Oral Health Inequities: Using Every Opportunity for Opportunistic Oral Healthcare

Abstract

Aims

The aim of this study was to determine if caries-free rates and the number of teeth affected by caries in children from inpatient, day stay, and specialist outpatient clinic groups differed significantly from the population and by ethnicity.

Methods

We extracted admissions for general medical admissions (inpatient) and day stay surgery for grommets (day stay) for 2019 from Starship Children's Hospital, Auckland, New Zealand, and children on the Auckland bronchiectasis register (specialist outpatient clinic). Oral health data was extracted from the Auckland Regional Dental Service database until the end of 2021. The primary outcome was caries free at approximately 5 years of age (±1 year) and the secondary outcome was decayed, missing, filled teeth (dmft) score.

Results

There were significant differences in the caries free rates and dmft scores by ethnicity at the population level and across all three selected patient groups. Compared to the ARDS population, neither the proportion with caries nor the number of teeth affected were different in the inpatient or day stay groups within ethnic groups. These patient groups were less likely to have an oral health record than the ARDS population. The specialist outpatient clinic group had significantly lower caries free status than the ARDS population.

Conclusions

Poor oral health pervades children in the Auckland region with significant inequities. Structures and systems committed to reducing inequities for Māori and other underserved populations (including Pacific peoples) need to be developed urgently to improve access and uptake of the free service including the opportunistic circumstance of hospital appointments and admissions.