Oral Health

• 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.