State-level differences in the oral health of Australian preschool age children

Background: This study compares oral health outcomes and behaviours for young Australian children by residential state or territory to determine whether state differences arise from individual exposures to risk factors. Methods: Cross-sectional data for 4606 2–3 year olds and 4464 6–7 year olds were obtained from the Longitudinal Study of Australian Children. Outcome measures were parent-reports of children’s caries experience, frequency of toothbrushing and dental services use. Results: For 2–3 year olds, children from the Australian Capital Territory were less likely to have parent-reported caries than children from other states, and more likely to brush their teeth twice daily and to have used dental services. For 6–7 year olds, optimal outcomes were observed in New South Wales for lowest caries experience, Western Australia for highest toothbrushing, and South Australia for highest dental services use. Adjustments for socio-demographic predictors did not eliminate state differences in oral health. Conclusions: Large state differences in the oral health of young children persisted after adjustment for individual sociodemographic determinants, suggesting these arise from variations in the systems to promote and care for children’s oral health. Several states would benefit from a stronger emphasis on oral health promotion in young children, and disparities from a young age suggest the need for better engagement of early childhood professionals in oral health promotion.