Search

The study aimed to determine the relative contributions of bitewing radiography and clinical examination to caries estimates for a New Zealand child population with high caries experience. An epidemiological survey was conducted of 171 12- and 13-year-old children attending schools in five communities. Examinations were conducted in dental clinics. Bitewing radiographs were taken at the time of the clinical examination. These were developed and read later, and the data from those were used at the analysis stage to adjust the caries diagnosis for the mesial, occlusal and distal surfaces of the posterior teeth. For almost all parameters, the use of radiographs resulted in higher estimates, although at the whole-mouth prevalence level the difference was not great. The percent difference between the estimates ranged from –0.1 to 166.7%. There were moderate differences between the clinical-only and radiographically adjusted whole-mouth estimates for mean DMFT, DT, DMFS and DS, but only a minor difference in caries prevalence. With the mesial and distal surfaces only, the prevalence and severity estimates were significantly greater, with a one-surface difference (on average) in mean DS being the largest difference observed, at 166.7%. The diagnostic discrepancy was much greater for approximal than occlusal surfaces. These findings support but also build upon earlier findings and again underline the need for bitewing radiographs to be a routine part of oral epidemiological surveys wherever logistics and funding permit. Copyright © 2009 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Objective: To describe the prevalence, severity and intra-oral distribution of dental caries among children from four Northland communities., Design: Cross-sectional epidemiological survey of a Census sample., Methods: Dental examinations were systematically conducted on all children aged 5 or 6 and all children 12 or 13 (and for whom parental consent was obtained) in Kaitaia, Kaikohe, Kawakawa/Moerewa and Dargaville. Bitewing radiography was used to aid caries diagnosis in the older age group. Data are reported for the deciduous dentition in the 5-6-year-olds, and the permanent dentition in the 12-13-year-olds., Results: There were 369 5-6-year-olds and 171 12-13-year-olds, approximately two-thirds of whom were Maori. Almost 88% of 5-6-year-olds had experienced dental caries, and this was lower among the Pakeha/Other group, those attending higher-decile schools, and those from Dargaville. Overall caries experience (represented by a mean dmft score of 5.6; sd 3.9) was higher among Maori children, those attending lower-decile schools, and those from Kaikohe, Kawakawa/ Moerewa or Kaitaia, as was the number of untreated decayed surfaces. Almost one in four children had lost at least one tooth due to caries, and this was higher among Maori children and those from schools in more deprived areas, and lower among children from Dargaville. Caries experience was greatest among the second molars in either arch, and lowest among the mandibular incisors. Among the 12-13-year-olds, 85% had experienced dental caries (mean DMFT = 3.7; sd 3.1). The number of untreated surfaces with decay (more than 3, on average) was considerably lower among children from Dargaville. Caries experience was greatest among the first molars in either arch (followed by the second premolars), and absent among the mandibular incisors., Conclusions: The prevalence and severity of dental caries in Northland is very high in comparison to the rest of New Zealand. The problem is particularly acute among northern communities and Maori. Dealing with the problem will require a combination of population health and personal health interventions.

On 20 July 2006, the Far North District Council resolved to fluoridate Kaitaia and Kaikohe. This was the first such initiative by any Territorial Local Authority (TLA) in New Zealand for 23 years, and resulted from a fluoridation advocacy programme. This paper describes the programme implementation, assesses its consistency with the principles of the Treaty of Waitangi, and critically examines the collaboration between the fluoride advocate and the key stakeholders. Process evaluation identified three main categories of programme implementation: policy advocacy, community action projects, and media advocacy. The collaboration of iwi, Maori health providers and the community suggests that the programme was consistent with the principles (partnership, participation and protection) ofthe Treaty ofWaitangi. Media advocacy played an important role in reflecting and engaging community views on fluoridation, and it influenced decision-making by the Far North District Council. The simultaneous, combined 'top-down and bottom-up' approach was an effective and successful strategy for fluoridation advocacy in the community. Less integrated approaches implemented on their own (such as the 'top down' approach in Whangarei and the 'bottom-up' approach in Dargaville) were not effective.