Oral Health Inequities: Using Every Opportunity for Opportunistic Oral Healthcare

Area of Science:

• Pediatric Dentistry
• Public Health
• Health Equity

Background:

• Childhood caries (tooth decay) remains a significant public health issue in New Zealand.
• Ethnic and socioeconomic disparities in oral health outcomes are well-documented in the Auckland region.
• Understanding oral health status across different healthcare settings is crucial for targeted interventions.

Purpose of the Study:

• To compare caries-free rates and decayed, missing, filled teeth (dmft) scores among children in inpatient, day stay, and specialist outpatient clinics with the general population.
• To investigate ethnic variations in oral health outcomes within these distinct pediatric patient groups.
• To identify potential disparities in oral health service utilization and outcomes.

Main Methods:

• Retrospective data extraction of pediatric admissions (inpatient, day stay) from Starship Children's Hospital (2019).
• Inclusion of children from the Auckland bronchiectasis register (specialist outpatient clinic).
• Oral health data linkage with the Auckland Regional Dental Service database (until 2021) to determine caries-free status and dmft scores around age 5.

Main Results:

• Significant ethnic differences in caries-free rates and dmft scores were observed at the population and patient group levels.
• Inpatient and day stay groups did not differ from the general population in caries prevalence or severity within ethnic groups.
• Specialist outpatient clinic attendees exhibited significantly lower caries-free status compared to the general population, and all patient groups had lower rates of oral health records.

Conclusions:

• Persistent oral health inequities exist among children in the Auckland region, disproportionately affecting Māori and Pacific peoples.
• Existing healthcare structures require urgent development to address these inequities and improve access to free dental services.
• Leveraging hospital appointments and admissions presents an opportunity for opportunistic oral health screening and intervention.