Caries and periodontal disease in Indigenous adults in Australia: a case of limited and non-contemporary data

Objective The aim of the present study was to identify all evidence about the prevalence and severity of clinically measured caries and periodontal disease in Indigenous adults in Australia published in peer-reviewed journals and to summarise trends over time. In addition, we examined whether the studies investigated associations between putative risk factors and levels of caries and periodontal disease. Methods PubMed was searched in September 2014, with no date limitations, for published peer-reviewed articles reporting the prevalence rates and/or severity of caries and periodontal disease in Indigenous adults living in Australia. Articles were excluded if measurement was not based on clinical assessment and if oral disease was reported only in a specific or targeted sample, and not the general population. Results The search identified 18 papers (reporting on 10 primary studies) that met the inclusion criteria. The studies published clinical data about dental caries and/or periodontal disease in Australian Indigenous adults. The studies reported on oral health for Indigenous adults living in rural (40%), urban (10%) and both urban and rural (50%) locations. Included studies showed that virtually all Indigenous adults living in rural locations had periodontal disease. The data also showed caries prevalence ranged from 46% to 93%. Although 10 studies were identified, the peer-reviewed literature was extremely limited and no published studies were identified that provided statistics for a significant proportion of Australia (Victoria, Tasmania, Queensland or the Australian Capital Territory). There were also inconsistencies in how the data were reported between studies, making comparisons difficult. Conclusions This review highlights a lack of robust and contemporary data to inform the development of policies and programs to address the disparities in oral health in Indigenous populations living in many parts of Australia. What is known about the topic? Many studies report that Indigenous people in Australia have poorer general health compared with non-Indigenous people. What does this paper add? This paper documents the available caries and periodontal disease prevalence and experience for Indigenous adults in Australia published in peer-reviewed journals. It demonstrates significant limitations in the data, including no data in several large Australian jurisdictions, inconsistency with reporting methods and most data available being for Indigenous adults living in rural locations. Therefore, the oral health data available in the peer-reviewed literature do not reflect the situation of all Indigenous people living in Australia. What are the implications for practitioners? It is important for oral health practitioners to have access to current and relevant statistics on the oral health of Indigenous Australians. However, we have highlighted significant evidence gaps for this population group within the peer-reviewed literature and identified the limitations of the available data upon which decisions are currently being made. This paper also identifies ways to capture and report oral health data in the future to enable more meaningful comparisons and relevance for use in policy development.

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Flying blind: trying to find solutions to Indigenous oral health

Australian Health Review ◽

10.1071/ah15157 ◽

2016 ◽

Vol 40 (5) ◽

pp. 570 ◽

Cited By ~ 4

Author(s):

Andrea M. de Silva ◽

Jacqueline Martin-Kerry ◽

Alexandra Geale ◽

Deborah Cole

Keyword(s):

