such as lengthy waiting lists, lack of transport, lack of information and fear of authorities and treatment. This study aimed to evaluate a system integration model for oral health care for clients of homeless services in Brisbane, Australia. This model aimed to provide a facilitated access pathway between homeless community organisations and a public dental service to improve access to dental care. Participants were adult (≥18 years) clients Brisbane homeless community organisations. Those who participated in the intervention evaluation completed a questionnaire, had their oral health screened and followed up for feedback at their dental appointment. Seventy-six clients of community organisations in Brisbane participated in the intervention and its evaluation. Fear was a barrier to accessing dental services for 23% (n = 18). Attendance to the subsequent appointments at the public dental clinic was high, with 85% (n = 64) attending their first appointment. A higher proportion of participants who had surgical and prosthodontic treatment needs at the screening did not attend their appointment compared to those with other needs. Overall the model piloted in this study had positive outcomes with high attendance rates to the dental facility and positive experiences by participants.
Publisher: Oxford University Press (OUP)
Date: 22-05-2018
Abstract: Despite a clear causal link between frequent consumption of sugar-sweetened beverages (SSBs) and dental disease, little is known about the implications of a tax on SSBs in the context of oral health. The aim of our study was to estimate the impacts of a SSB tax on the Australian population in the context of oral health outcomes, dental care utilisation and associated costs. We designed a cohort model that accounted for the consequences of the tax through the mechanisms of consumer response to price increase, the effect on oral health due to change in sugar intake, and the implications for dental care use. Our results indicate that in the adult population an ad valorem tax of 20% would lead to a reduction in decayed, missing and filled teeth (DMFT) by 3.9 million units over 10 years, resulting in cost savings of A$666 million. Scenario analyses show that the outcomes are sensitive to the choice of the time horizon, tax rate, price elasticity of demand for SSBs, and the definition of target population. We found that the total and per-person consequences of SSB tax were considerable, both in terms of dental caries (tooth decay) averted and dental care avoided. These results have to be compounded with the implications of SSB tax for other aspects of health and health care, especially in the context of chronic diseases. On the other hand, the improved outcomes have to be weighted against a welfare loss associated with introducing a tax.
Publisher: Hindawi Limited
Date: 27-08-2018
DOI: 10.1111/HSC.12644
Abstract: The relationship between homelessness and ill health is complex, and many risk factors for homelessness such as unemployment, low income, and substance abuse are also risk factors for poor oral health. In order to overcome barriers to access dental care, previous studies have recommended integrating dental care, referral pathways, and information within the overall care provided by support services available to people at risk of homelessness. This study aimed to evaluate a dental service developed and implemented to improve access to oral health care of disadvantaged youth in Brisbane. A mobile dental clinic run by volunteer dental professionals was implemented into a community organisation for disadvantaged youth. Participants were clients of Brisbane Youth Services who were disadvantaged youth, ≤25 years and attended the dental clinic in a 1 year period. A questionnaire collected demographic information, a self-assessment of oral health and an evaluation of their experiences with the dental clinic. Clinical data including DMFT, appointment attendance and items of service provided were collected. One hundred and twelve clients participated in the four dental clinic weeks and its evaluation. Cost was the greatest reported barrier to accessing dental care among participants. More than half (57%) of participants who pre-booked an appointment failed to attend. A total of 640 services were delivered, with an estimated value of $48,000. The majority (69%, n = 444) of the services provided were preventative services. Almost all of the clients felt the service they received was suitable for them (97%, n = 98) and would use the service again (98%, n = 99). This dental clinic model is feasible and sustainable due to its integration into an existing homeless youth service, low running costs, acceptability to clients and an interest by dental practitioners to volunteer. It provides a useful model which could be scaled up and implemented in other regions.
