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Oral health inequalities between young Aboriginal and non-Aboriginal children living in Ontario, Canada.

https://arctichealth.org/en/permalink/ahliterature148361
Source
Community Dent Oral Epidemiol. 2009 Dec;37(6):495-508
Publication Type
Article
Date
Dec-2009
Author
Herenia P Lawrence
Darlene Binguis
Jan Douglas
Lynda McKeown
Bonita Switzer
Rafael Figueiredo
Margaret Reade
Author Affiliation
Community Dentistry Discipline, Department of Biological and Diagnostic Sciences, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada. herenia.lawrence@dentistry.utoronto.ca
Source
Community Dent Oral Epidemiol. 2009 Dec;37(6):495-508
Date
Dec-2009
Language
English
Publication Type
Article
Keywords
Child, Preschool
Confidence Intervals
Cross-Sectional Studies
Dental Caries - epidemiology
Female
Health Status Disparities
Humans
Indians, North American
Male
Odds Ratio
Ontario - epidemiology
Oral Health
Oral Hygiene Index
Abstract
To investigate (i) oral health inequalities between off-reserve Aboriginal and non-Aboriginal children entering junior kindergarten (JK) in the Thunder Bay District, Northwest Ontario, Canada, (ii) oral health inequalities between kindergarten-aged (4 years old) Aboriginal children living on reserves in the Sioux Lookout Zone (SLZ), Northwest Ontario and those living off-reserve in the Thunder Bay District and (iii) early childhood caries (ECC) trends among SLZ children between 2001 and 2005.
Cross-sectional oral health data (dmft/s Indices) for 416 (2003/2004), 687 (2004/2005) and 544 (2005/2006) 3- to 5-year olds attending JK in the Thunder Bay District were collected by calibrated dental hygienists with the District's Health Unit. Secondary analysis of oral health status data from two studies conducted in the SLZ between 2001 and 2005 provided the dmft of random samples of children younger than 6 years of age living in 16-20 First Nations communities.
When compared with non-Aboriginal children aged 3-5 years attending the same schools in the Thunder Bay District between 2003 and 2006, off-reserve Aboriginal children had 1.9 to 2.3 times the risk of having ECC (dmft > 0), 2.9 to 3.5 times the risk of a dmft > 3 and 1.8 to 2.5 times the risk of untreated decayed teeth after adjusting the prevalence ratios for child's age and sex, school's risk level and clustered-correlated data. The mean dmft of on-reserve Aboriginal 4-year olds in 2005 was 11.2 and 5.9 for their off-reserve Aboriginal counterparts. In 2001, the mean dmft scores (95% confidence interval) of 2-, 3- and 4-year-old Aboriginal children in the SLZ were: 9.1 (8.3-9.9), 12.4 (11.8-13.1), 13.1 (12.1-14.2). In 2005, similarly aged SLZ children had a mean dmft of: 6.2 (5.2-7.1), 8.9 (8.2-9.6), 11.2 (10.5-11.9), representing significant reductions in caries severity (32%, 28% and 14.5%, respectively).
Significant disparities in caries experience exist between off-reserve Aboriginal and non-Aboriginal children living in the same locales and between Aboriginal children living on- and off-reserve in northwestern Ontario. The study showed decreased trends in the severity of ECC for children in the SLZ occurring over the 5-year period. Despite this progress, the oral health of young Aboriginal children in Ontario continues to lag far behind that of non-Aboriginal children, demanding further programs and policies to tackle the social determinants of oral health and resolve these inequalities.
PubMed ID
19780768 View in PubMed
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A 2-year community-randomized controlled trial of fluoride varnish to prevent early childhood caries in Aboriginal children.

https://arctichealth.org/en/permalink/ahliterature157658
Source
Community Dent Oral Epidemiol. 2008 Dec;36(6):503-16
Publication Type
Article
Date
Dec-2008
Author
Herenia P Lawrence
Darlene Binguis
Jan Douglas
Lynda McKeown
Bonita Switzer
Rafael Figueiredo
Audrey Laporte
Author Affiliation
Community Dentistry Discipline, Department of Biological and Diagnostic Sciences, Faculty of Dentistry, University of Toronto, Toronto, ON, Canada. herenia.lawrence@utoronto.ca
Source
Community Dent Oral Epidemiol. 2008 Dec;36(6):503-16
Date
Dec-2008
Language
English
Publication Type
Article
Keywords
Caregivers - education
Cariostatic Agents - administration & dosage - therapeutic use
Child, Preschool
Cluster analysis
DMF Index
Dental Caries - epidemiology - prevention & control
Female
Fluorides, Topical - therapeutic use
Health Education, Dental
Health Status Disparities
Humans
Incidence
Indians, North American
Infant
Logistic Models
Male
Ontario - epidemiology
Prevalence
Sodium Fluoride - administration & dosage
Tooth, Deciduous
Abstract
To measure the effectiveness of fluoride varnish (FV) (Duraflor), 5% sodium fluoride, Pharmascience Inc., Montréal, QC, Canada) and caregiver counseling in preventing early childhood caries (ECC) in Aboriginal children in a 2-year community-randomized controlled trial.
Twenty First Nations communities in the Sioux Lookout Zone (SLZ), Northwest Ontario, Canada were randomized to two study groups. All caregivers received oral health counseling, while children in one group received FV twice per year and the controls received no varnish. A total of 1275, 6 months to 5-year-old children from the SLZ communities were enrolled. In addition, a convenience sample of 150 primarily non-Aboriginal children of the same age were recruited from the neighboring community of Thunder Bay and used as comparisons. Longitudinal examinations for the dmft/s indices were conducted by calibrated hygienists in 2003, 2004 and 2005.
Aboriginal children living in the SLZ or in Thunder Bay had significantly higher caries prevalence and severity than non-Aboriginal children in Thunder Bay. FV treatment conferred an 18% reduction in the 2-year mean 'net' dmfs increment for Aboriginal children and a 25% reduction for all children, using cluster analysis to adjust for the intra-cluster correlation among children in the same community. Adjusted odds ratio for caries incidence was 1.96 times higher in the controls than in the FV group (95% CI = 1.08-3.56; P = 0.027). For those caries-free at baseline, the number (of children) needed to treat (NNT) equaled 7.4.
Findings support the use of FV at least twice per year, in conjunction with caregiver counseling, to prevent ECC, reduce caries increment and oral health inequalities between young Aboriginal and non-Aboriginal children.
PubMed ID
18422711 View in PubMed
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