Oral Health ◽

Indigenous People ◽

Hospital Admissions ◽

Health Data ◽

Indigenous Populations ◽

Oral Disease ◽

Caries Experience ◽

Published Evidence ◽

Health Differences ◽

Indigenous Children

Objective The aim of the present study was to identify all published evidence about oral health in Indigenous children in Australia and to determine trends in Indigenous oral health over time. Methods PubMed was used to search for published peer-reviewed articles that reported caries (decay) prevalence rates and/or caries experience (based on caries indices) in Indigenous children. Studies included in the analysis needed to report clinical oral health data (not self-reported dental experiences), and articles were excluded if they reported caries in only a select, specific or targeted sample (e.g. only children undergoing hospital admissions for dental conditions). Results The review identified 32 studies that met the inclusion criteria. These studies reported data from the Northern Territory (n = 14), Western Australia (n = 7), South Australia (n = 7), Queensland (n = 7), New South Wales (n = 1), Australian Capital Territory (n = 1) and Tasmania (n = 1). Of the studies, 47% were in rural locations, 9% were in urban locations and 44% were in both rural and urban locations. Data are limited and predominantly for Indigenous children living in rural locations, and there are no published studies on caries in Indigenous children living in Victoria. Conclusions The present study documents the published prevalence and severity of caries in Indigenous children living in Australia and highlights that limited oral health data are available for this priority population. Although risk factors for oral disease are well known, most of the studies did not analyse the link between these factors and oral disease present. There is also inconsistency in how caries is reported in terms of age and caries criteria used. We cannot rely on the available data to inform the development of policies and programs to address the oral health differences in Indigenous populations living contemporary lives in metropolitan areas. What is known about the topic? Many studies report that Indigenous people have poorer general health in Australia compared with non-Indigenous people. What does this paper add? This paper documents the available published prevalence and experience of caries for Indigenous children in Australia. It demonstrates significant limitations in the data, including no Victorian data, inconsistency with reporting methods and most data being for Indigenous children who are living in rural locations. What are the implications for practitioners? It is important for practitioners to have access to oral health data for Indigenous children in Australia. However, the present study highlights significant knowledge gaps for this population group and identifies ways to collect data in future studies to enable more meaningful comparisons and policy development.

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Relationship between dental and periodontal health status and the salivary microbiome: bacterial diversity, co-occurrence networks and predictive models

Scientific Reports ◽

10.1038/s41598-020-79875-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

M. Relvas ◽

A. Regueira-Iglesias ◽

C. Balsa-Castro ◽

F. Salazar ◽

J. J. Pacheco ◽

...

Keyword(s):

Oral Health ◽

Periodontal Disease ◽

Bacterial Diversity ◽

Predictive Models ◽

Oral Disease ◽

Rrna Gene ◽

Convenience Sample ◽

Core Microbiome ◽

Rdna Sequencing ◽

The Impact

AbstractThe present study used 16S rRNA gene amplicon sequencing to assess the impact on salivary microbiome of different grades of dental and periodontal disease and the combination of both (hereinafter referred to as oral disease), in terms of bacterial diversity, co-occurrence network patterns and predictive models. Our scale of overall oral health was used to produce a convenience sample of 81 patients from 270 who were initially recruited. Saliva samples were collected from each participant. Sequencing was performed in Illumina MiSeq with 2 × 300 bp reads, while the raw reads were processed according to the Mothur pipeline. The statistical analysis of the 16S rDNA sequencing data at the species level was conducted using the phyloseq, DESeq2, Microbiome, SpiecEasi, igraph, MixOmics packages. The simultaneous presence of dental and periodontal pathology has a potentiating effect on the richness and diversity of the salivary microbiota. The structure of the bacterial community in oral health differs from that present in dental, periodontal or oral disease, especially in high grades. Supragingival dental parameters influence the microbiota’s abundance more than subgingival periodontal parameters, with the former making a greater contribution to the impact that oral health has on the salivary microbiome. The possible keystone OTUs are different in the oral health and disease, and even these vary between dental and periodontal disease: half of them belongs to the core microbiome and are independent of the abundance parameters. The salivary microbiome, involving a considerable number of OTUs, shows an excellent discriminatory potential for distinguishing different grades of dental, periodontal or oral disease; considering the number of predictive OTUs, the best model is that which predicts the combined dental and periodontal status.

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CD8+ T cell landscape in Indigenous and non-Indigenous people restricted by influenza mortality-associated HLA-A*24:02 allomorph

Nature Communications ◽

10.1038/s41467-021-23212-x ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Luca Hensen ◽

Patricia T. Illing ◽

E. Bridie Clemens ◽

Thi H. O. Nguyen ◽

Marios Koutsakos ◽

...