Publisher: Wiley
Date: 28-05-2022
DOI: 10.1111/CDOE.12662
Abstract: Studying parent‐child pair health provides the opportunity to identify risk factors and opportunities for oral health prevention and intervention focusing on the family context. The aim of this study was to describe the oral health of children aged 11‐12 years and their parents in a national s le of parent‐child dyads in Australia. The Child Health CheckPoint is a study of 11 to 12‐year‐old children and one parent nested within the Longitudinal Study of Australian Children, a nationally representative cohort study. In 2015‐16, the study collected two‐dimensional photographic intra‐oral images and was scored using visual assessments of the teeth, oral hygiene and malocclusion. Of the 1874 CheckPoint families, 1396 biological parent‐child pairs had at least one oral health measure recorded. Over two‐thirds of children had moderate to severe gingival inflammation (69.7%, 95%CI 64.7‐74.9). Parents had a lower proportion of poor oral hygiene (2.1%, 95% CI 1.4‐3.0) than children (13.0%, 95% CI 11.3‐14.9). High concordance was seen in the Modified Gingival Index correlation coefficient 0.49 (95%CI 0.44‐0.53). The high concordance in gingival health between child‐parent pairs supports the familial and behavioural links established in previous studies. Children had poorer oral hygiene but fewer visible dental caries lesions than their parents. As dental caries is a chronic and cumulative disease, preventive interventions targeting children's oral hygiene are needed.
Publisher: Elsevier BV
Date: 04-2014
DOI: 10.1016/J.EJON.2013.10.010
Abstract: Head and neck cancer (HNC) treatment disrupts quality of life and is associated with in idualised supportive care needs. This study aimed to describe the support needs that affected the QoL of HNC patients, and to describe how patients coped with unmet support needs. Qualitative, semi-structured interviews were held with 8 participants previously treated for HNC. Participants were identified through snowball and convenience s ling methods. Interview data was analysed using content analysis (CA). Inductive CA was used to describe support needs and directed CA was guided by the stress appraisal and coping model to describe coping with unmet support needs. Support needs that affected QoL related to acute needs while undergoing treatment and support in coping with permanent treatment side effects. Coping with psychological stressors (i.e. depression and anxiety) affected QoL in the first six to twelve months following treatment. Coping was influenced by loss of access to the supportive hospital environment after treatment, and resulted in feelings of isolation post treatment. HNC patients drew support from professional and personal networks while undergoing treatment and post treatment. Patients described difficulties in coping with the side effects of treatment and accessing supportive care when away from the hospital setting. The transactional model of stress, appraisal and coping is useful in understanding the psychosocial outcomes of head and neck cancer however conclusions from this study are limited by a small and homogenous s le.
Publisher: Wiley
Date: 25-12-2018
DOI: 10.1111/IDH.12376
Abstract: Managing oral health after the treatment for head and neck cancer requires meticulous daily oral hygiene practices and regular professional dental care however, the in idual factors and health system structures required to achieve oral health are often not well considered. This study aimed to explore how oral health was understood and managed after head and neck cancer treatment and identify factors that influenced oral health behaviours and dental service utilization. A qualitative, inductive approach was used for data collection and analysis. S ling of participants was purposive, using a maximum variation approach, and data were analysed using thematic analysis. Participants were recruited from the maxillofacial clinic at a tertiary facility in Brisbane, Queensland, Australia. Twenty-one participants took part in the study. Findings described in idual and structural factors that influenced the management of oral health post-treatment. In idual determinants of oral health behaviours included a cognitive shift towards lifelong oral health management of unexpected barriers and management of competing priorities. Structural factors included availability, accessibility of services, and continuity of care. The ability to fund oral health emerged as a salient theme that influenced both in idual and structural factors. Strong self-efficacy and financial and spousal support enhanced the management of oral health, whereas difficulty managing competing issues post-treatment, such as psychological and financial stress, limited participants' capacity to prioritize and manage oral health. Policy initiatives are needed to address the structural barriers caused by a lack of timely access to general and preventive dental care post-treatment.
Publisher: Oxford University Press (OUP)
Date: 29-09-2014
DOI: 10.1093/NDT/GFT401
Abstract: Oral disease may be increased in people with chronic kidney disease (CKD) and, due to associations with inflammation and malnutrition, represents a potential modifiable risk factor for cardiovascular disease and mortality. We summarized the prevalence of oral disease in adults with CKD and explored any association between oral disease and mortality. We used systematic review of observational studies evaluating oral health in adults with CKD identified in MEDLINE (through September 2012) without language restriction. We summarized prevalence and associations with all-cause and cardiovascular mortality using random-effects meta-analysis. We explored for sources of heterogeneity between studies using meta-regression. Eighty-eight studies in 125 populations comprising 11 340 adults were eligible. Edentulism affected one in five adults with CKD Stage 5D (dialysis) {20.6% [95% confidence interval (CI), 16.4-25.6]}. Periodontitis was more common in CKD Stage 5D [56.8% (CI, 39.3-72.8)] than less severe CKD [31.6% (CI, 19.0-47.6)], although data linking periodontitis with premature death were scant. One-quarter of patients with CKD Stage 5D reported never brushing their teeth [25.6% (CI, 10.2-51.1)] and a minority used dental floss [11.4% (CI, 6.2-19.8)] oral pain was reported by one-sixth [18.7% (CI, 8.8-35.4)], while half of patients experienced a dry mouth [48.4% (CI, 37.5-59.5)]. Data for kidney transplant recipients and CKD Stages 1-5 were limited. Oral disease is common in adults with CKD, potentially reflects low use of preventative dental services, and may be an important determinant of health in this clinical setting.
