Summary

Oral health is an important part of overall health and quality of life. Poor oral health can affect adults and children alike, causing pain, embarrassment, even social marginalisation. For children, the effects can be long-term, and carry through to adulthood.

Aboriginal and Torres Strait Islander children are more likely than non-Indigenous children to experience tooth decay. Several factors contribute to the poorer oral health of Indigenous children, including social disadvantage and lack of access to appropriate diet and dental services.

Since 2007, the Australian Government has helped fund oral health services for Indigenous children aged under 16 in the Northern Territory. The Northern Territory Remote Aboriginal Investment Oral Health Program (NTRAI OHP) complements the Northern Territory Government Child Oral Health Program by providing preventive (application of full-mouth fluoride varnish and fissure sealants) and clinical (tooth extractions, diagnostics, restorations and examinations) services.

This report presents data from the NTRAI OHP from July 2012 to December 2020.

How many Indigenous children received services in the NTRAI OHP?

In 2020, full-mouth fluoride varnish services, fissure sealant applications and clinical service visits were provided to Indigenous children in the Northern Territory under the NTRAI OHP. Of those children:

  • 4,454 received 5,485 full-mouth fluoride varnish services, a decrease of 1,322 services from 2019
  • 1,017 received fissure sealant applications to 4,187 teeth during 1,083 services, a decrease of 2,079 teeth from 2019
  • 2,469 received clinical services during 3,036 visits (excluding 1,464 visits classified as urban)—such as dental assessments, fillings, extractions, or preventive services—a decrease of 1,744 visits from 2019.

The infographic shows that in 2020, 4,454 children received fluoride varnish services; 1,017 children received fissure sealant applications; and 2,469 children received clinical service visits.
Sources: tables S2.1, S2.3, S2.6

How many Indigenous children experienced tooth decay in the NTRAI OHP?

Tooth decay varied by age, and in 2020, children aged 9 experienced the highest rate of tooth decay (88%). In comparison, children aged 1–3 experienced the lowest rates of tooth decay (37%).  

The infographic shows that, among NTRAI OHP participants in 2020, 37%25 of 1–3 year olds, 80%25 of 7 year olds, 88%25 of 9 year olds and 74%25 of 15 year olds experienced tooth decay.
Source: Table S3.1

How many decayed, missing or filled teeth did Indigenous children have?

A widely used indicator to measure oral health status is a count of the number of decayed, missing or filled teeth.

On average, in 2020, children in the NTRAI OHP aged 6 had the highest average number of decayed, missing or filled baby teeth (dmft), at 5.2 teeth, while children aged 15 had the highest average number of decayed, missing or filled permanent teeth (DMFT), at 4.0 teeth.

The infographic shows that Indigenous children aged 6 in the NTRAI OHP had on average 5.2 decayed, missing or filled baby teeth in 2020. For those aged 15 the average was 4.0 decaying, missing, or filled permanent teeth in 2020.

What was the impact of COVID-19?

Between 2019 and 2020 the number of full-mouth fluoride varnish services, fissure sealant applications and clinical service visits decreased. This was largely due to a fall in attendances between March and April 2020, coinciding with the introduction of restrictions imposed to control the spread of COVID-19. For example, the number of full-mouth fluoride varnish services for Indigenous children in March 2020 was 606—decreasing to 42 in April 2020, and then increasing to 309 services in May 2020.

Is the program meeting its benchmarks?

Outcomes for the NTRAI OHP are monitored through performance indicators and benchmarks. In 2020, COVID-19 restrictions are likely to have affected services delivered. However, the service delivery targets for all three service types were met or exceeded (Table S1). This was likely to have been affected by COVID-19 restrictions in 2020.

Table S1: Progress against benchmarks, 2020
Service delivery targets Outcomes
At least 3,800 clinical service visits per year 4,500 clinical service visits*
At least 5,485 fluoride varnish applications in 202 5,485 fluoride varnish applications provided
Fissure sealant applications to at least 3,000 teeth in 2020 Fissure sealant applications to 4,187 teeth
Health outcome targets  
At least 50% of total service items are preventive services 66% of total service items were preventive in 2020

* In 2020, the benchmark outcome was 4,500 clinical service visits. Historically, clinical urban services have been excluded from reporting. For 2020 the specification for counting the number of clinical service visits includes 1,464 clinical urban services. Therefore 2020 benchmark data are not comparable with previous years.