Gaps in smiles and services: a cross-sectional study of dental caries in refugee-background children

BMC Oral Health

Georgia A Paxton³  Tatiana Polizzi²  Ingrid L Laemmle-Ruff¹  Alicia Quach² 

[1] Department of Health, Office of the Chief Health Officer, Melbourne, Australia;Department of General Medicine, The Royal Children’s Hospital, Melbourne, Australia;Murdoch Children’s Research Institute, Melbourne, Australia

关键词: Refugee;    Oral health;    Dental services;    Children;    Caries;   

Others  :  1118167
DOI  :  10.1186/1472-6831-15-10

 received in 2014-08-19, accepted in 2015-01-14,  发布年份 2015

【 摘 要 】

Background

Refugees are reported to experience high rates of dental disease, although there are limited data on refugee children. The aim of this study was to report on oral health in refugee-background children in Australia, and to assess their follow-up at dental services.

Methods

Cross-sectional study of opportunistic oral health screening and subsequent dental service use in refugee-background children attending a refugee health clinic in Victoria, Australia, between November 2006 – November 2010.

Results

350 patients (0 – 18 years, mean age 8 years 7 months) had oral health screening; 241 (68.9%) were born overseas, (176 Africa, 65 other countries) and 109 (31.1%) were born in Australia to African-background families. Parents were concerned about oral health in 65/341 (19.1%) children, with specific concern about caries in only 9/341 (2.6%). On assessment, 155/336 (46.1%) had visible caries and 178/345 (51.6%) had caries experience (dmft/DMFT > 0). Where parents were concerned about caries, they were likely to be present (positive predictive value = 100%), however absence of parent concern about caries was not reassuring (negative predictive value = 56.1%).

Compared to Australian-born children of African background; African-born children were more likely to be referred for further dental care (adjusted PR 1.33, 95% CI [1.02 – 1.73]), although there was no statistically significant difference in caries prevalence. African-born children were less likely to have caries compared to other overseas-born children (adjusted PR 0.73, 95% CI [0.58 – 0.93]). Overall 187/344 (54.4%) children were referred for further dental care; 91/124 (73.4%) attended any dental appointment. Attendance rates were 90% with a phone reminder system for appointments, attendance reduced when this system lapsed.

Conclusions

Oral health is an important public health issue in refugee-background children, despite low levels of parent concern and very few parent reported caries. Routine direct oral health assessment is important in refugee-background children and co-ordinated health systems may help improve their attendance at dental services.