Publisher: Emerald
Date: 03-04-2018
Abstract: Australian sales of hyperpalatable beverages (HPB) (a term used to describe naturally or artificially sweet beverages) have followed a consistent upward trend since 2000. The purpose of this paper is to examine HPB brand placements in the top 20 annual highest grossing movies in Australia in 2010-2014. A content analysis was undertaken on the 20 highest grossing movies annually from 2010 to 2014. Movies were analysed according to the prevalence and portrayal of branded beverages. In total, 35 per cent of movies contained an HPB brand placement. Movies were more likely to be classified M, MA15+, R/R18+, and categorised as comedy, or action/adventure genre. Soft drinks were the most prevalent category (60.9 per cent), and Coca Cola Company manufactured 40.6 per cent of the brands that were embedded throughout the movies. This study revealed some of industry’s non-direct marketing strategies through HPB placement in movies. Findings suggest that further scrutiny is needed of the relatively underresearched medium of beverage advertising.
Publisher: Wiley
Date: 03-2021
DOI: 10.1111/ADJ.12846
Abstract: Prescribing of antibiotics by dentists for surgical prophylaxis or as an adjunct to managing dental infections is a substantial part of the overall landscape for prescribed antibiotics in health care settings. We explored trends in the antibiotic prescribing patterns of Australian dentists over the 12‐year period, 2005–2016. We obtained data on dispensed prescriptions of antibiotics from registered dentists subsidized on the Pharmaceutical Benefits Scheme. Australian dentists were responsible for almost 7 million dispensed prescriptions of antibiotics over 12 years an average of 24 prescriptions per year per dentist. The most commonly prescribed antibiotic was amoxicillin, followed by amoxicillin + clavulanic acid and metronidazole. These top three antibiotics constituted more than 80% of all antibiotics prescribed and their use increased dramatically over time. There was a large increase in the prescribing of broad‐spectrum antibiotics over time, most of which occurred from 2011 to 2016. Excessive prescribing of broad‐spectrum antibiotics runs contrary to national antimicrobial stewardship (AMS) initiatives and guidelines. Multifaceted educational strategies are essential to align prescribing with current best practice. High‐level evidence to inform clear guidelines on antibiotic prescribing in dental infections, with audit and feedback, should reduce the inappropriate use of antibiotics in dentistry.
Publisher: AMPCo
Date: 03-2018
DOI: 10.5694/MJA17.00777
Publisher: Wiley
Date: 28-09-2016
DOI: 10.1111/CDOE.12263
Abstract: The symptoms of multiple sclerosis ( MS ) can affect oral care and access to dental services, but there is limited literature describing the oral health and perceived oral healthcare needs of people with MS . This study aimed to explore the oral health experiences, oral health behaviours and barriers to accessing dental care perceived by people living with MS in Australia. Six focus groups were held across two metropolitan areas (Brisbane, Queensland and Melbourne, Victoria) and one regional area (Toowoomba, Queensland). Focus group data were analysed using thematic analysis. Living with MS was a highly in idual experience due to the range of symptoms that may be experienced. In addition to having different symptom experiences to others with MS , in idual symptoms also differed on a daily basis as the disease relapsed and remitted. The physical expressions of MS directly and indirectly affected the oral health of participants. Additionally, oral health was affected by the side effects of medications and orofacial pain symptoms. Depending on the symptoms experienced by the in idual, personal oral hygiene was affected and professional dental appointments were difficult. Participants also experienced structural barriers to accessing professional dental care including difficulty accessing transport to‐and‐from dental appointments, space limitations in the dental surgery and financial barriers to care. Dental care was perceived to be inflexible and was not tailored to in idual experiences of MS , which contributed to perceptions of poor quality and appropriateness of care. It is important for dental professionals to offer tailored and in idualized dental care when treating people with MS . Our findings suggest that there needs to be greater interprofessional communication and referral to manage atypical dental pain symptoms. Oral health education for people with MS should include altered strategies to performing daily oral hygiene, the management of xerostomia and advice regarding low cariogenic diets suitable for dysphagia. Additionally, policy and strategies to improve the oral health of people with MS should focus on enhancing access through transport, reducing the cost of dental services to the in idual and providing domiciliary oral health care.
