Poor Oral Health and the Hospitalization of Children in Western Australia - Essay Example

? Poor oral health and the hospitalization of children in Western Australia al affiliation Poor oral health and the hospitalization of children in Western Australia For many decades, Australia has had to deal with poor oral health issues affecting a large part of the population, particularly children. In Western Australia a majority of children are affected by dental diseases, as well as general oral diseases. A majority of the children affected by ill oral health, according to Christian & Blinkhorn (2012, p. 1), are aged between 1- 18 years, and mostly originate from the non-fluoridated areas of Western Australia. In most cases, children affected by severe oral diseases have to be hospitalized in order to provide them with the necessary dental care. In accordance, this essay aims to analyze the reasons for the hospitalization of these children and the rates of hospitalization among different social and age groups. In addition, the easy will examine the sources of funding, the cost of dental healthcare, and the impact of hospitalization and the provision of such care on the health care system. Oral diseases accounting for the hospitalization of children According to Kruger et.al (2006, pp. 232), statistics from 1999-2003 revealed that more than 26, 000 hospitalization cases in western Australia among children aged below 18 years were as a result of oral health conditions. There many types of oral diseases which account for different hospitalization rates. For example, dental caries, otherwise known as dental decay, is a disease that is very prevalent in among children in Western Australia affecting the enamel (Arrow, 2008 pp.257). Study shows that the severity of dental caries often forces children to be hospitalized in order to control the disease. In consideration of oral health care, children with dental caries need to undergo multiple extractions of teeth inside a hospital (Slade et.al, 2011, pp. 30). This procedure cannot be conducted outside a hospital because it requires the use of general anesthesia. After dental caries, “pulp and periapical tissues” is the second most prevalent cause of hospitalization for children in Western Australia (Williams et.al, 2011 pp.19). In addition, there is a relatively high number of children who suffer from abnormal tooth eruptions. According to approximately 10 per cent of teenagers in Western Australia experience these abnormal eruptions which lead to embedded and impacted teeth (Williams et.al, 2011 pp.19). Periodontitis affects approximately 18 per cent of all children in Western Australia. Other conditions such as facial deformities are not so prevalent, although there are quite a number of newborns with conditions such as cleft lip. Oral cancer is not so common among children in Western Australia, meaning that fewer cases of hospitalization are cancer-related. Psychological reasons Poor oral health leads to the emergence of psychological reasons that call for the hospitalization of children (Williams et.al, 2011 pp.19). For example, a child may be required to be admitted at the hospital, as a result of anxiety. Secondly, medical professionals may be forced to admit a patient to ensure proper patient management. In hospital, the physiological and psychological health of a patient is easier to monitor, as opposed to dealing with an out-patient. The age of the patient also determines the probability for admission. Dealing with children, in this case, it becomes paramount to admit a child who has undergone psychological distress due to poor oral health. Hospitalization ensures that the child becomes psychologically stabilized, anxiety is significantly reduced, and the child gets proper medical care. Although the above discussion about the reasons for the hospitalization of children with oral health problems represents the whole of Western Australia, the rates of hospitalization are dependent on a number of factors. Rural versus Metropolitan Children In studying the rates of hospitalization among metropolitan and rural children in western Australian, Tennant et.al (2000, pp. 205) argues that there is no big difference in their statistics. Kruger, Dyson, & Tennant (2006, pp. 235) share this opinion by stating that the rates of hospitalization among 5-8 year olds are similar for metropolitan and rural children. Nonetheless, the statistics for infants show that rural infants are more likely to be hospitalized for dental problems than metropolitan infants. In a different scenario, reports indicate that most hospitalizations are more likely to occur in metropolitan areas that have private hospitals (ibid). However, Dogar et.al (2011, pp.2) is of a different opinion, when he states that children living in rural areas are thrice at risk of hospitalization due to dental problems compared to their metropolitan counterparts. The reason for this disparity is that children in the rural areas do not get access to dental care services, until there are 5 years of age (ibid). These children attend dental clinics at such a late stage of their lives mainly due to inaccessibility of clinics, and ignorance by parents. On the other hand, children in metropolitan areas