Author
A. John Spencer
Bio: A. John Spencer is an academic researcher from University of Adelaide. The author has contributed to research in topics: Population & Water fluoridation. The author has an hindex of 40, co-authored 126 publications receiving 5226 citations.
Papers published on a yearly basis
Papers
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TL;DR: Results are consistent with a hypothesised vicious cycle of dental fear whereby people with high dental fear are more likely to delay treatment, leading to more extensive dental problems and symptomatic visiting patterns which feed back into the maintenance or exacerbation of existing dental fear.
Abstract: Based on the hypothesis that a vicious cycle of dental fear exists, whereby the consequences of fear tend to maintain that fear, the relationship between dental fear, self-reported oral health status and the use of dental services was explored. The study used a telephone interview survey with interviews predominantly conducted in 2002. A random sample of 6,112 Australian residents aged 16 years and over was selected from 13 strata across all States and Territories. Data were weighted across strata and by age and sex to obtain unbiased population estimates. People with higher dental fear visited the dentist less often and indicated a longer expected time before visiting a dentist in the future. Higher dental fear was associated with greater perceived need for dental treatment, increased social impact of oral ill-health and worse self-rated oral health. Visiting patterns associated with higher dental fear were more likely to be symptom driven with dental visits more likely to be for a problem or for the relief of pain. All the relationships assumed by a vicious cycle of dental fear were significant. In all, 29.2% of people who were very afraid of going to the dentist had delayed dental visiting, poor oral health and symptom-driven treatment seeking compared to 11.6% of people with no dental fear. Results are consistent with a hypothesised vicious cycle of dental fear whereby people with high dental fear are more likely to delay treatment, leading to more extensive dental problems and symptomatic visiting patterns which feed back into the maintenance or exacerbation of existing dental fear.
426 citations
29 Mar 2007
TL;DR: Australia's dental generations provides a detailed snapshot of oral health in the adult population at the beginning of the twenty-first century, and describes levels of oral disease, perceived oral health and patterns of dental care for the nation, and among sociodemographic subgroups.
Abstract: Australia's dental generations provides a detailed snapshot of oral health in the adult population at the beginning of the twenty-first century. Drawing on the findings from the 2004-06 National Survey of Adult Oral Health, the report describes levels of oral disease, perceived oral health and patterns of dental care for the nation, and among sociodemographic subgroups. The report also analyses trends in oral health that have occurred since the first national oral health survey conducted 17 years ago. The results illustrate how unique historical experiences of four generations born throughout the twentieth century have left a lasting imprint on the distribution of oral health in today's population.
289 citations
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TL;DR: The commonly held view that the poor oral health of poor people is explained by personal neglect was not supported in this study.
Abstract: The definitive version is available at www.blackwell-synergy.com Copyright © 2006 Blackwell Munksgaard
201 citations
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TL;DR: An oral health promotion programme based on repeated rounds of anticipatory guidance initiated during the mother's pregnancy was successful in reducing the incidence of S-ECC in these very young children.
Abstract: – Objective: Despite a marked improvement in oral health of Australian children over the last 30 years, severe early childhood caries (S-ECC) affects up to 17% of 2- to 3-year-old children with some requiring hospitalization and invasive treatment. This provided a compelling rationale to develop and test an oral health promotion programme which aimed to reduce this unnecessary suffering. The purpose of this study was to test the efficacy of an oral health promotion programme for the parents of infants, starting during the pregnancy, using a randomized controlled trial.
Methods: A programme was developed around the provision of anticipatory guidance to nulliparous women (women expecting their first child) in Adelaide. Mothers in the test group received oral health promotion information during pregnancy, and later when the child reached 6 and 12 months of age. After the second round of information the test group mothers were randomized again. The information was reinforced in one of the test subgroups through a telephone consultation. There was no contact with mothers in the control group after enrolment. At the age of 20 ± 2.5 months all test and control group children were examined by a dentist. The case definition of an incidence of S-ECC was one or more upper incisor teeth being carious at the level of a cavitated or noncavitated lesion. The differences in S-ECC incidence between the test and control groups, and the test subgroups were analysed.