Publisher: MDPI AG
Date: 22-12-2016
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/HR15001
Abstract: History is replete with debates between health professionals with concerns about practices and products and others who either challenge scientific evidence or believe that the greatest public good is achieved through maintenance of the status quo. This paper provides a 1950s socio-scientific perspective on a recurring problem for health professionals. It analyses dentists' promotion of oral health by discouraging sugar consumption and the sugar industry's defence of its staple product. Despite scientific evidence in support of its case, the dental profession lacked influence with government and large sections of the Australian community. The ision of powers within the Australian Constitution, together with the cause, nature and ubiquity of caries and Australians' tolerance of the disease, were relevant to the outcome. In contrast, the sugar industry was a powerful force. Sugar was a pillar of the Australian and Queensland economies. The industry contributed to the history of Queensland and to Queenslanders' collective psyche, and enjoyed access to centralized authority in decision-making. The timing of the debate was also relevant. Under Prime Minister Robert Menzies, the Australian Government was more concerned with promoting industry and initiative than oral health. This was a one-sided contest. Patterns of food consumption evolve from interactions between availability, culture and choice. Food and associated etiquettes provide far more than health, nutrients and enjoyment. They contribute to economic and social development, national and regional identity and the incidence of disease. The growing, milling and processing of sugarcane and the incorporation of sugar into the Australian diet is a case study that illuminates the interface between health professionals, corporations, society and the state. Today, for a variety of reasons, health professionals recommend limits for daily intake of sugar. Calls for dietary reform are not new and invariably arouse opposition. The issue came to the fore between 1945 and 1960, when dentists contended that the consumption of sugar either caused or contributed to a major health problem, namely dental caries (tooth decay). Representatives of the sugar industry defended their staple product against these claims, which emerged at a critical time for the industry. With hindsight, these exchanges can be seen as a precursor to more erse and recurring debates relating to contemporary health c aigns. This paper documents and analyses the contemporaneous scientific and socio-political backgrounds underpinning these engagements
Publisher: Elsevier BV
Date: 12-2013
DOI: 10.1016/J.OOOO.2013.08.005
Abstract: Clinical identification of underlying histopathology of oral mucosal lesions (OMLs) remains difficult. The study aims to identify clinical indicators of underlying histopathology of oral malignant and potentially malignant disorders. All clinical patient records of an oral medicine and pathology clinic over a 12-year period were manually searched. Cases of OMLs with a histopathologic diagnosis of dysplasia (n = 124) and malignancy (n = 27) and a s le of nondysplastic OMLs (n = 109) were analyzed using both univariate and multivariate analysis and odds ratios for an association with clinical characteristics. A nonhomogeneous clinical appearance was strongly associated with underlying dysplasia in both univariate and multivariate analysis (P < .001 odds ratio, 4.4). For lesions with homogeneous appearance, dysplasia was associated with lesion location (P = .005 odds ratio, 2.6) and smoking history (P = .04). These findings suggest that a nonhomogeneous mucosal lesion is a significant independent indicator for underlying oral epithelial dysplasia, with location, size, and color as additional contributing factors.
Publisher: Wiley
Date: 26-05-2014
DOI: 10.1111/ADJ.12167
Abstract: Homeless people experience a much higher burden of general health conditions and have much poorer oral health than the rest of the population. The aim of this study was to determine the oral health impacts and general quality of life of an urban homeless population. A convenience s le of 58 adults (dentate n = 56) experiencing homelessness were assessed using a survey which included the 14-item Oral Health Impact Profile and the 26-item World Health Organization's Quality of Life - short version. A subset (n = 34) also underwent a dental examination. The study participants were younger, more likely to be Indigenous, smoked daily and avoided dental care because of cost than the rest of the population. Dentate homeless adults reported significantly greater oral health impacts when compared with the Australian dentate population. General quality of life was significantly poorer than for the rest of the population. Treatment need was associated with greater oral health impacts. Poor oral health is prevalent and adversely impacts quality of life for homeless people, but it is only one of a range of complex social and health challenges being faced by these in iduals. Dental care should be better integrated within homeless support services.