start attending dental clinics at a very early stage. This observable fact is due to the accessibility of dental clinics, coupled with increased awareness on the side of the parents concerning the importance of good oral health. Pre-School versus Primary School versus High School Hospitalization Rates According to Kruger et.al (2005, pp. 258), pediatrics in Australia recommend that a child should start visiting dental clinics immediately after the eruption of the first primary teeth. Unfortunately, most children in Australia do not have access to oral hygiene clinics until they join school. In addition, “pulp and periapical tissues” is another prevalent condition that increases hospitalization rates among pre-school children. As for primary school children, the occurrence of dental caries and subsequent hospitalization are lower than those of pre-school children (Kruger, 2006, pp. 232). Similarly, primary school children also experience cases of “pulp and periapical tissues”, although at a lower rate than pre-primary school children. Statistically, most hospital admissions involving high school children are as a result of “embedded and impacted teeth” or abnormal tooth eruption (ibid). Among all the age groups sampled in the period between 1999 and 2003, high school children had the highest hospitalization rates, followed by pre-primary school children, then primary school children (Kruger et.al, 2005 pp.258). Aboriginality Hospital admissions among children with poor oral health in Western Australia are largely dependent on the origins of these children. For aboriginal children, the hospitalization rates are way much higher as compared to those among non-aboriginal children, for general poor oral health. Statistics show that aboriginal children are more likely to suffer from dental caries and other oral-related diseases, and end up in hospital, as compared to non-aboriginal children (Davis, pp. 118). According to Dogar et.al (2011, pp. 3), a recent study reveals that aboriginal children reported more cases of toothache than non-aboriginal children. Statistically, approximately 30 per cent of aboriginal children experienced toothache, while only 7 per cent of non-aboriginal children had ever experienced the same. This figure also represents the prevalence of tooth decay between the two groups, leading to hospitalization. This disparity between aboriginal and non-aboriginal children and related hospitalization rates has been attributed to reasons, such as aboriginal children being reported to brush their teeth less often, compared to non-aboriginal children. Do et.al (2010, pp. 962) also adds that non-aboriginal children have more access to dental clinics, as well as the resources to pay for regular checkups. On the contrary, aboriginal children rarely go for dental checkups due to inaccessibility and lack of resources to pay for the services. However, according to Martin-Iverson et.al (2000, pp. 19) hospital admissions for dental cries among non-aboriginal high school children are 31 times higher than those of their aboriginal counterparts. The figure for pre-school and that of primary school children for dental caries is similar to that for high school children. Nonetheless, cases of “pulp and periapical tissues” were significantly higher for aboriginal children, in comparison with their non-aboriginal equivalents (Kruger et.al, 2006 pp.232). Where do the funds for hospitalization for oral conditions come from? The government of Australia, according to Barraclough & Gardner (pp.72) is not wholly responsible for funding the hospital costs of children with oral health problems. For most cases, parents are forced to meet the higher proportion of hospitalization costs. The Australian government meets the operational costs of these hospitals, thus leaving the parents to pay the admission and treatment fees. According to Kruger et.al (2006, pp. 235) most hospitalizations concerning oral problems for children take place in private hospitals. Accordingly, parents are forced to pay for the hospitalization process fully. Nonetheless, it is important to note that the Australian government provides funds in support of various public health programs addressing children with poor oral health. For example, Merrick et.al (2012, pp. 2-4) states that the government has been actively constructing dental therapy centers to screen people, particularly children for oral diseases. Focusing totally on oral health among children, especially the pre-school age group, the government has provided funds for the running of various programs. For example, there is the “Child in Care’ program” funded by the government to give dental assessment to children (Merrick et.al, 2012, pp. 2-4). What is the cost of hospitalization for oral conditions? The provision of healthcare services to children affected by oral health issues in Western Australia has been a very costly undertaking. According to Kruger et.al (2006, pp.235) in the period between 1999 and 2003, the cost of hospitalization for children was 40 million dollars. Most of these funds went towards treating “pulp and periapical tissues” and dental caries conditions. Tenant et.al (2000, pp.204) affirms how expensive oral healthcare for west Australian children