Results: Of 649 women enroled in the programme (test group 327, control group 322), 441 had their child examined at follow-up. The incidence of S-ECC in the test group was 1.7% and in the control group 9.6% (P < 0.001).
Conclusion: An oral health promotion programme based on repeated rounds of anticipatory guidance initiated during the mother’s pregnancy was successful in reducing the incidence of S-ECC in these very young children.
189 citations
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TL;DR: The high frequency of social impact reported in this study no doubt reflects extensive levels of disease experience, including high rates of missing teeth and edentulism, among older adults.
Abstract: Oral symptoms and their effects on well-being provide an indication of the social impact of oral disease and can be used to document the burden of illness within populations. This report presents findings about the social impact of oral disease among a random sample of 1217 non-institutionalized persons aged 60 years and over living in Adelaide and Mt Gambier. They completed a questionnaire containing 49 questions about the effect of oral conditions on dysfunction, discomfort and disability. Over 5 per cent of dentate persons and over 10 per cent of edentulous persons reported impacts such as difficulty in chewing, discomfort during eating and avoidance of foods 'fairly often' or 'very often' during the previous 12 months. Impacts on social roles and interpersonal relationships were reported by up to 5 per cent of persons. Edentulous persons reported social impact more frequently, particularly in areas related to chewing and eating. Older age was associated with significantly greater amounts of impact among dentate persons, while edentulous males reported significantly more impact than edentulous females. There were larger variations among dentate persons according to their dental utilization patterns, with the highest levels of impact reported by individuals who usually attended for dental problems and who had attended the previous year. The high frequency of social impact reported in this study no doubt reflects extensive levels of disease experience, including high rates of missing teeth and edentulism, among older adults.
183 citations
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TL;DR: The findings suggest that the OHIP-14 has good reliability, validity and precision and will be important to replicate these findings in other populations.
Abstract: Growing recognition that quality of life is an important outcome of dental care has created a need for a range of instruments to measure oral health-related quality of life. This study aimed to derive a subset of items from the Oral Health Impact Profile (OHIP-49)-a 49-item questionnaire that measures people's perceptions of the impact of oral conditions on their well-being. Secondary analysis was conducted using data from an epidemiologic study of 1217 people aged 60+ years in South Australia. Internal reliability analysis, factor analysis and regression analysis were undertaken to derive a subset (OHIP-14) questionnaire and its validity was evaluated by assessing associations with sociodemographic and clinical oral status variables. Internal reliability of the OHIP-14 was evaluated using Cronbach's coefficient alpha. Regression analysis yielded an optimal set of 14 questions. The OHIP-14 accounted for 94% of variance in the OHIP-49; had high reliability (alpha = 0.88); contained questions from each of the seven conceptual dimensions of the OHIP-49; and had a good distribution of prevalence for individual questions. OHIP-14 scores and OHIP-49 scores displayed the same pattern of variation among sociodemographic groups of older adults. In a multivariate analysis of dentate people, eight oral status and sociodemographic variables were associated (P < 0.05) with both the OHIP-49 and the OHIP-14. While it will be important to replicate these findings in other populations, the findings suggest that the OHIP-14 has good reliability, validity and precision.
1,926 citations
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Griffith University1, University of Glasgow2, University of Pittsburgh3, Trinity College, Dublin4, University College London5, Public Health Foundation of India6, Radboud University Nijmegen7, Heidelberg University8, Universidade Federal do Rio Grande do Sul9, National University of Colombia10, University of California, San Francisco11, New York University12, McGill University13
TL;DR: The extent and consequences of oral diseases, their social and commercial determinants, and their ongoing neglect in global health policy are described to highlight the urgent need to address oral diseases among other NCDs as a global health priority.
