Melbourne Dental School - Research Publications
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ItemPractice characteristics and service provision rates of dental hygienists in Australia(WILEY, 2018-02)INTRODUCTION: Dental hygienists (DHs) have been practising in Australia since the early 1970s. OBJECTIVE: This study describes the clinical activity of Australian DHs. METHODS: A questionnaire was mailed to members of two professional associations representing DHs. Practitioner characteristics, employment characteristics and clinical activity on a self-reported typical practice day were collected. The proportion of each service item of all services provided was estimated. Associations between practice characteristics and service provision were assessed by log-binomial regression models. RESULTS: Adjusted response rate was 60.6%. Of the DHs included in analysis (n=341), 80% were employed in general practice, and nearly all (96%) worked in the private sector. About half (53.7%) of all service provided were preventive services, and one-fourth (23.9%) were diagnostic. Service provision varied by practice and practitioner characteristics, with the largest variations observed by practice type. Unadjusted analysis showed that general practice DHs provided a higher mean number of periodontal instrumentation and coronal polishing (0.92 vs 0.26), fluoride applications (0.64 vs 0.08), oral examinations (0.51 vs 0.22) and intraoral radiographs (0.33 vs 0.07) per patient visit and a lower mean number of impressions (0.05 vs 0.17) and orthodontic services (0.02 vs 0.59) than specialist practice DHs. In adjusted analysis, rates of periodontal services also significantly varied by practice type; other associations persisted. CONCLUSION: Service provision of DHs varied by practice type. Practice activity was dominated by provision of preventive services while provision of periodontal treatments, fissure sealants and oral examinations was relatively limited indicating areas in which DHs are possibly underutilized.
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ItemPerceptions of oral health by those living with mental illnesses in the Victorian Community - The consumer's perspective(WILEY, 2018-05)OBJECTIVE: To understand the way people living with mental illness in an Australian community experience and define oral health. STUDY POPULATION: People living with serious mental illness in the Victorian Community. METHODS: Qualitative methodologies were used in this study. Two focus groups and four semi-structured interviews were conducted. The data were transcribed and thematically analysed. RESULTS: Participants generally valued oral health and recognized that attending regular dental appointments played a key role in improving their oral health. Participants felt that their mental illness overwhelmed their ability to maintain good oral health. Coping, dental fear, stigma, financial barriers and communication were identified as issues around utilization and access to care. DISCUSSION: Experiences of oral health were both positive and negative. Barriers and enablers, extending beyond participant oral health literacy for oral health, were identified from the data, and recommendations around personal, environmental and clinical supports were made. CONCLUSION: This is a valuable study that provides new insight into a complicated issue. Recommendations to create a supportive dental environment and direction to improve the dental experience have been made to make oral health more accessible for people living with mental illness. Recommendations have also been made for community-based mental health organizations to aid the improvements in oral health with this group of people, thus building a collaborative approach to support oral health for this vulnerable group.
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ItemApplied scope of practice of oral health therapists, dental hygienists and dental therapists(WILEY-BLACKWELL, 2016-09)BACKGROUND: Oral health therapists (OHTs) are an emerging workforce whose training incorporates the skills of dental hygienists (DHs) and dental therapists (DTs). There are concerns that OHTs are underutilized. This study compares the employment characteristics and applied practice scope of OHTs with those of DTs and DHs. METHODS: Members of two professional associations representing DHs, DTs and OHTs, were surveyed by mail. Data collected included demographic and employment characteristics and clinical activity on a typical practice day. Applied practice scope was described by calculating the proportion of practitioners that had provided ≥1 of a selected range of key services. Log binomial regression was used to compare OHTs to DTs and DHs. RESULTS: The response rate was 60.6% (n = 1083) and of these 90.9% were employed. Preventive services dominated service provision. The proportion of OHTs that provided fluoride applications (77%) was higher than the proportion of DTs (53%, p < 0.05), and was not significantly different from the proportion of DHs (70%). The proportion of OHTs that provided (48%) fissure sealants was lower than the proportion of DTs (70%) and substantially higher than the proportion of DHs (10%, p > 0.05). CONCLUSIONS: Overall, the applied practice scope of OHTs appeared to differ from DTs and DHs.
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ItemBody mass index and dental caries in children and adolescents: a systematic review of literature published 2004 to 2011(BMC, 2012)THE OBJECTIVE: The authors undertook an updated systematic review of the relationship between body mass index and dental caries in children and adolescents. METHOD: The authors searched Medline, ISI, Cochrane, Scopus, Global Health and CINAHL databases and conducted lateral searches from reference lists for papers published from 2004 to 2011, inclusive. All empirical papers that tested associations between body mass index and dental caries in child and adolescent populations (aged 0 to 18 years) were included. RESULTS: Dental caries is associated with both high and low body mass index. CONCLUSION: A non-linear association between body mass index and dental caries may account for inconsistent findings in previous research. We recommend future research investigate the nature of the association between body mass index and dental caries in samples that include a full range of body mass index scores, and explore how factors such as socioeconomic status mediate the association between body mass index and dental caries.