Keyword(s):

T Cells ◽

T Cell ◽

High Risk ◽

Indigenous People ◽

Influenza A ◽

Indigenous Populations ◽

Indigenous Australians ◽

T Cell Epitopes ◽

Cell Responses ◽

Severe Influenza

AbstractIndigenous people worldwide are at high risk of developing severe influenza disease. HLA-A*24:02 allele, highly prevalent in Indigenous populations, is associated with influenza-induced mortality, although the basis for this association is unclear. Here, we define CD8+ T-cell immune landscapes against influenza A (IAV) and B (IBV) viruses in HLA-A*24:02-expressing Indigenous and non-Indigenous individuals, human tissues, influenza-infected patients and HLA-A*24:02-transgenic mice. We identify immunodominant protective CD8+ T-cell epitopes, one towards IAV and six towards IBV, with A24/PB2550–558-specific CD8+ T cells being cross-reactive between IAV and IBV. Memory CD8+ T cells towards these specificities are present in blood (CD27+CD45RA− phenotype) and tissues (CD103+CD69+ phenotype) of healthy individuals, and effector CD27−CD45RA−PD-1+CD38+CD8+ T cells in IAV/IBV patients. Our data show influenza-specific CD8+ T-cell responses in Indigenous Australians, and advocate for T-cell-mediated vaccines that target and boost the breadth of IAV/IBV-specific CD8+ T cells to protect high-risk HLA-A*24:02-expressing Indigenous and non-Indigenous populations from severe influenza disease.

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Interdental Cleaning and Oral Health Status in an Adult Cohort, 2015 to 2018

Journal of Dental Research ◽

10.1177/0022034520926139 ◽

2020 ◽

Vol 99 (10) ◽

pp. 1150-1156

Author(s):

B.W. Chaffee ◽

D. Persai ◽

M.V. Vora

Keyword(s):

Oral Health ◽

Periodontal Disease ◽

Odds Ratio ◽

Adjusted Odds Ratio ◽

Disease Risk ◽

The United States ◽

Oral Health Status ◽

Oral Disease ◽

Health Study ◽

Lower Odds

Interdental cleaning is routinely recommended, despite limited evidence supporting efficacy to prevent advanced oral disease endpoints, such as caries and periodontal disease. We aimed to examine associations between interdental cleaning and oral health in a large, generalizable prospective cohort of adults in the United States. Data were drawn from wave 3 (2015 to 2016, n = 26,086 included in analysis) and wave 4 (2016 to 2018, n = 22,585) of the adult component (age ≥18 y) of the nationally representative Population Assessment of Tobacco and Health Study. Survey-weighted multivariable regression models estimated the associations between wave 3 weekly interdental cleaning frequency and 6 measures of self-reported oral health—overall rating, tooth extractions, gum bleeding, loose teeth, bone loss around teeth, and gum disease—cross-sectionally and prospectively, with adjustment for established periodontal disease risk factors. As compared with no interdental cleaning, interdental cleaning ≥7 times/wk was prospectively associated with greater odds of excellent self-rated oral health (adjusted odds ratio, 1.37; 95% CI, 1.17 to 1.62), lower odds of bleeding gums (adjusted odds ratio, 0.62; 95% CI, 0.54 to 0.70), but not statistically significantly lower odds of other oral health conditions in the following 12 mo. Older age, lower socioeconomic status, diabetes, and cigarette smoking were consistently associated with worse oral health across all outcome measures. Findings were largely robust to alternative model and variable specifications. Interdental cleaning is associated with better perceived oral health and less self-reported gingivitis. Prevention of more advanced disease states was not demonstrated. These findings should be interpreted cautiously given the self-reported nature of the measures and relatively short follow-up period.

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CD8+ T-cell landscape in Indigenous and non-Indigenous people restricted by influenza mortality-associated HLA-A*24:02 allomorph

10.1101/2020.10.02.20206086 ◽

2020 ◽

Author(s):

Luca Hensen ◽

Patricia T. Illing ◽

E. Bridie Clemens ◽

Thi H.O. Nguyen ◽

Marios Koutsakos ◽

...

