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The impact of different determinants on the dental caries experience of children living in Australia rural and urban areas


Ha, DH and Crocombe, LA and Khan, S and Do, LG, The impact of different determinants on the dental caries experience of children living in Australia rural and urban areas, Community Dentistry and Oral Epidemiology, 49, (4) pp. 337-345. ISSN 0301-5661 (2021) [Refereed Article]

Copyright Statement

2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd

DOI: doi:10.1111/cdoe.12606


Aims: Evidence suggests there are geographical variations in child oral health and this has prompted research into determinants of that variation. This study aimed to investigate factors attributable to the difference in child oral health between urban and rural areas in Australia.

Method: Data were from the National Child Oral Health Study 2012-14, a population-based study of 5- to 14-year-old children, who underwent oral epidemiological examinations by trained examiners. Caries prevalence (dmfs/DMFS > 0) and experience (dmfs/DMFS count) in the primary dentition (5- to 8-year-old) and permanent dentition (9- to 14-year-old) were calculated. Children were grouped by residential location (urban or rural areas). A parental questionnaire collected information on family socio-economic factors, and individual health behaviours (dental access, sugar consumption and toothbrushing). Residential history was used to calculate lifetime exposure to water fluoridation (WF). Analyses were weighted to produce population-representative estimates. The primary outcomes were assessed separately for the two groups in regression models with robust standard error estimation to estimate prevalence ratios and mean ratios and their 95% confidence intervals. Population Attributable Fractions were calculated using the population distribution of the exposures and their adjusted estimates.

Results: 10 581 5- to 8-year-old and 14 041 9- to 14-year-old children were included. Caries prevalence was higher in rural than in urban areas. In multivariable models, exposure to fluoridation, reason for dental visit and consumption of sugary beverages were consistently associated with caries prevalence and experience. WF coverage attributed to differences in caries prevalence (10% vs 21%) and experience (14% vs 35%) in the permanent dentition. High consumption of sugary beverages attributed to a higher primary and permanent dental caries experience in rural than in urban areas. Dental access was also attributed to the differences between the two areas.

Conclusion: Factors at both community and individual levels attributed to the observed differences in child caries prevalence and experience between urban and rural areas.

Item Details

Item Type:Refereed Article
Keywords:child, dental caries, determinants, oral health, permanent teeth, primary teeth, rural
Research Division:Biomedical and Clinical Sciences
Research Group:Dentistry
Research Field:Oral medicine and pathology
Objective Division:Health
Objective Group:Clinical health
Objective Field:Treatment of human diseases and conditions
UTAS Author:Crocombe, LA (Associate Professor Leonard Crocombe)
UTAS Author:Khan, S (Dr Shahrukh Khan)
ID Code:146430
Year Published:2021
Web of Science® Times Cited:5
Deposited By:UTAS Centre for Rural Health
Deposited On:2021-09-07
Last Modified:2021-10-12

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