Melbourne Dental School - Research Publications

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    Social practice theory: An innovative approach to considering preschool children's poor oral health
    Durey, A ; Gibson, BJ ; Ward, PR ; Calache, H ; Slack-Smith, L (WILEY, 2021-05-13)
    Oral disease in early childhood is highly prevalent and costly and impacts on the child and family with significant societal costs. Current approaches have largely failed to improve young children's oral health. This paper proposes a different approach to conceptualize poor oral health in preschool children (0-5 years) using social practices. Social practice theory offers an innovative perspective to understanding oral health by shifting emphasis away from the individual and onto how practical, social and material arrangements around the oral health of preschool children exist, change or become embedded in the social structures they inhabit. This novel approach contributes to the growing theoretical understanding in this area and has the potential to offer insights into the problem and ways it might be addressed.
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    Collaborative Oral Health Care
    Mamerto, ML ; Calache, H ; Ivanovic, A ; Bettega, A ; Martin, RE ; McKee, S (UBIQUITY PRESS LTD, 2021-01-01)
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    Evaluation of an intervention to promote minimally invasive dentistry (MID) in an Australian community dental agency-A pilot study
    Nguyen, TM ; Tonmukayakul, U ; Calache, H (WILEY, 2021-06-02)
    OBJECTIVES: To evaluate the impact of an intervention consisting of a 1-day continuing professional development (CPD) education programme on the International Caries Classification and Management System (ICCMS™ ), and monthly performance feedback, and to promote minimally invasive dentistry (MID) for children aged under 12 years in an Australian community dental agency. The a priori hypotheses assumed the intervention would increase preventive services, and treatment demand was met. METHODS: A quasi non-randomized controlled trial with convenience sampling method was adopted. Fourteen dental practitioners received the intervention. The prevalence of dental caries and gingivitis in Australian children was used to determine the treatment demand and used as the performance benchmark. Ten types of preventive and non-preventive dental services were examined. A Difference-in-Differences (DiD) of 12-month pre- (baseline) and post-intervention analysis was performed. RESULTS: The intervention group demonstrated increases in topical fluoride application and dietary analysis and advice services. The standard care group had increases in oral prophylaxis or scale and clean, topical fluoride application and oral hygiene instructions (p-value <0.05). The DiD analysis confirmed the above findings in the intervention group, while other preventive services declined. In the intervention group, the performance benchmark for oral prophylaxis or scale and clean and oral hygiene instructions was met at baseline and post-intervention. CONCLUSIONS: Only a few preventive services had already met the performance benchmark. The intervention was associated with varied changes to preventive and non-preventive dental services. More robust study design addressing the study limitations and validating the performance benchmark is required.
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    A Cost Analysis of an Outreach School-Based Dental Program: Teeth on Wheels
    Nguyen, TM ; Tonmukayakul, U ; Calache, H (MDPI, 2021-02-01)
    BACKGROUND: This study evaluated an outreach mobile dental service called Teeth on Wheels (TOW). The dental program targeted Australian children from low household income, who are eligible for the Child Dental Benefits Scheme (CDBS) in Victoria, Australia. The program is complemented with a school-based oral health promotion element. METHODS: A retrospective cohort study was performed with a convenience sample. Children must have had at least three dental examinations during the 2016-2019 calendar years to be included in the study. Comparisons were made between the 2016-17 and 2018-19 calendar years. It was hypothesised that the program would result in reduced costs and the number of restorations and extractions in the latter period. RESULTS: A total of 414 children were included in the analysis. The total mean costs of the program per child reduced from AU$605.3 in 2016-17 to AU$531.1 in 2018-19. The results showed an overall mean reduction in all restorations and extractions performed, but only statistical significance was noted for reductions of restored deciduous teeth. CONCLUSIONS: This outreach program, which is focused on prevention and minimally invasive dentistry, can be a promising alternative model of delivery for dental services in young children.
