Papers by Kaye Roberts-Thomson
BMC Oral Health, Oct 24, 2018
Background: Dental general anaesthetics undertaken on young children are amongst the most common ... more Background: Dental general anaesthetics undertaken on young children are amongst the most common of all potentially preventable hospitalisations of children in Australia. They are costly for families and the community and entail some risk. The aim of the study was to explore the views of stakeholders about factors associated with children's dental general anaesthetics in Victoria, Australia and to identify policy implications. Methods: Interviews with stakeholders were used to develop a framework of factors. Interview data were subject to qualitative analysis, informed by Interpretative Phenomenological Analysis. Results: Eight themes that encompassed 30 main factors were identified through focused discussions with 16 stakeholders. While the safety of dental general anaesthetics has improved and mortality rates are low, side effects are common. Push factors for children's dental general anaesthetics include a perceived greater 'child-focus'; preferred models of care; low oral health literacy; parent guilt; convenience; and some dentists reluctance to treat high needs children in the clinic. Factors that may decrease the prevalence of dental general anaesthetics include: prevention of dental caries; using alternative approaches; an appropriate workforce mix; enhancing oral health literacy; and development of guidelines. The prevalence of hospitalisation of children to treat dental caries is increasing. Many factors influence the prevalence of paediatric dental general anaesthetics -relating to the child, parent, oral health professional, financial impact, health risk, and accessibility to facilities. There are quality of care and convenience benefits but also high costs and possible health risks. Family, workforce and health system factors have been identified that could decrease the prevalence of paediatric dental general anaesthetics.
Australian Dental Journal, Jun 1, 2020
Background: The use of fluoride involves a balance between protection against caries and risk of ... more Background: The use of fluoride involves a balance between protection against caries and risk of dental fluorosis. Prevalence and trend of dental fluorosis in the adult population are not frequently reported. Objective: To describe the prevalence of dental fluorosis in the Australian adult population. Method: Data from the National Study of Adult Oral Health (NSAOH) 2004-06 and 2017-18 were used. Prevalence of fluorosis was reported using data from the NSAOH 2017-18. Case definitions of fluorosis were as follows: having a TF score of 2+ (TF2+) or a TF score of 3+ (TF3+) on one or more maxillary central incisors. Synthetic cohorts were constructed by year of birth allowing for time trend analysis. Results: One in ten Australian adults were found to have dental fluorosis at TF2+. The prevalence of TF3 + was low. Time trend analysis revealed an increase in the prevalence and severity of fluorosis among those born during 1970s to 1980s decade. Such prevalence declined among those who were born after measures were introduced in early 1990s to reduce exposure to discretionary fluorides. The prevalence of dental fluorosis in the Australian adult population was found to be related to populationlevel changes in fluoride exposure.
Journal of Dental Research, Aug 1, 2007
Burden-of-oral-disease studies have been hampered by lack of data on disability weights. It is li... more Burden-of-oral-disease studies have been hampered by lack of data on disability weights. It is likely that disability weights will vary between conditions such as gingivitis and periodontal pockets. The aims of this study were to assess health-related quality of life and disability weights for periodontal conditions. A random sample of 45- to 54-year-olds was surveyed during 2004-05 (n = 879, response rate = 43.8%), with oral examinations on n = 709 persons (completion rate = 80.7%). Oral disease symptoms were recorded by the EuroQol, from which disability weights were calculated. Reported pain/discomfort ranged from 6.1% of persons (gingivitis) to 25.8% of persons (6+ mm pockets). Lower disability weights were associated with gingivitis (0.001) and 6+ mm gingival recession (0.004), with higher weights for 6+ mm loss of attachment (0.012) and 6+ mm pocket depth (0.018). Variation in symptom experience indicated the need for investigators to identify periodontal conditions and apply appropriate disability weights in burden-of-disease studies.
BMC Health Services Research, Jan 3, 2008
Background: While the majority of dental care in Australia is provided in the private sector thos... more Background: While the majority of dental care in Australia is provided in the private sector those patients who attend for public care remain a public health focus due to their socioeconomic disadvantage. The aims of this study were to compare dental service profiles provided to patients at private and public clinics, controlling for age, sex, reason for visit and income. Methods: Data were collected in 2004-06, using a three-stage, stratified clustered sample of Australians aged 15+ years, involving a computer-assisted telephone interview (CATI), oral examination and mailed questionnaire. Analysis was restricted to those who responded to the CATI. Results: A total of 14,123 adults responded to the CATI (49% response) of whom 5,505 (44% of those interviewed) agreed to undergo an oral epidemiological examination. Multivariate analysis controlling for age, sex, reason for visit and income showed that persons attending public clinics had higher odds [Odds ratio, 95%CI] of extraction (1.69, 1.26-2.28), but lower odds of receiving oral prophylaxis (0.50, 0.38-0.66) and crown/bridge services (0.34, 0.13-0.91) compared to the reference category of private clinics. Socio-economically disadvantaged persons who face barriers to accessing dental care in the private sector suffer further oral health disadvantage from a pattern of services received at public clinics that has more emphasis on extraction of teeth and less emphasis on preventive and maintenance care.