【 授权许可】

   
2015 Quach et al.; licensee BioMed Central.

【 参考文献 】

• [1]Armfield JM, Slade GD, Spencer AJ: Socioeconomic differences in children’s dental health: The Child Dental Health Survey, Australia 2001. AIHW 2006., Cat. no. DEN 152
• [2]Paxton G, Smith N, Win AK, Mulholland N, Hood S: Refugee status report: a report on how refugee children and young people in Victoria are faring. Department of Education and Early Childhood Development: Victorian Government; 2011:135.
• [3]Davidson N, Skull S, Calache H, Murray SS, Chalmers J: Holes a plenty: oral health status a major issue for newly arrived refugees in Australia. Aust Dent J 2006, 51(4):306-311.
• [4]Brennan DS, Spencer AJ: Variation in dental service provision among adult migrant public-funded patients. Aust N Z J Public Health 1999, 23(6):639-642.
• [5]Davidson N, Skull S, Calache H, Chesters D, Chalmers J: Equitable access to dental care for an at-risk group: a review of services for Australian refugees. Aust N Z J Public Health 2007, 31(1):73-80.
• [6]Davidson N, Skull S, Chaney G, Frydenberg A, Jones C, Isaacs D, Kelly P, Lampropoulos B, Raman S, Silove D, Buttery J, Smith M, Steel Z, Burgner D: Comprehensive health assessment for newly arrived refugee children in Australia. J Paediatr Child Health 2004, 40(9–10):562-568.
• [7]Marino R, Wright C, Minichiello V, Schofield M, Calache H: A qualitative process evaluation of an oral health promotion program for older migrant adults. Health Promot J Austr 2005, 16(3):225-228.
• [8]Marino R, Wright FA, Minas IH: Oral health among Vietnamese using a community health centre in Richmond. Aust Dent J 2001, 46(3):208-215.
• [9]Smith DKSF: Aspects of tooth decay in recently arrived refugees. Aust NZ J Public Health 2000, 24:623-626.
• [10]Lamb CE, Whelan AK, Michaels C: Refugees and oral health: lessons learned from stories of Hazara refugees. Health Promot J Austr 2009, 33(4):618-627.
• [11]Kingsford Smith D, Szuster F: Aspects of tooth decay in recently arrived refugees. Aust N Z J Public Health 2000, 24(6):623-626.
• [12]Cote S, Geltman P, Nunn M, Lituri K, Henshaw M, Garcia RI: Dental caries of refugee children compared with US children. Pediatrics 2004, 114(6):e733-740.
• [13]Locker D, Clarke M, Murray H: Oral health status of Canadian-born and immigrant adolescents in North York, Ontario. Community Dent Oral Epidemiol 1998, 26:177-181.
• [14]Almerich-Silla JM, Montiel-Company JM, Ruiz-Miravet A: Caries and dental fluorosis in a western Saharan population of refugee children. Eur J Oral Sci 2008, 116(6):512-517.
• [15]Evans RW, Bedi R, Lind OP: The oral health status and treatment needs of Vietnamese refugee children in transit in Hong Kong. N Z Dent J 1985, 81(366):116-120.
• [16]Kalsbeek H, Zijlstra-Remon N, Filedt Kok-Weimar TL: Oral health and dental care in refugee children. Ned Tijdschr Tandheelkd 2001, 108(10):404-407.
• [17]Geltman PL, Radin M, Zhang Z, Cochran J, Meyers AF: Growth status and related medical conditions among refugee children in Massachusetts, 1995–1998. Am J Public Health 2001, 91(11):1800-1805.
• [18]Hjern A, Kocturk-Runefors T, Jeppson O, Tegelman R, Hojer B, Adlercreutz H: Health and nutrition in newly resettled refugee children from Chile and the Middle East. Acta Paediatr Scand 1991, 80(8–9):859-867.
• [19]World Health Organization: Oral health Surveys: Basic Methods. 4th edition. Geneva, Switzerland: WHO; 1997.
• [20]Chrisopoulos S, Beckwith K, Harford JE: Oral health and dental care in Australia: key facts and figures 2011. AIHW 2011., Cat no. DEN 214
• [21]Ha DH, Roberts-Thomson KF, Armfield JM: The Child Dental Health Surveys Australia, 2005 and 2006. AIHW 2011., Cat. no. DEN 213
• [22]Armfield JM: High caries children in Australia: a ‘tail’ of caries distribution. Aust Dent J 2005, 50(3):204-206.
• [23]Benson J, Williams J: Age determination in refugee children. Aust Fam Physician 2008, 37(10):821-825.
• [24]State Government of Victoria: Water fluoridation in Victoria and Australia. http://www.health.vic.gov.au/water/fluoridation/maps.htm webcite
• [25]Department of Immigration and Citizenship: Fact Sheet 60 – Australia’s Refugee and Humanitarian Program. [http://www.immi.gov.au/media/fact-sheets/60refugee.htm webcite]
• [26]Ha D: Dental decay among Australian children. AIHW 2011., Cat. no. DEN 210
• [27]Petersen PE, Bourgeois D, Ogawa H, Estupinan-Day S, Ndiaye C: The global burden of oral diseases and risks to oral health. Bull World Health Organ 2005, 83(9):661-669.
• [28]World Health Organization: Oral health: what is the burden of disease?. 2012. http://www.who.int/oral_health/disease_burden/global/en/ webcite
• [29]Marinho VC, Higgins JP, Sheiham A, Logan S: Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2003, (1):CD:002278].
• [30]Walvekar SV, Qureshi BA: Endemic fluorosis and partial defluoridation of water supplies – A public health concern in Kenya. Community Dent Oral Epidemiol 1982, 10(3):156-160.
• [31]Fewtrell L, Smith S, Kay D, Bartram J: An attempt to estimate the global burden of disease due to fluoride in drinking water. J Water Health 2006, 4:533-542.
• [32]Mount GJ, Hume WR: Preservation and Restoration of Tooth Structure. 2nd edition. Sandgate Queensland: Knowledge Books; 2005.
• [33]van Palenstein Helderman WH, Matee MI, van der Hoeven JS, Mikx FH: Cariogenicity depends more on diet than the prevailing mutans streptococcal species. J Dent Res 1996, 75(1):535-545.
• [34]Renzaho AMN, Burns C: Post-migration food habits of sub-Saharan African migrants in Victoria: A cross-sectional study. Nutr Diet 2006, 63(2):91-102.
• [35]Geltman PL, Adams JH, Cochran J, Doros G, Rybin D, Henshaw M, Barnes LL, Paasche-Orlow M: The impact of functional health literacy and acculturation on the oral health status of Somali refugees living in Massachusetts. Am J Public Health 2013, 103(8):1516-1523.
• [36]Kandelman D, Arpin S, Baez RJ, Baehni PC, Petersen PE: Oral health care systems in developing and developed countries. Periodontol 2000 2012, 60(1):98-109.
• [37]Nicol P, Al-Hanbali A, King N, Slack-Smith L, Cherian S: Informing a culturally appropriate approach to oral health and dental care for pre-school refugee children: a community participatory study. BMC Oral Health 2014, 14:69. BioMed Central Full Text
• [38]Victorian Foundation for Survivors of Torture: Promoting refugee health: a guide for doctors and other health care providers caring for people from refugee backgrounds. 2nd edition. 2007. [Victoria Foundation for Survivors of Torture]
• [39]Dental Health Services Victoria: Patient information: fees. http://www.dhsv.org.au/patient-information/fees/ webcite
• [40]Sheik-Mohammed M, Macintyre CR, Wood NJ, Leask J, Isaacs D: Barriers to access to health care for newly resettled sub-Saharan refugees in Australia. Med J Aust 2006, 185(11):594-597.