Oral health of Indigenous adult public dental patients in Australia

Abstract

Background: 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. Methods: 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. Results: 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. Conclusions: 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.