Keyword(s):

T Cells ◽

T Cell ◽

High Risk ◽

Indigenous People ◽

Influenza A ◽

Indigenous Populations ◽

Indigenous Australians ◽

T Cell Epitopes ◽

Cell Responses ◽

Severe Influenza

ABSTRACTIndigenous people worldwide are at high-risk of developing severe influenza disease. HLA-A*24:02 allele, highly prevalent in Indigenous populations, is associated with influenza-induced mortality, although the basis for this association is unclear. We defined CD8+ T-cell immune landscapes against influenza A (IAV) and B (IBV) viruses in HLA-A*24:02-expressing Indigenous and non-Indigenous individuals, human tissues, influenza-infected patients and HLA-A*24:02-transgenic mice. We identified immunodominant protective CD8+ T-cell epitopes, one towards IAV and six towards IBV, with A24/PB2550-558-specific CD8+ T-cells cells being cross-reactive between IAV and IBV. Memory CD8+ T-cells towards these specificities were present in blood (CD27+CD45RA- phenotype) and tissues (CD103+CD69+ phenotype) of healthy subjects, and effector CD27-CD45RA-PD-1+CD38+CD8+ T-cells in IAV/IBV patients. Our data present the first evidence of influenza-specific CD8+ T-cell responses in Indigenous Australians, and advocate for T-cell-mediated vaccines that target and boost the breadth of IAV/IBV-specific CD8+ T-cells to protect high-risk HLA-A*24:02-expressing Indigenous and non-Indigenous populations from severe influenza disease.One Sentence SummaryInfluenza-specific CD8+ T-cell specificities restricted by HLA-A*24:02.

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How oral infections can influence chronic kidney disease – a review of the literature

African Journal of Nephrology ◽

10.21804/23-1-4110 ◽

2020 ◽

Vol 23 (1) ◽

Author(s):

Carla Cruvinel Pontes ◽

Usuf ME Chikte

Keyword(s):

Chronic Kidney Disease ◽

Oral Health ◽

Kidney Disease ◽

Periodontal Disease ◽

Negative Impact ◽

The Body ◽

Oral Disease ◽

Oral Diseases ◽

Oral Infections ◽

Source Of Infection

A healthy mouth is necessary for optimal health and quality of life. However, oral health is often compromised in adults with chronic kidney disease (CKD). The aim of this review was to present the scientific foundations behind the connection between oral diseases and chronic kidney disease (CKD) in adults, discuss common oral conditions and their systemic effects, investigate biological pathways through which oral infections affect the body and provide guidelines for physicians/nephrologists. Prevalence of oral disease is increased in CKD, including periodontal disease, oral mucosal lesions, edentulousness, xerostomia, gingival overgrowth in immunosuppressed patients and potentially caries. There is moderate to strong evidence to support a negative impact of oral infections in CKD, particularly periodontal disease, with systemic inflammation, bacteraemia of oral origin, endothelial function and gut dysbiosis being potential pathways for this interaction. Poor oral health can be a hidden source of infection and has been associated with increased mortality in CKD patients. Elimination of potential foci for oral infections is crucial before renal transplantation. Frequent dental monitoring is crucial for these patients and should be part of a multidisciplinary approach to manage CKD, with special attention to end-stage kidney disease.

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Challenges in Oral Health Provision and Utilization in the Australian Indigenous Population: A Scoping Review

10.21203/rs.3.rs-42699/v1 ◽

2020 ◽

Author(s):

Peivand Bastani ◽

Yaser Sarikhani ◽

Arash Ghanbarzadegan ◽

Faeze Ostovar ◽

Lisa Jamieson

Keyword(s):

