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T11 Australia's & the World's Smile- Oral Health & Sleep…
T11 Australia's & the World's Smile- Oral Health & Sleep
Cost of dental care
dental care is NOT covered by Medicare- cost is a v imp reason for lack of dental care
ppl w/o private health insurance= 2x as likely (44%) as those w/ insurance (20%) to avoid visiting a dentist due to cost
of ppl who did visit a dentist in the prev 12 months, 20% did not have the recommended dental treatment due to cost
RFs for poor dental/oral health
Tobacco use
Alcohol consumption
Nutrition- sugar, poor diet
Lack of fluoridated water/toothpaste
Age
8 key oral health messages
brush 2x daily for 2 mins
floss every day
protect teeth during contact sports by wearing a mouth guard
get regular dental check-ups
Chew sugar-free gum when brushing is not possible
Use a mouth rinse
Stop tobacco use & lower alcohol consumption to reduce risk of oral cancers, gum disease & tooth loss
Cut down sugary food & drinks
Highest @ risk of dental decay or lack of dental care
rural & remote
Aboriginal & TS Islanders ppl
Lower SES
No private health insurance
Australian children & teeth
after decreasing steadily from the late 1970s, the ave #teeth affected by decay for children aged 6-12 plateaued in the late 1990s & early 2000s & then increased
ave # of affected baby teeth of children aged 6 increased from 1.5 in 1996 to 2.6 in 2010
ave # affected permanent teeth of children aged 12 increased from 0.8 in 2000 to 1.3 in 2010
Improved oral health bc
fluoridated drinking water & toothpaste
improvements to preventive oral health services & dental hygiene practices
Global view
tooth decay: world's most common noncontagious disease
dental disease: over 90% world's pop will suffer some form in their lifetime
No natural teeth: globally ~30% of ppl aged 65-74
oral cancer: 3rd most common cancer in SE Asia
incidence rates of oral cancer: higher in men than women
Dental visits
most dental visits were made to a private dental practice
Many dental-related hospitalisations tht were considered potentially preventable if timely & adequate non-hospital care had been provided
Children aged 5-9 has the highest rate of potentially preventable hospitalisations due to dental conds
Spending has increased
by 46% over the last decade
individuals were the largest source of funds for dental spending
Total gov contributions, including premium rebates from the Aus Gov, & state & territory govs
Private health insurance funds paid 16%, while other non-gov funding sources accounted for 0.4%
Determinants of dental health
SES
Gender
Age
Occupation
Ethnicity
Strats to address dental health in the at risk grps
promote and campaigns school based: educate children
sugar tax
increase access to dental services in rural & remote areas
Sleep
How much we need vs how much we are getting
Adult 7-8 hours/night
Teenager 9-10 hours/night
School children at least 10 hours/night
18.4% adults slept less than 6.5hours/night & 11.7% experiences chronic sleepiness
3 Primary Sleep Disorders
Obstructive Sleep Apnoea OSA
Insomnia
Restless Leg Syndrome RLS
OSA
repetitive pauses or reduction in breathing during sleep
due to collapse of upper airway
accompanied by reduction in bld O2 lvls
followed by awakening to breathe resulting in chronic tiredness & fatigue
Insomnia
inadequate or poor quality sleep
may cause daytime sleepiness & impaired conc, lethargy & irritability
can include:
difficulty falling asleep
waking up frequently during night w/ difficulty returning to sleep
waking up too early in the morn
feeling un-freshed in the morn
RLS
common, under-diagnosed & treatable CNS disorder
characterised by leg sensations tht cause an almost irresistable urge to move legs
urge to move
worsening symptoms @ night
Relief w/ mvt
Causes
low ferritin (iron stores)- may develop symptoms
renal insufficiency
low back pain
anxiety
neuromuscular disorders: Parkinson's & multiple sclerosis
Excessive Daytime Sleepiness (EDS)
Causes of EDS
Sleep deprivation: jet lag, behavioural, altered sleep phase
Frag of sleep: OSA, RLS
Primary CNS hypersomnias: Narcolepsy, Idiopathic hypersomnia
Neurological: Parkinson's, multiple sclerosis, stroke
Psychiatric: Depression, anxiety disorders, schizophrenia
Other organic diseases: Congestive heart failure, chronic renal disease, liver failure
Medications: alcohol, opiates
Measuring EDS
Epworth Sleepiness Scale: score of 10 or more= EDS
would never doze, slight chance of dozing, moderate chance of dozing, high chance of dozing
Other causes of inadequate sleep
poor sleep hygiene
shift-work/ circadian rhythm disruption
excessive work hours
screens & blue light