Our past research
ARCPOH has a long history in research in population oral health, providing evidence for an important area of public health policy and service provision and gaining national and international standing for its research in this field and extensive collaborative linkages.
Core research areas
ARCPOH has an established record of research in five core research areas:
Distribution and determinants of oral health
Oral diseases and disorders are widespread and extensive in the population. ARCPOH has contributed to research in documenting and exploring trends in oral diseases and their distribution in the population. Research that seeks to understand the determinants of change over time or variation between subgroups in the population is fundamental to the process of improving oral health.
Burden and impact of oral disease
Oral disease has traditionally been described in terms of clinical measures; for example, teeth with experience of disease. This research area extends the capacity to measure oral disease experience through measures of oral-health-related quality of life and wellbeing, and how oral disease impacts on daily living; for example, disability-adjusted life years. Such research has become crucial to identifying priority areas in national health agendas. ARCPOH's research has identified marked variations in oral disease measures; for example, social gradients in oral-health-related quality of life and the factors underlying such variation, including individual behaviours and the individual, school/work and community circumstances that ultimately determine oral health.
Effectiveness of population oral health interventions
Research on water fluoridation and the prevention of dental caries and dental fluorosis, with additional emphasis on effectiveness in adult and older adult age groups, has been a priority area for ARCPOH.
Oral health services and labour force research
The dental labour force necessary to provide dental services and access to high-quality dental care is fundamental to oral-health-related quality of life and improved oral health. The particular focus in this research has been on public dental care program evaluation, private dental insurance, health labour force supply and distribution.
Oral health policy analysis
Research in this area focused on the provision of public dental care, including cost analysis of public dental care programs under a range of assumptions and with differing approaches to the management of demand and patient flows.
Below are examples of research projects led by ARCPOH in these areas.
National Surveys of Adult of Oral Health
Through collaboration with state and territory health authorities, ARCPOH has led, coordinated and delivered the only three national surveys of adult oral health in Australia. The initial National Oral Health Survey of Australia (NOHSA) was undertaken in 1987-1988; the second National Survey of Adult Oral Health (NSAOH) was conducted in 2004-2006; the third was conducted in 2017-2018 (NSAOH 2017-18).
The three surveys provide a descriptive 'snapshot' of oral health in the adult population of Australia, providing evidence that can contribute to the development of oral health policies and programs in Australia. Such evidence is essential because oral diseases represent a considerable burden on the health of the public.
The National Child Oral Health Study
The 2012-14 National Child Oral Health Study (NCOHS) was conducted in partnership with states and territories. NCOHS was a complex, multistage, stratified cross-sectional study of the child population aged 5-14 years in Australia. A total of 24,664 children from 841 participating schools completed the study. The study described the levels of dental caries experience and its components, dental fluorosis and other health conditions. It describes protective and risk factors, patterns of dietary intake and dental service use across Australian states and territories.
Minimally invasive approach manage early childhood caries in Aboriginal pre-schoolers
Early childhood caries (ECC) impact significantly on the quality of life of young children and their family. Hospital admission for the management of dental caries is a potentially avoidable hospitalization, the cost of which in Western Australia (WA) has been estimated at $3150 per admission in 2008-09, and the rate is higher among the Aboriginal population with a trend of increasing rates of admissions. A randomised pilot trial, which tested the effectiveness of a minimally invasive approach to managing ECC in WA, demonstrated nearly a ten-fold reduction in the need for referral for specialist dental care, which potentially had an impact on the likely need for hospital admissions. The intervention was cost saving and showed improvements in childhood oral health-related quality of life and reduced the occurrence of new decay. The study adopted the atraumatic restorative treatment (ART) approach, which relied principally on the use of hand instruments to remove dental caries and prepare the cavity, without the use of local anaesthesia, and the prepared cavity restored with a glass-ionomer cement. The children were also provided with preventive care by fissure sealing of at risk teeth and fluoride varnish applications. ART was originally developed to provide dental care to children in developing countries and communities. We aim to test the WA pilot RCT in field settings in the Kimberley region of WA among Aboriginal communities to determine its efficacy as a model of service delivery in rural and remote locations, where there is limited access to dental care. The study will use a delayed intervention cluster randomized design to ensure care is offered to all children in the study frame (preschool children) in the communities that agree to participate, with the control group being offered care after a time delay. The investigators will work closely with the Aboriginal communities and include capacity building and training as a component of the study.
The South Australian Dental Longitudinal Study (SADLS)
SADLS is a prospective cohort of adults age 60 years or more. Dental examinations occurred at baseline (1991-92), and follow up at 2 years, 5 years and 11 years (ending in 2002-03). A total of 445 participants were followed for the duration of study; in addition to clinical dental examinations and sociodemographic information, data was collected on medication use, general health and multi-morbidity.
Analysis of Indigenous data in National Survey of Adult Oral Health
The National Survey of Adult Oral Health was conducted between 2017 and 2018 by the Australian Research Centre of Population Oral Health (within which IOHU is nested). A total of 15,731 adults from across Australia took part, 2.2 percent of whom identified as being Aboriginal and/or Torres Strait Islander. Kostas is currently comparing dental disease estimates for Indigenous Australians from the 2004-06 national survey and the 2017-18 one. A series of publications is also proposed using the complete data set, which will comprise a subset that specifically focusses on Indigenous oral health risk factors.