Oral Health

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  Commencement of– ‘Aged Care Oral Health Capacity Building Program.’ The aim of the project is to develop a supportive program to build the oral health capacity of staff caring for residents of aged care facilities at Barwon Health.  To date, over 300 staff have completed REDCAP pre-surveys in the aged care sector, and a group of Oral Health Champions (OHC) has been developed following expressions of interest and attending an initial interprofessional workshop developed by the research group.

• Funding awarded: Healthier Smiles Community Grant – Australian Dental Association Dental Health Foundation (ADADHF) $12,612.54 to improve the oral health of residents in aged care facilities initially at Barwon Health
• Presentations accepted for 2025 Australian Association of Gerontology Conference and 2025 Oral Health Association of Australia Congress.

• Affiliate A/Prof Michael Smith attended the Australian Dental Congress and the FDI Congress in Sydney (September 2023) to be inducted as a Fellow of Section VIII of the International College of Dentists (ICD).
• A/Prof Rachel Martin joined the research team in 2023. Rachel is a Co-Founder and Director of the Australian Network for the Integration of Oral Health (NIOH), a director of the Australian Dental Research Foundation Board, Chairs of the Public Dentists Committee of the ADA Vic Branch, is a Member of the World Federation of Public Health Associations Oral Health Working Group and is a member and chair on various Committees of the Dental Board of Australia.
• A/Prof Rachel Martin was invited as a speaker for Aged Care Research and Innovation Industry (ARIA) Conference 5-6 July, 2024. Panel topic: food, nutrition and oral health.

Within Australia, dental caries is a prevalent disease affecting children. Childhood dental caries can cause acute pain and problems with eating resulting in decreased self-esteem and sleep deprivation. In severe cases a dental general anaesthetic (GA) may be required. Historically, from 2010-2012 at Barwon Health Oral Health services there were 235 events under GA. The average age at consultation was 5.5 years. Severe dental caries along with long waiting times prompted a change in dental processes.

The Wide Smiles program commenced in 2013 with the goal of utilising Minimal Intervention Dentistry (MID) to implement a positive change in the oral health of children (aged 3-7 years) by applying fluoride directly to affected tooth surfaces. MID techniques encourage non-surgical dental treatments and encourage individualised care plans with patient/ parent/ guardian management. There were 13,537 children who received dental screening at 67 kindergartens, 28 schools and 34 Early Learning Centres in the region. Of these children, 39,646 tooth surfaces had topical fluoride applied to white spot lesions. At follow up, 92% of tooth surfaces where fluoride was applied, had stabilized or improved. There were 36,474 tooth surfaces averted from further decay. The children welcomed the Oral Health therapists at their early learning centre and viewed these visits with a positive response.

In order to continue providing excellent dental care/research-areas to the community a further evaluation of the effectiveness of the Wide Smiles program in reducing dental caries rates throughout the Geelong and Colac-Otway region from 1 January 2017 – 31 June 2021 is proceeding. Newsletters will be utilised to communicate outcomes with families involved in the Wide Smiles program.

While delivery of this program has been enormously successful, engagement with families has been identified as a potential opportunity to improve the program.  Parents’ experiences managing oral hygiene habits were explored.  Thirteen semi-structured interviews were conducted and questions were framed according to the COM-B model of behaviour change.  A digital resource was developed presenting a timeline, including key milestones of specific dental habits such as the eruption of teeth, the first dental appointments and the introduction of fluoridated toothpaste.  This resource aims to address the gaps in knowledge highlighted by parents and facilitate oral hygiene habits for pre-school aged children.

This important public health project focussed on areas which are growing in population rapidly and where teledentistry approaches in the public health settling haven’t previously been investigated.  Teledentistry began at BH and CAH oral health services in 2020 to engage with patients/carers of children who had missed-out on outreach and recall visits during the COVID-19 pandemic.

Between 10 August and 30 September 2020, teledentistry consultations were offered to parents/carers of children on the dental recall list or were seen with demineralization, hypomineralisation and caries whilst being enrolled in the Wide Smiles early years dental outreach program.  Parents/carers were contacted via telephone and offered a dental teleconference consultation for their child.  An estimate of the contribution of teledentistry to activity in terms of Dental Weighted Activity Units (DWAU’s) was made.

Only 15.6% of parents/cares of children who missed their recall appointments did not respond to SMS and telephone calls, while 18.6% of parents/carers of children who missed their Wide Smiles preschool and primary school visit did not respond to SMS and telephone calls.  Only 8.9% of parents/carers of children who missed their recall appointment did not want any dietary analysis or advice or oral hygiene instruction compared with 48.4% of Wide Smiles participants who didn’t require any assistance.  Teledentistry contributed to 25% of activity in August and September in terms of DWAU’s.  Teledentistry was very well received with parents/carers of children who had missed their recall appointments.  The Oral Health Service will continue to take advantage of teledentistry when appropriate to engage with families as well as traditional face-to-face consultations.

The Australian population is living longer, and it is estimated that by 2031, the proportion of the Australian population over 65 years will be approximately 18% (6 million), which will increase to 22% (9 million) by 2061 (ABS Population Projections 2012-2101).  The number of residential aged care places within the Greater Geelong region is 3330 (as of June 2023).  Older people are among the specific groups of people in Australia who have a higher incidence of poor oral health.  They often require more specific support in the maintenance of oral hygiene and must have access to affordable and timely dental care in order to maintain oral function and prevent the unnecessary adverse impacts of poor oral health on their overall health status.

The Aged Care Oral Health Capacity Building Program aims to develop a supportive program to build the oral health capacity of staff caring for residents of aged care facilities at Barwon Health. The OHS regular Mouth Matters for Elders Program will run alongside the Capacity Building Program

The program has two elements: an online evidence-based course and a peer led practical training program. Pre and post training surveys will be provided to nursing and personal care workers in the study settings to collect information on the oral health related knowledge, attitudes and practices of nursing and personal care workers employed in Barwon Health residential aged care.

The research group is an interprofessional collaborative including OHS staff, Clinical Nurse Educators and Interprofessional Education Coordinator from the Centre for Education and Training, and external oral health and dental experts, Mrs Cath Carboon and Dr Mark Wotherspoon.

A group of Oral Health Champions (OHC) has been developed at the case site following expressions of interest and attending an initial interprofessional workshop developed by the research group.

With emerging evidence suggesting that oral health and the oral microbiome may influence mental wellbeing, and that disruptions in the oral microbiome may play a role in the development of neurodegenerative diseases, consenting residents will also provide a saliva sample at each Mouth Matters for Elders assessment to explore the potential impacts of the intervention on the oral microbiome.  This component of the research project is in collaboration with Deakin University, Food and Mood Centre with IMPACT seed funding.

The study objectives are:

• To evaluate a supportive program to build the oral health capacity of staff caring for residents at aged care facilities in Barwon Health;
• Explore and propose processes, practices and resources to sustain desirable changes within the current environment;
• Examine the impacts of the supportive oral health program on aged care residents’ oral health-related quality of life, oral health status and the oral microbiome.

The project aligns with Australia’s National Oral Health Plan Foundation Areas 1 and 3:

1. Oral Health Promotion through strengthening the focus on oral health as an integral part of general health, and
2. Systems Alignment and Integration through developing evidence-based models of care and including oral health components in all relevant models of care in the general health sector.