Oral health of Indigenous adult public dental patients in Australia

Abstract

Indigenous Australians have been reported in a range of studies to have worse health than non-Indigenous Australians. Among health care card holders, a financially disadvantaged group eligible for public-funded dental care, oral health may also be worse among Indigenous persons. The aims of this study were to examine the oral health of Indigenous compared to non-Indigenous adult public dental patients in terms of caries experience and periodontal status, controlling for age and gender of patient, type of care and geographic location. Patients were sampled randomly by state/territory dental services in 2001-2002. Dentists recorded oral health status at the initial visit of a course of care using written instructions. The samples were weighted in proportion to the numbers of public-funded dental patients for each state/territory. Multivariate logistic regression showed that the presence of periodontal pockets of 6+ mm was higher (P < 0.05) among Indigenous compared to non-Indigenous patients (OR = 2.24, 1.34-3.76), after controlling for age and gender of patients, type of care and geographic location. Multivariate negative binomial regression analysis (RR: rate ratio) controlling for age and gender of patients, type of care and geographic location indicated that Indigenous patients had higher numbers of decayed teeth (RR = 1.42) and missing teeth (RR = 1.44) but lower numbers of filled teeth (RR = 0.51) compared to non-Indigenous patients (P < 0.05). There was no significant difference in the DMFT index, indicating similar cumulative past and present experience of dental caries for Indigenous and non-Indigenous patients. Indigenous adult public dental patients had worse oral health status than non-Indigenous patients, with a higher percentage of Indigenous patients having periodontal pockets 6+ mm, and Indigenous patients having more decayed and missing teeth. Indigenous patients lack both timely and appropriate preventive and treatment services.