Trial delivers promising results for oral health of Indigenous people
BRISBANE, Australia: In Australia, considerable oral health disparities exist between Indigenous and non-Indigenous populations. Health reports indicate that Indigenous Australians, particularly those in remote communities, are much more likely to have multiple caries and untreated dental disease owing to factors such as poor access to dental clinics, cost and lack of awareness. However, a new study out of Queensland has suggested that simple interventions in treating dental caries could have significant benefits for Indigenous children.
The research, funded by an Australian National Health and Medical Research Council project grant, was conducted prior to the COVID-19 pandemic by a team led by Dr Ratilal Lalloo, an associate professor at the University of Queensland’s School of Dentistry. Several members of the research team had previously published a paper demonstrating the effectiveness of water fluoridation in reducing dental caries in a remote Indigenous community in Far North Queensland. Though the community’s water supplies were fluoridated from 2005, the programme ceased in 2011, and this cessation has, according to the researchers, likely led to a worsening of dental caries statuses among the local population.
The researchers thus sought to find out what effect simple preventive interventions, such as application of a fluoride varnish and selective placement of fissure sealants, would have on caries issues in the Indigenous community.
“The overall purpose of the study was to determine whether professional interventions known to be effective individually, but deliberately applied together for maximum effect, compared to care as usual, were associated with a decrease in caries incidence and were cost-effective,” the study authors noted.
Approximately 600 children between 5 and 17 years of age were invited to participate in the study, and 408 of them consented to a head, neck and oral epidemiological examination as well as treatment if necessary. Of this group, 51% continued to receive follow-up examinations and treatment over the ensuing two years of observation. Overall, these children were found to have significantly fewer tooth surfaces with carious lesions at the two-year follow-up examination than those who did not receive any treatment.
“While our annual intervention reduced caries incidence, caries increment remains unacceptably high in this community, even in children who received it,” the authors noted in their paper. “These interventions are resource-intensive, so consideration should be given to proven cost-effective interventions such as the reintroduction of water fluoridation.”
In an interview with the Brisbane Times, Lalloo noted that the research had already made a positive difference in the lives of the Indigenous children who had received examinations and treatment when necessary.
“Normally in research you don’t treat existing disease, but in our case we were given funds to employ a clinical team, and the children who took part all benefited from having their tooth decay treated,” he said.
Speaking to Dental Tribune International, Lalloo mentioned that the research team was now aiming to “translate this work into policy and practice changes based on the evidence from the study”.
“We were hoping to return to this community to measure the impact of not continuing the intervention, but funding applications were unfortunately not successful,” Lalloo added.
The study, titled “Carious lesions in permanent dentitions are reduced in remote Indigenous Australian children taking part in a non-randomised preventive trial”, was published on 28 January 2021 in PLOS One.