Keuskamp D, Brennan DS, Roberts-Thomson KF. Medical GP assessment of need for dental care: The or... more Keuskamp D, Brennan DS, Roberts-Thomson KF. Medical GP assessment of need for dental care: The oral health for older people study.
Despite suffering poor oral health, prior to 2005 only a small percentage of Aboriginal people at... more Despite suffering poor oral health, prior to 2005 only a small percentage of Aboriginal people attended SA Dental Service clinics. Effective health promotion has the potential to play an important role in reducing oral health inequalities amongst Aboriginal people. Through the Aboriginal Liaison Program (ALP), partnerships have formed between the SA Dental Service and Aboriginal Health/Case Workers. These partnerships have been pivotal in raising the profile of oral health and increasing the acceptability of dental services among Aboriginal people, resulting in an increase in Aboriginal people accessing dental care.
Oral health of Australian children: The National Child Oral Health Study 2012–14, 2016
Despite some improvement, child oral health has remained a significant population health issue in... more Despite some improvement, child oral health has remained a significant population health issue in Australia in the 21 st Century. The evidence documented in this book has pointed to substantial inverse social patterning of oral health status, dental service use, dental and general behaviours among Australian children. The identification of the numerous factors and the relation between them at an individual child, family, school and community level poses both difficulties and opportunities for programs to improve child oral health and reduce social inequalities in child oral health.
Community Dentistry and Oral Epidemiology, 2019
Background: The "failure of success" theory predicts that as subsequent generations of older adul... more Background: The "failure of success" theory predicts that as subsequent generations of older adults retain more teeth, those additional teeth will experience more oral disease like root surface caries. The theory in relation to root surface caries has never been tested in a cross-generational study. This study aims to compare root surface caries across generations of South Australian older adults to test the theory and explore risk indicators for root surface caries. Methods: Data were from the baseline of two South Australian studies separated by 22 years. In both studies, stratified random samples of people aged 60+ years from Adelaide and Mount Gambier were recruited. Dental examinations were performed by trained and calibrated dentists. One of the dental examiners from the earlier study was the gold standard examiner in the second study. Risk indicators included behavioural factors, clinical oral conditions, sociodemographic and socioeconomic status. Root surface caries was assessed as untreated root surface caries (root decayed surfaces [RDS]), treated root surface caries (root filled surfaces [RFS]) and treated or untreated root surface caries (root decayed and filled surfaces [RDFS]) and was presented as the prevalence and summed count. Multivariable models for Poisson and negative binomial distributions were used to estimate prevalence ratios (PR) and mean ratios (MR), respectively, and their 95% confidence intervals (95% CI). Results: The current generation of South Australian older adults has significantly lower RDS (PR [95% CI] = 0.65 [0.47-0.89]; MR [95% CI] = 0.51 [0.35-0.73]) and RDFS (PR [95% CI] = 0.84 [0.71-0.99]; MR [95% CI] = 0.76 [0.65-0.90]) than the previous generation. The RFS in the previous and current generation was similar. Gingival recession, irregular brushing, dental visiting for a problem and smoking were the indicators for RDS, while age, gingival recession, tooth brushing frequency, time since last dental visit and reason of visiting were the indicators for RFS or RDFS. Conclusions: These results do not support the "failure of success" theory in relation to root surface caries among South Australian older adults. Despite the higher number of teeth retained, the current generation of older adults has less root surface caries than the previous generation. Behavioural factors remain the indicators of root surface caries across the generations.
Australia\u27s Health 2002 is the eighth biennial health report of the Australian Institute of He... more Australia\u27s Health 2002 is the eighth biennial health report of the Australian Institute of Health and Welfare. It is the nation\u27s authoritative source of information on patterns of health and illness, determinants of health, the supply and use of health services, and health service costs and performance. Australia\u27s Health 2002 is an essential reference and information resource for all Australians with an interest in health
Journal of Paediatrics and Child Health, 2010
This review of the oral health of children in Australia, New Zealand, Canada and the USA demonstr... more This review of the oral health of children in Australia, New Zealand, Canada and the USA demonstrates that significant oral health inequalities exist in each nation. Despite traditionally low levels of disease in Indigenous communities, dental caries is now highly prevalent and of increased severity among Indigenous children in comparison to their non-Indigenous counterparts. Early childhood caries is particularly prevalent. The high level of dental disease experience at an early age is associated with increased rates of general anaesthesia and greater risk of dental caries in later life. The rates and severity of dental caries experienced by young Indigenous children are even more alarming when we consider that dental caries is essentially a preventable disease. The success of specific preventive programmes is encouraging; these approaches should be further evaluated and implemented as part of broader health promotion programmes for Indigenous children and families in order to decrease current oral health disparities.
