Spotlight on Tasmania: Prioritising oral health from early childhood and beyond

Tooth decay is one of the most common childhood diseases, yet it is almost entirely preventable.

The Australian Institute of Health and Welfare reports that in Australia in 2016 about 2 in 5 (42%) of children aged 5-10 had experienced decay in their primary (baby) teeth, and more than 1 in 4 (27%) had untreated decay in these teeth.  Of those aged 6 to 14, 1 in 4 (24%) had experienced decay in their permanent teeth and more than 1 in 10 (11%) had untreated decay in these teeth.[1]

In 2007, Child Dental Health Survey showed that Tasmanian children had some of the worst teeth in the nation.   In 5 to 6-year old children, the mean decayed missing and filled baby teeth in Tasmania was 2.21.[2]

To address this, Oral Health Services Tasmania (OHST) implemented early intervention and preventative programs that focused on pregnancy and those aged 0-5 years.  Then, in 2013, an ambitious and first-in-the-nation oral health program was introduced for school-aged children.

The Oral health of Australian children: The National Child Oral Health Study 2012–14 report indicates that in Tasmania, the mean number of decayed missing and filled teeth in children aged between 5 and 10 years was 1.4[3]

To give a national perspective, the prevalence of untreated decay and overall caries in the primary dentition (more commonly known as baby teeth) was highest among Northern Territory children (39.5% and 53.1%, respectively), followed by children in Queensland (29.9% and 50.2%). The prevalence of untreated dental caries in ACT, South Australia, West Australia and Tasmania was lower than the national average. The prevalence of overall dental caries experience was lowest in ACT.[4]

About Tasmania’s Fissure Sealant and Fluoride Varnish Program for schools

The Fissure Sealant and Fluoride Varnish program (FSFVP) was developed in partnership with the Tasmanian Department of Education for targeted schools.  Using mobile equipment, oral health professionals visited schools.

At these visits, children were examined by oral health professionals and fissure sealants were placed on erupted back molars, and Fluoride Varnish was applied to children aged 6-13 years.  These are basic, but important oral health interventions. 

Fissures are natural pits or grooves in molar teeth, and they are a common location for decay because tooth brushes usually can’t adequately access these areas.  A fissure sealant fills in the pits or grooves, and decay.

Fluoride varnish is a highly-concentrated form of fluoride that is applied to the teeth, ideally twice a year, and gives added protection against tooth decay.

These visits also offered the oral health professionals the opportunity to observe any other oral health issues that may require additional attention.

A major challenge for the OHST was accessing those children most likely to develop dental decay.  To do this, schools were identified according to Socio-Economic Indexes for Areas and the Australian Early Development Instrument.

The results

The result was that many Tasmanian children were examined and treated by an oral health professional for the very first time at school.  Many issues were identified during these examinations, including chronic draining abscesses and open cavities.

An additional benefit of the program is oral health professionals have the opportunity to engage with parents of those children identified as requiring follow-up care.  This often eases any pre-existing parental concerns about dental care and encourages parents to continue a regular oral health examination schedule.

Of course, the real results are in the number of Tasmanian children with tooth decay, and the latest NCOHS published in 2016 showed that there was a significant improvement in rates of decay in Tasmanian children. In fact, Tasmanian childhood decay rates are now below the national average. Internal OHST data also shows that there has been a decrease in decayed, missing or filled teeth state wide.

The success of the program has seen an increase in the number of schools visited. As a result, OHST is in the process of purchasing three new dental trucks for the FSFVP.  These additional resources will significantly ease the strain on the existing mobile equipment and will also provide the ability to visit schools in more remote areas.

Oral health for new young mums

OHST has also commenced an early intervention program for new young mums.  This program offers priority appointments for young mums in early pregnancy, providing them with improved oral health as well as educating about oral health in pregnancy and beyond.

These mums are then also seen 6 and 12 months after the birth of their child, again reinforcing good oral health practices, as well as establishing their child’s “home” for oral health from an early age.

Early childhood caries are an indicator for dental disease later in life, as well as broader health issues associated with oral health issues (eg diabetes, cardiovascular disease, respiratory disease, adverse pregnancy outcomes and even stroke[5]). This means that programs like FSFVP and the new young mums program are vital and valuable community resources, establishing positive life-long oral health experiences and practices.

 

 

[1] Australian Institute of Health and Welfare 2018, Australia’s health 2018. Australia’s health series no. 16. AUS 221. Canberra AIHW.

[2] Mejia GC, Amarasena N, Ha DH, Roberts-Thomson KF and Ellershaw AC 2012. Child Dental Health Survey Australia 2007: 30-year trends in child oral health. Dental statistics and research series no. 60. Cat. no. DEN 217. Canberra: AIHW.

[3] DH Ha, KF Roberts-Thomson, P Arrow, KG Peres and LG Do. 2016. Children’s Oral Health Statistics in Australia, 2012-2014. In LG Do and AJ Spencer (editors). Oral Health of Australian Children: The National Child Oral Health Study 2012-2014. Adelaide: University of Adelaide Press.

[4] DH Ha, KF Roberts-Thomson, P Arrow, KG Peres and LG Do. 2016. Children’s Oral Health Statistics in Australia, 2012-2014. In LG Do and AJ Spencer (editors). Oral Health of Australian Children: The National Child Oral Health Study 2012-2014. Adelaide: University of Adelaide Press.

[5] https://www.dhsv.org.au/__data/assets/pdf_file/0013/2515/links-between-oral-health-and-general-health-the-case-for-action.pdf

 

 

Dr Chris Handbury: After 25 years in private dental practice, Dr Handbury joined the public sector and was Principal Dentist in Bundaberg, Queensland and Director Oral Health in Townsville. After a short break, he took up a position as Principal Dentist and Program Director in the Northern Territory. He has recently moved to Tasmania where he is Clinical Director of Oral Health Services. Dr Handbury is also on the Australian Dental Council and a founding member of the Oral Health Advisory Panel.

 

 


The Oral Health Advisory Panel (OHAP), is a group of independent healthcare professionals with the aim of raising awareness of the importance of good oral health and its impact on general wellness.  The Panel aims to take oral health beyond the dental clinic.

Follow the Oral Health Advisory Panel via twitter @OHAPanel to stay up to date with practical advice on good oral health habits.


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