is, by stating that in 1995, approximately 111 million dollars were used for the hospitalization of children under 18 years of age. According to the MHS annual report (2011, pp. 141) the cost of hospitalization for children with poor oral health is high due to the many procedures involved. In order to fully treat the oral condition, the child needs to undergo root canal therapy. Such a procedure would require a pedodontist, and the use of anesthesia. The cost of getting the pediatrician to operate, plus the use of general anesthesia would cost approximately two thousand Australian dollars (Shearer & Jamieson, 2012; pp.324). Many parents, especially rural-based, aboriginal ones cannot afford such high hospitalization and treatment costs. Accordingly, most parents prefer such procedures as the extraction of decayed teeth and the filling of missing teeth, which are relatively cheaper. How has hospitalization impacted on the healthcare system in Western Australia? Poor oral health among children in Western Australia has for a long time been treated as a separate condition from other health issues. However, this perception as argued by the Department of Health, Western Australia (2011) is wrong, since oral health has a big impact on general health outcomes. According to Department of Health, Western Australia (2011, pp. 4-8) while reporting on the proceedings of a Clinical Senate meeting, the speakers unanimously agreed that good oral health is integral in reducing chronic illnesses and mortality levels in Western Australia. Accordingly, poor dental and overall oral health is a medical problem that impacts the healthcare system in the same degree as chronic diseases. In essence the economic cost of hospitalization of children with poor oral health contributes largely in the reduction of the health budget (ibid). In a similar opinion, Shearer & Jamieson (2012, pp. 325) state that the hospitalization of children with oral diseases affects the general public health sector. In the end, such a child will have to undergo other forms of treatment apart from oral, thereby reflecting the impact that hospitalization of children for oral diseases has on the general healthcare system. Conclusion Evidently, the oral health of most children in Western Australia needs to be addressed urgently. More specifically, aboriginal pre-school children from the rural areas are a risk population in as far as poor oral health is concerned. Although the hospitalization rates according to the Department of Health, Western Australia (2011, pp.25) have relatively gone down, more effort is required in fighting oral diseases. Communities in Western Australia need to be taught the importance of good diet, general oral hygiene, and regular dental checkups for children, in order to reduce cases of poor oral health. The government also needs address dental checkups in Medicare scheme and provide accessible dental clinics, thus significantly reducing hospitalization rates for children with oral health problems. References Arrow, P. 1998. Oral Hygiene in the Control of Occlusal Caries. Community Dentistry and Oral Epidemiology, Community Dentistry and Oral Epidemiology, 26 (5), pp. 324–330. 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Trend Of Income-Related Inequality Of Child Oral Health In Australia, Journal Of Dental Research, September 2010, 89(9), pp. 959-964. Dogar, F., Kruger, E., Dyson, K., & Tennant, M. 2011. Oral Health of Pre-School Children in Rural and Remote Western Australia. The International Electronic Journal of Rural and Remote Health Research, Education, Practice and Policy. Available at http://www.rrh.org.au [Accessed November 9, 2012]. Kruger, E., Dyson, K., & Tenant, M. 2005. Pre-School Child Oral Health in Rural Western Australia. Australian Dental Journal, 50(4), pp. 258-262. Kruger, E., Dyson, K., & Tennant, M. 2006. Hospitalization of Western Australian Children for Oral Health Related Conditions: A 5-8 Year Follow Up. Australian Dental Journal, 51(3), pp. 231-236. Martin-Iverson, N., Pacza, T., Phatouros, A., & Tenant, M. 2000. Indigenous Australian Dental Health: A Brief Review of Caries Experience. Australian Dental Journal, 45 (1), pp.17-20. Merrick et.al. 2012. Reducing Disease Burden and Health Inequalities arising From Chronic Disease among Indigenous Children: An Early Childhood Caries Intervention. Available at http://www.biomedcentral.com [Accessed November 9, 2012] Metropolitan Health Service. 2010. Key Performance Indicators. Available at www.health.wa.gov.au [Accessed November 9, 2012]. Shearer, M., &Jamieson, L. 2012. Indigenous Australians and Oral Health, Oral Health Care -Prosthodontics, Periodontology, Biology, Research and Systemic Conditions. Available at http://www.intechopen.com/books/oral-health-careprosthodontics [Accessed November 9, 2012]. Slade et.al. 2011. Effect of Health Promotion and Fluoride Varnish on Dental Caries among Australian Aboriginal Children: Results from a Community-Randomized Controlled Trial. Community Dentistry and Oral Epidemiology, 39 (1), pp. 29-43. Williams S., Jamieson L., MacRae A., & Gray C .2011. Review of Indigenous oral health. Available at http://www.healthinfonet.ecu.edu.au/oral_review [Accessed November 9, 2012]. Read More