Publisher: Elsevier BV
Date: 11-2021
Publisher: Wiley
Date: 03-02-2018
DOI: 10.1111/INM.12314
Abstract: Reducing the burden of physical illness among people living with severe mental illnesses (SMI) is a key priority. Smoking is strongly associated with SMIs resulting in excessive smoking related morbidity and mortality in smokers with SMI. Smoking cessation advice and assistance from mental health practitioners would assist with reducing smoking and smoking-related harms in this group. This study examined the attitudes and practices of Australian mental health practitioners towards smoking cessation and tobacco harm reduction for smokers with SMI, including adherence to the 5As (ask, assess, advise, assist and arrange follow up) of smoking cessation. We surveyed 267 Australian mental health practitioners using a cross-sectional, online survey. Most practitioners (77.5%) asked their clients about smoking and provided health education (66.7%) but fewer provided direct assistance (31.1-39.7%). Most believed that tobacco harm reduction strategies are effective for reducing smoking related risks (88.4%) and that abstinence from all nicotine should not be the only goal discussed with smokers with SMI (77.9%). Many respondents were unsure about the safety (56.9%) and efficacy (39.3%) of e-cigarettes. Practitioners trained in smoking cessation were more likely (OR: 2.9, CI: 1.5-5.9) to help their clients to stop smoking. Community mental health practitioners (OR: 0.3, CI: 0.1-0.9) and practitioners who were current smokers (OR: 0.3, CI: 0.1-0.9) were less likely to adhere to the 5As of smoking cessation intervention. The results of this study emphasize the importance and need for providing smoking cessation training to mental health practitioners especially community mental health practitioners.
Publisher: Springer Science and Business Media LLC
Date: 22-05-2017
Publisher: Wiley
Date: 23-08-2013
DOI: 10.1111/IDH.12051
Abstract: This review aims to systematically review the literature describing quality of life (QoL) outcomes and support needs in patients with oral cancer along the cancer trajectory. This is needed to form an evidence base for the design of interventions that enhance outcomes for this group. Six electronic databases were searched. The results were screened for eligibility, and articles were included if they described patient-reported QoL outcomes that were translatable to support needs in patients with oral cancer. Data were extracted and synthesized according to the support needs identified and their relative impact on QoL. Methodological quality was assessed using the Effective Public Health Practice Project (EPHPP) Quality Assessment Tool. Thirty-one articles met the inclusion criteria. Support needs related to coping with the burden of radiotherapy in both psychosocial and physical aspects, swallowing dysfunction, dry mouth and oral functional deficits. Issues of depression, anxiety and malnutrition were identified as having a significant impact on QoL. Oral cancer support needs are highly subjective and varied in severity across the cancer continuum. Support needs that may warrant further investigation include management of changes to oral health and functioning, swallowing and nutritional compromise and psychological effects of cancer and treatment.
Publisher: Wiley
Date: 20-08-2019
DOI: 10.1111/EJE.12459
Abstract: Dentistry students face a challenging academic and clinical curriculum that can result in depression and anxiety. While studies usually report sources of stress for dentistry students, there is less information on levels of stress. This study used the Depression, Anxiety and Stress Scale (DASS-21), to report perceived levels of depression, anxiety and stress in a cohort of Australian undergraduate dentistry students. Students enrolled in years 1-4 of the Bachelor of Dental Science (Honours) program at The University of Queensland were invited to complete the DASS-21 using an online questionnaire. Students completed the same questionnaire 1 year later. At baseline, the mean DASS-21 scores for this cohort (n = 179 females = 56%) were in the normal range for depression (4.69, SD 3.87) and stress (5.50, SD 3.65), and mild range for anxiety (4.25, SD 3.21). Overall, 24% (n = 42), 44% (n = 78) and 11% (n = 20) of students had moderate or above levels of depression, anxiety and stress, respectively. At 1-year follow-up, DASS-21 scores were not significantly different. Dental students have higher levels of depression, anxiety or stress than the general population, indicating they may be at risk for greater psychological distress. The information from this study should guide curriculum and learning environment design, as well as interventions to support students through this challenging degree.
Location: United States of America
Start Date: 02-2020
End Date: 12-2023
Amount: $249,993.00
Funder: Australian Research Council
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