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    Perceived barriers encountered by oral health professionals in the Australian public dental system providing dental treatment to individuals with special needs
    Lim, MAWT ; Liberali, SAC ; Calache, H ; Parashos, P ; Borromeo, GL (WILEY, 2021-02-23)
    AIMS: To investigate barriers experienced by clinicians treating individuals with special needs in the Australian public dental system. METHODS AND RESULTS: Oral health professionals working at primary care clinics in the public dental system were invited to participate in semi-structured interviews or focus groups to discuss the challenges they faced in managing patients with special needs. Qualitative methods, employing inductive thematic analysis, revealed two primary barriers: 1. clinicians lacked confidence in their ability to treat patients with special needs because of insufficient training and experience, and difficulties obtaining information about their patients, and 2. barriers within the public dental system, including inadequate funding, equipment and facilities, and productivity pressures prevented clinicians from being able to provide the care patients required. The priority and understanding of the oral health for these individuals within the public dental system and wider disability sector was also raised. CONCLUSION: A perceived lack of training and experience in managing individuals with special needs was a barrier to treating patients with special needs. Other significant barriers were under-resourcing of the public dental system and a lack of priority and understanding regarding oral health among carers of individuals with special needs and other health professionals.
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    Nutrition and oral health in early childhood: associations with formal and informal childcare
    Carpenter, L ; Gibbs, L ; Magarey, A ; Dashper, S ; Gussy, M ; Calache, H (CAMBRIDGE UNIV PRESS, 2021-04-01)
    OBJECTIVE: To examine associations between childcare type and nutrition and oral health indicators. DESIGN: Cross-sectional data extracted from a longitudinal birth cohort. Parent-completed FFQ and questions regarding oral health and childcare use. The associations between childcare type, classified into four groups: parent care only (PCO), formal childcare only (FCO), informal childcare only (ICO) or combination of care (F&I), and nutrition and oral health indicators were examined. SETTING: Home and childcare. PARTICIPANTS: Families with children aged 3 years (n 273) and 4 years (n 249) in Victoria, Australia. RESULTS: No associations were observed between childcare type and core food/beverage consumption or oral health indicators. For discretionary beverages, compared with children receiving PCO at age 3 years, children in FCO or F&I were less likely to frequently consume fruit juice/drinks (FCO: adjusted OR (AOR) 0·41, 95 % CI 0·17, 0·96, P = 0·04; F&I: AOR 0·32, 95 % CI 0·14, 0·74, P = 0·008). At age 4 years, children receiving FCO or ICO were less likely to consume sweet beverages frequently compared with children receiving PCO: fruit juice/drink (ICO: AOR 0·42, 95 % CI 0·19, 0·94, P = 0·03; FCO: AOR 0·35, 95 % CI 0·14, 0·88, P = 0·03) and soft drink (ICO: AOR 0·23, 95 % CI 0·07, 0·74, P = 0·01; FCO: AOR 0·14, 95 % CI 0·03, 0·76, P = 0·02). CONCLUSIONS: Associations between childcare type and discretionary beverage intake were observed. Investigation into knowledge, attitudes and activities in formal and informal childcare settings is required to explore different health promotion practices that may influence nutrition and oral health.
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    Perspectives of the public dental workforce on the dental management of people with special needs
    Lim, MAWT ; Liberali, SAC ; Calache, H ; Parashos, P ; Borromeo, GL (WILEY, 2021-03-19)
    BACKGROUND: People with special health care needs continue to have difficulties accessing regular dental care partly due to oral health professionals feeling they lack the knowledge and experience to provide treatment to these individuals. METHODS: Qualitative interviews and focus groups provided an insight into the types and nature of supports that oral health professionals working in the Australian public dental system desired and felt may improve their willingness and/or ability to treat patients with special needs. RESULTS: Although participants did not identify one group of patients with special needs that were more difficult to treat, they did report a feeling of being unsupported. Clinicians felt that improved training and access to ongoing education in Special Needs Dentistry, opportunities for greater support from specialists or other health professionals, either through networking or other media such as telehealth, and fostering a more supportive clinical environment, particularly in relation to appointment lengths and productivity pressures, may improve their willingness and ability to treat patients with special needs. CONCLUSIONS: Additional support, in the form of greater interaction with specialists and reduced time and productivity pressures, may improve the willingness of oral health professionals in the public dental system to treat patients with special needs.