1,349 citations
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Harvard University1, University of Queensland2, Johns Hopkins University3, ICF International4, Centre for Mental Health5, Boston University6, University of Sydney7, University of Melbourne8, Imperial College London9, University of New South Wales10, University of California, San Diego11, Emory University12, University of Pennsylvania13, Autonomous University of Barcelona14, University of London15, National Institutes of Health16, French Institute of Health and Medical Research17, Medical Research Council18, Auckland University of Technology19, Federal University of São Paulo20, National Institute of Population and Social Security Research21, Howard University22, Flinders University23, Erasmus University Rotterdam24, King's College London25, Karolinska Institutet26, University of California, San Francisco27, All India Institute of Medical Sciences28, Nova Southeastern University29, University of Miami30, Swansea University31, Tehran University of Medical Sciences32, Queen Mary University of London33, Allen Institute for Brain Science34, University of Cape Town35, Columbia University36, Watford General Hospital37, Centro Studi GISED38, University of Oxford39, Deakin University40, University of British Columbia41, University of Toronto42, Box Hill Hospital43, Vanderbilt University44, University of Washington45, Brandeis University46, University of Tokyo47, The Queen's Medical Center48, Norwegian University of Science and Technology49, China Medical Board50, University of Cambridge51, Royal Cornwall Hospital52, Cedars-Sinai Medical Center53, Shanghai Jiao Tong University54
TL;DR: In this paper, a comprehensive re-estimation of disability weights for the Global Burden of Disease Study 2010 through a large-scale empirical investigation in which judgments about health losses associated with many causes of disease and injury were elicited from the general public in diverse communities through a new, standardised approach.
1,130 citations
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TL;DR: There is an essential relation between poverty and fluorosis as malnutrition is found to play an aggressive role in its severity, as the lack of access to clean water denies the most essential of all rights, the right to life.
Abstract: ‘Water is life,’ so central to human life, yet over one billion people across the world have no access to safe drinking water. Of late, there has been increasing global attention focused on resolving water quality problems especially in developing countries, as the lack of access to clean water denies the most essential of all rights, the right to life. The latest estimates suggest that around 200 million people, from among 25 nations the world over, are under the dreadful fate of fluorosis. India and China, the two most populous countries of the world, are the worst affected. India is plagued with numerous water quality problems due to prolific contaminants mainly of geogenic origin and fluoride stands first among them. The weathering of primary rocks and leaching of fluoride-containing minerals in soils yield fluoride rich groundwater in India which is generally associated with low calcium content and high bicarbonate ions. The unfettered ground water tapping exacerbates the failure of drinking water so...
1,116 citations
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TL;DR: The negative impact of poor oral conditions on the quality of life of older adults is an important public health issue, which must be addressed by policy-makers and the means for strengthening oral health programme implementation are available.
Abstract: The proportion of older people continues to grow worldwide, especially in developing countries. Non-communicable diseases are fast becoming the leading causes of disability and mortality, and in coming decades health and social policy-makers will face tremendous challenges posed by the rapidly changing burden of chronic diseases in old age. Chronic disease and most oral diseases share common risk factors. Globally, poor oral health amongst older people has been particularly evident in high levels of tooth loss, dental caries experience, and the prevalence rates of periodontal disease, xerostomia and oral precancer/cancer. The negative impact of poor oral conditions on the quality of life of older adults is an important public health issue, which must be addressed by policy-makers. The means for strengthening oral health programme implementation are available; the major challenge is therefore to translate knowledge into action programmes for the oral health of older people. The World Health Organization recommends that countries adopt certain strategies for improving the oral health of the elderly. National health authorities should develop policies and measurable goals and targets for oral health. National public health programmes should incorporate oral health promotion and disease prevention based on the common risk factors approach. Control of oral disease and illness in older adults should be strengthened through organization of affordable oral health services, which meet their needs. The needs for care are highest among disadvantaged, vulnerable groups in both developed and developing countries. In developing countries the challenges to provision of primary oral health care are particularly high because of a shortage of dental manpower. In developed countries reorientation of oral health services towards prevention should consider oral care needs of older people. Education and continuous training must ensure that oral health care providers have skills in and a profound understanding of the biomedical and psychosocial aspects of care for older people. Research for better oral health should not just focus on the biomedical and clinical aspects of oral health care; public health research needs to be strengthened particularly in developing countries. Operational research and efforts to translate science into practice are to be encouraged. WHO supports national capacity building in the oral health of older people through intercountry and interregional exchange of experiences.
968 citations