title: Caries burden and efficacy of a referral pathway in a cohort of preschool refugee children.
abstract: BACKGROUND
  This study aimed to assess the early caries experience and the efficacy of a community based dental referral pathway in preschool refugees in Western Australia.
  
  
  METHODS
  Preschool refugee children referred to the Western Australian paediatric hospital Refugee Health Clinic were prospectively screened for caries by a paediatric dentist before being referred to community dental clinics. Dental forms and medical records were audited to assess decayed, missing and filled teeth (dmft), medical data and dental services engagement. Poisson regression analysis determined the contribution of count variables to the final model.
  
  
  RESULTS
  Among the 105 screened children (54% male, median age 3.2 years, 41% Burmese), community dental clinic engagement was low (46%, n=48). Of the 62% with caries (n=65/105, mean dmft 5.2, SD 4.1), 45% were recommended for specialist dental services and 48% were treated. After adjustment for age, gender and total number of teeth, caries incidence was significantly associated with BMI-for-age Z score (p=0.02).
  
  
  CONCLUSIONS
  Preschool refugee caries burden was high. The community dental referral pathway was ineffective compared to co-located intersectorial dental screening. Specialist dental service needs are high in this cohort and require a targeted approach.
authors.affiliation: School of Paediatrics and Child Health, The University of Western Australia, Perth, Australia.
authors.forename: P
authors.initials: P
authors.lastname: Nicol
authors.forename: R
authors.initials: R
authors.lastname: Anthonappa
authors.forename: N
authors.initials: N
authors.lastname: King
authors.forename: L
authors.initials: L
authors.lastname: Slack-Smith
authors.forename: G
authors.initials: G
authors.lastname: Cirillo
authors.forename: S
authors.initials: S
authors.lastname: Cherian
mesh_terms: D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003151:Community Health Centers; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D004245:DMF Index; D019140:Dental Care for Children; D003731:Dental Caries / Q000175:diagnosis; D003740:Dental Clinics; D005260:Female; D006301:Health Services Needs and Demand; D006776:Hospitals, Pediatric; D006801:Humans; D007223:Infant; D008297:Male; D008403:Mass Screening; D010512:Periodontal Index; D011446:Prospective Studies; D012017:Referral and Consultation; D012036:Refugees; D014904:Western Australia
keywords: Early childhood caries; intersectorial collaboration; oral health screening; referral pathways; refugee