Trends in access to dental care among Australian adults 1994-2008

This report examines trends in dental visiting among Australian adults between 1994 and 2008, using data from the surveys that investigated people’s dental experiences in the 12-month period before each of the years specified.

Summary

The National Dental Telephone Interview Survey (NDTIS) is a computer-assisted telephone survey of a random sample of the Australian population aged 5 years and over. The survey collects basic features of oral health and dental care within the Australian population, including access to services. Surveys were conducted in 1994, 1996, 1999, 2002, 2005 and 2008.

From 1994 to 2008 the proportion of adults who were classified as concession cardholders increased from 20.3% to 23.2%. In all years, the lowest proportion of cardholders was in the 25–44 years age group and the highest in the 65 years and older age group.

Dental insurance cover was held by about 40% of adults from 1994 to 1996, with a steady decline from 42.0% in 1994 to 36.2% in 1999. However, following the introduction of the 30% rebate scheme in July 1999 and Lifetime Health Cover in July 2000, private health insurance dental coverage increased to 46.5% in 2002 and 50.0% in 2008. In all years, insurance coverage was highest in the 45–64 years age group.

From the surveys conducted between 1994 and 2008, just over one in two adults made a dental visit in the 12 months before each survey. Prevalence was higher in older compared with younger adults, in females, non-cardholders, insured persons, those living in urban areas and those who usually visited for a check-up.

Over the same period, more than 85% of these adults attended a private dental practice. Rates of visiting a private practice were higher for adults aged between 25 and 64 years compared with younger and older adults and for non-cardholders, insured persons, urban dwellers and those who usually visited for a check-up.

After a decline between 1994 and 1996, the proportion of adults visiting for a check-up rather than for a problem increased between 1996 and 2008.

During the period 1994–2008, around 50% of adults reported that they usually made a dental visit at least once a year or that they usually visited for a check-up. Usually making a dental visit at least once a year and usually visiting for a check-up were both more prevalent for females, non-cardholders, insured persons and urban dwellers. The higher rate of check-up visiting by non-cardholders and insured persons increased over this period of time.

From 1994 to 2008, between 13.1% and 17.5% of adults who made a dental visit in the previous 12 months, received an extraction. The rate was higher in adults who usually visited the dentist for a problem, cardholders and uninsured persons. Visiting for a problem was associated with a higher rate of fillings across all years.

The proportion of adults who received a scale and clean during the period 1994–2008 remained between 71% and 74%. Non-cardholders, insured persons, urban dwellers and those who usually visited for a check-up were more likely to receive a scale and clean.

The proportion of adults who reported that they had avoided or delayed dental care due to cost increased from 27.1% in 1994 to 34.3% in 2008. It was higher for females, cardholders, uninsured persons and those who usually visited for a problem, and increased between 1994 and 2008 for cardholders, the uninsured and those who usually visited for a problem.

There was no clear trend in reporting that cost had prevented recommended dental treatment over the period 1994–2008. Cardholders, the uninsured and those who usually visit for a problem were more likely to report that cost had prevented recommended treatment.

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