Orofacial clefts are some of the most common birth defects with significant personal and social i... more Orofacial clefts are some of the most common birth defects with significant personal and social impacts. The prevalence has been documented among many populations with some variation among ethnic groups as well as risk factors that include environmental factors and genetic variants. Orofacial clefts have a significant impact on the lives of those affected, particularly when left untreated. The International Perinatal Database of Typical Orofacial Clefts (IPDTOC) has enabled comparison of prevalence rates between different countries but lack data from many developing countries. Environmental factors which have been associated with clefts include maternal smoking, alcohol, lower levels of folic acid, maternal health and medications. However, recognised demographic and environmental factors account for only about 50% of total risk and are yet to provide sufficient evidence for preventive programmes.
Australia's Health 2002 is the eighth biennial health report of the Australian Institute of H... more Australia's Health 2002 is the eighth biennial health report of the Australian Institute of Health and Welfare. It is the nation's authoritative source of information on patterns of health and illness, determinants of health, the supply and use of health services, and health service costs and performance. Australia's Health 2002 is an essential reference and information resource for all Australians with an interest in health.
International Journal of Environmental Research and Public Health, 2021
Background: To determine the perception of oral health status and its associated factors among ad... more Background: To determine the perception of oral health status and its associated factors among adults living in rural areas in Karnataka state, India. Methods: A cross-sectional study was conducted among adults in the age group of 35–54 years old residing in villages in a southern state in India. The main outcome measure was poor self-rated oral health (SROH) among adults in rural India. Results: About 873 adults participated in the study. The prevalence of poor SROH was 15.2%. Adults of age 40–44 years, females, those in lower socioeconomic conditions, and those with high caries experience (DMFT ≥ 4) and periodontal disease were associated with poor SROH. Those who had visited a dentist in the previous one year were 1.9 times more likely to report poor oral health. Conclusions: Nearly 15% of rural people reported poor oral health. Socioeconomic conditions, sex, age, smoking, and dental visiting were associated with poor SROH. People’s perception of poor oral health was associated w...
ABSTRACT Objective: To explore the reasons why few dentists choose to primarily provide care to d... more ABSTRACT Objective: To explore the reasons why few dentists choose to primarily provide care to disadvantaged patients in their main practice. Many reasons have been reported as to why dentists have not been willing or able to sustain working with underserved populations but little is known about what drives those who do. Method: A cross sectional self-report questionnaire survey of a random sample of registered dentists in Australia was conducted between November 2012 and July 2014 to collect information on reasons dentists choose to provide care to disadvantaged patients (DPs). Dentists treating DPs were those seeing, in a regular fortnight, at least 50 per cent of patients from one or more of the following groups; Aboriginal & Torres Strait Islands, Residential Care facility patients, Incarcerated, New migrants and refugees and Special needs people. A binomial logistic regression was performed using the categorical outcome variable to predict factors associated with treating DPs. Result: An adjusted response rate of 62.6% was achieved. On a regular fortnight, less than 5% of patients seen by 60% of dentists at their main practice were disadvantaged. Of all patients seen at the dentists’ main practice, only 6.2% of dentists saw 50% or more DPs. Reason for working at the practice and treating DPs was significantly associated (p<0.05). Over two thirds (68.4%) did not seek the opportunity themselves and were twice as likely to treat DPs (adjusted OR 1.96, 95% CI: 1.10-3.49). Not choosing dentistry for its ‘status’, (adjusted OR 0.55, 95% CI: 0.31-1.00) ‘good hours’ (OR 2.68, 95% CI: 1.16-6.2) and ‘self-employment’ (adjusted OR 2.68 95% CI: 1.21-5.93) were significantly associated with treating DPs. Empathy, resilience and socio-demographic characteristics were not. Conclusion: Dentists treating DPs could encourage others to do the same so they, too, can make a positive contribution in overcoming disparities in oral health outcomes.
The Child Dental Health Survey, Australia 1998 reports on the state of oral health in Australia’s... more The Child Dental Health Survey, Australia 1998 reports on the state of oral health in Australia’s school-age children, including age-specific and age-standardised measures of dental decay and treatment by State and Territory, and national estimates of these measures for 1998. Differences in dental caries experience by geographic location, national trends and international comparisons are also described. JM Armfield, KF Roberts-Thomson AJ Spencer
Rural and remote health
This research compared the oral health status of school children in Dili (the capital of Timor Le... more This research compared the oral health status of school children in Dili (the capital of Timor Leste) in 2002 and 2014. The 2014 oral health survey of Dili's children replicated the methods of an AusAID-supported oral health survey conducted in 2002. Equal numbers of children were invited to participate from four age groups (6-8, 9-11, 12-14 and 15-17 years). For the 2014 survey, the subdistricts of Dom Aleixo, Cristo Rei, Metinaro and Vera Cruz were randomly selected for inclusion. A questionnaire was used to collect data on demographics and oral health behaviours. Oral epidemiological examinations were conducted by four dentists and five dental nurses. The 2014 survey in Dili recruited 758 participants for the questionnaire and 655 children for the oral examination. In 2014, a lower proportion of children reported brushing their teeth the previous day (97% vs 100%, <i>p</i>=0.01) and a larger proportion reported having toothache (40% vs 19%, <i>p</i><...
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Papers by Kaye Roberts-Thomson