Public Health ◽

Oral Health ◽

Health Services ◽

Scoping Review ◽

Research Question ◽

Indigenous Populations ◽

Indigenous Australians ◽

Service Access ◽

Indigenous Australian ◽

Oral Health Services

Abstract Background Oral health is a vital area of public health. Access to dental services are particularly important among Indigenous populations at a global level. This scoping review aimed to investigate challenges in the provision and utilization of oral health services among Indigenous Australians. The findings may be an important contribution to the literature and facilitate policymakers in reducing inequities in dental service access and utilisation among this vulnerable population. Methods This scoping review was conducted up to June 10, 2020. Five main databases were searched, including PUBMED, SCOPUS, ISI Web of Science, EMBASE and PROQUEST. The main key words were: oral health, dental health, utilization, provision, access, Indigenous, Native, Aboriginal and Torres Strait Islander. Arksey and O’Malley`s protocol was applied, which comprises 5 steps of: (1) identifying the research question; (2) identifying relevant studies; (3) study selection; (4) charting the data and collating and; (5) summarising and reporting results. Thematic analysis was used to summarize and analyse the data applying MAX QDA10 software for qualitative data analysis. For a better understanding of the themes and subthemes, a thematic network was presented. Results Results show that there are six main themes and fourteen sub-themes affecting Indigenous Australians` utilization and provision of oral health services. Personal characteristics, Socio-economic status and challenges regarding access were that the main factors influencing utilization of oral health services. The findings suggest that challenges relating to public health, policymaking and service provision can affect Indigenous Australians provision to oral health services. Conclusion Benefits in Indigenous Australian access and utilization of oral health services may improve if policy makers at both national and local levels increase resourcing in this important public health sector. A deeper understanding of the social and cultural nuances driving Indigenous Australians’ reluctance to attend for dental care is crucial.

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Factors influencing the perceived importance of oral health within a rural Aboriginal and Torres Strait Islander Community in Australia.

10.21203/rs.2.19642/v3 ◽

2020 ◽

Author(s):

Anna Tynan ◽

David Walker ◽

Taygan Tucker ◽

Barry Fisher ◽

Tarita Fisher

Keyword(s):

Oral Health ◽

Health Services ◽

Indigenous Community ◽

Oral Disease ◽

Indigenous Australians ◽

Family Responsibilities ◽

Factors Influencing ◽

Perceived Importance ◽

Oral Health Services ◽

Depth Interviews

Abstract Background: Indigenous Australians suffer from higher rates of oral disease and have more untreated dental problems and tooth extractions than the general population. Indigenous Australians also have lower rates of accessing oral health services and are more likely to visit for a problem rather than a check-up. Multiple issues effect health service and prevention programs including: characteristics of health services such as distances to health services; existence of social and cultural barriers; available wealth and social support; and, characteristics of the individual and community including the importance given to the disease. This paper seeks to explore the perceived importance of oral health within a rural Indigenous community in Australia and the factors influencing this perception.Methods: The study used a phenomenology research design incorporating focus group discussions and in-depth interviews. It was undertaken in partnership with communities’ Health Action Group who guided the focus, implementation and reporting of the research. A convenience sample was recruited from established community groups. Thematic analysis on the transcripts was completed. Results : Twenty-seven community members participated in three focus groups and twelve in-depth interviews. The study found that the community gives high priority to oral health. Factors influencing the importance include: the perceived severity of symptoms of oral disease such as pain experienced due to tooth ache; lack of enabling resources such as access to finance and transport; the social impact of oral disease on individuals including impact on their personal appearance and self-esteem; and health beliefs including oral health awareness. Participants also noted that the importance given to oral health within the community competed with the occurrence of multiple health concerns and family responsibilities.Conclusion: This paper highlights the high importance this rural Indigenous community gives to oral health. Its findings suggest that under-utilisation of oral health services is influenced by both major barriers faced in accessing oral health services; and the number and severity of competing health and social concerns within the community. The study results confirm the importance of establishing affordable, culturally appropriate, community-based oral health care services to improve the oral health of rural Indigenous communities.

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Microbiota populations in supragingival plaque, subgingival plaque, and saliva habitats of adult dogs

Animal Microbiome ◽

10.1186/s42523-021-00100-9 ◽

2021 ◽

Vol 3 (1) ◽

Author(s):

Patrícia M. Oba ◽

Meredith Q. Carroll ◽

Celeste Alexander ◽

Helen Valentine ◽

Amy J. Somrak ◽

...

