Rural/Remote AMS practitioners manage a greater OM burden than urban AMS practitioners, but affected children have less access to specialist ear health services and longer waiting times. One in five rural/remote Aboriginal children wait longer than recommended for audiology testing, and one in eight Aboriginal children nationwide wait longer than recommended for ENT services.

Background: The aim of this study was to document the three main indicators of severe periodontal destruction and to evaluate factors associated with those indicators in an urban Indigenous population in Australia. Methods: A cross-sectional survey of a convenience sample of Aboriginal adults from an Australian urban area was undertaken. Socio-demographic data and smoking status were collected by interview and health status by a medical record audit. Clinical attachment loss (CAL) was used to determine prevalence, extent and severity of severe periodontitis. Factors with significant association with periodontal indicators at bivariate level were further included in multivariable analysis controlling for age and gender. Results: A total of 251 Aboriginal adults participated in the study. The proportion with severe periodontitis was 11.9% (95% CI: 7.6-16.3), extent: 5.0% (95% CI: 3.3-6.7) and severity: 5.3 mm (95% CI: 5.0-5.6). These estimates are significantly higher than that of other Australians. Current smokers had significantly higher prevalence rate (PR) of severe periodontitis: PR = 2.8 (95% CI: 1.3-6.0). People with diabetes and current smokers had significantly higher extent of sites with CAL 6+ mm: 1.9 (1.1-3.3) and 2.1 (1.2-3.6) respectively. Having diabetes was associated with significantly higher severity score (b: 0.96 (SE: 0.47)). Conclusions: A high proportion of this urban Aboriginal population had severe periodontal disease related to smoking and diabetes.

Australian AMS practitioners treat OM more aggressively in Aboriginal children, consistent with the Australian Government guidelines, despite half being unaware of them. Opportunities to improve management include increased use of pneumatic otoscopy and tympanometry, and decreased antibiotic usage for OM with effusion and chronic suppurative OM.

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