Keyword(s):

Oral Health ◽

Oral Cavity ◽

Periodontal Disease ◽

Bacterial Species ◽

Oral Disease ◽

Oral Microbiota ◽

Subgingival Plaque ◽

Oral Diseases ◽

Supragingival Plaque

Abstract Background Oral diseases are common in dogs, with microbiota playing a prominent role in the disease process. Oral cavity habitats harbor unique microbiota populations that have relevance to health and disease. Despite their importance, the canine oral cavity microbial habitats have been poorly studied. The objectives of this study were to (1) characterize the oral microbiota of different habitats of dogs and (2) correlate oral health scores with bacterial taxa and identify what sites may be good options for understanding the role of microbiota in oral diseases. We used next-generation sequencing to characterize the salivary (SAL), subgingival (SUB), and supragingival (SUP) microbial habitats of 26 healthy adult female Beagle dogs (4.0 ± 1.2 year old) and identify taxa associated with periodontal disease indices. Results Bacterial species richness was highest for SAL, moderate for SUB, and lowest for SUP samples (p < 0.001). Unweighted and weighted principal coordinates plots showed clustering by habitat, with SAL and SUP samples being the most different from one another. Bacteroidetes, Proteobacteria, Firmicutes, Fusobacteria, Actinobacteria, and Spirochaetes were the predominant phyla in all habitats. Paludibacter, Filifactor, Peptostreptococcus, Fusibacter, Anaerovorax, Fusobacterium, Leptotrichia, Desulfomicrobium, and TG5 were enriched in SUB samples, while Actinomyces, Corynebacterium, Leucobacter, Euzebya, Capnocytophaga, Bergeyella, Lautropia, Lampropedia, Desulfobulbus, Enhydrobacter, and Moraxella were enriched in SUP samples. Prevotella, SHD-231, Helcococcus, Treponema, and Acholeplasma were enriched in SAL samples. p-75-a5, Arcobacter, and Pasteurella were diminished in SUB samples. Porphyromonas, Peptococcus, Parvimonas, and Campylobacter were diminished in SUP samples, while Tannerella, Proteocalla, Schwartzia, and Neisseria were diminished in SAL samples. Actinomyces, Corynebacterium, Capnocytophaga, Leptotrichia, and Neisseria were associated with higher oral health scores (worsened health) in plaque samples. Conclusions Our results demonstrate the differences that exist among canine salivary, subgingival plaque and supragingival plaque habitats. Salivary samples do not require sedation and are easy to collect, but do not accurately represent the plaque populations that are most important to oral disease. Plaque Actinomyces, Corynebacterium, Capnocytophaga, Leptotrichia, and Neisseria were associated with higher (worse) oral health scores. Future studies analyzing samples from progressive disease stages are needed to validate these results and understand the role of bacteria in periodontal disease development.

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How well does the National Disability Insurance Scheme respond to the issues challenging Indigenous people with disability?

Aotearoa New Zealand Social Work ◽

10.11157/anzswj-vol29iss4id281 ◽

2017 ◽

Vol 29 (4) ◽

pp. 49-60 ◽

Cited By ~ 1

Author(s):

Phuong Lan Do

Keyword(s):

Indigenous People ◽

Disability Insurance ◽

Indigenous Communities ◽

Social Model ◽

Indigenous Populations ◽

Disability Services ◽

Indigenous Australians ◽

Insurance Scheme ◽

The Social ◽

Colonial Theory

INTRODUCTION: The participation rates of Indigenous Australians in disability services were significantly lower than the prevalence of disability in Indigenous communities. The Australia’s National Disability Insurance Scheme (NDIS) promises changes to the lives of Australians with disability in general and particularly for the Indigenous population living with disability. This article presents research exploring how the NDIS takes into consideration the issues challenging Indigenous people’s access to, and use of, disability services.METHODS: The theoretical underpinning of the research drew on the social model of disability and post-colonial theory, which informed a systematic review of disability services for Indigenous people, an analysis of the current policy-making process and current NDIS legislation.FINDINGS: The systematic literature review revealed the social, attitudinal, physical and communication barriers experienced by Indigenous people accessing and using disability services; however, the policy analysis of the NDIS indicates that the new legislation does not address these challenges faced by this multi-disadvantaged Australian population group.CONCLUSION: This research highlights the urgent need for disability policy improvements and promotes further design of culturally appropriate healthcare for Indigenous populations, who are still “disabled”, not only by colonised histories but also through contemporary socio-economic marginalization.

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