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Dental services are provided to improve oral health and reduce disease. As more people are retaining more of their teeth into old age, this is also likely to increase older people’s need for dental services . For example, in 2013, 42% of people aged 65 and over who had some natural teeth also wore dentures .
For more information on the oral health of older Australians, see Oral health and disease.
Dental services are commonly delivered by dental practitioners (such as dentists and dental surgeons), and range from routine and preventive care to treatment of dental problems and emergencies.
In 2013, around 6 in 10 adults aged 15 and over reported visiting a dentist in the last 12 months. This ranged from 55% of those aged 25–44 years to 7 in 10 (70%) of those aged 65 and over (up from 60% of older people in 1994) [3, 5].
During the same period, among older people who visited a dentist, the average number of visits increased from 2.3 in 1994 to 2.6 in 2013 (Table 1). The most common type of service was scale and clean, followed by fillings.
(a) Dentate people whose last dental visit was in the last 12 months.
Sources: National Dental Telephone Interview Surveys [1, 2, 3, 4, 5, 7].
In 2013, the dental visiting pattern could be described as ‘favourable’ (visiting a dentist once or more per year and having a usual dental provider) for almost half (48%) of people aged 65 and over who had any natural teeth (dentate people). For their most recent visit, 53% of older dentate people reported check-up as the reason . When people’s reason for last visiting a dentist was a dental problem instead, their average number of visits was higher.
The ABS 2012 Survey of Disability, Ageing and Carers (SDAC) also collected people’s self-reported use of dental services and experiences of services received for those aged 65 and over (the survey was carried out more recently in 2015, but this iteration restricted these questions to only those people aged 65 and over who were identified as having a disability—in the 2012 survey, these questions applied to all older people, but other differences in methodology may account for the differences reported here compared with the proportions reported for the National Dental Telephone Interview Survey). The 2012 SDAC found that around half of men (51%) and women (52%) aged 65 and over reported having visited a dental professional (dentist, dental hygienist or dental specialist) in the last 12 months, and the proportions decreased with age for both genders (Figure 1). Overall, 51% of older people had seen a dental professional in the previous year .
Source: AIHW analysis of ABS 2012 Survey of Disability, Ageing and Carers data. Findings based on use of ABS TableBuilder data .
In Australia, the majority of dentists (85% in 2013) work in the private sector as general dental practitioners—specialist dentists made up only 10% of registered dentists . Dental services are also delivered in hospitals, and around 5% of registered dentists were employed in hospitals in 2013 .
According to the SDAC, among people who had used dental services in the last 12 months in 2012, 1 in 10 (12%) people aged 65 and over had received public dental care .
The proportion of older people whose last visit had been to a public dental clinic also varied by sex and age group (Figure 2)—overall, women were slightly more likely to report receiving public dental care in the last 12 months (12%) than men (11%), with this pattern more evident in some age groups than others .
(a) People who had seen any dental professional in the last 12 months and last received care through a public dental clinic.
Source: AIHW analysis of the ABS 2015 Survey of Disability, Ageing and Carers data. Findings based on use of ABS TableBuilder data .
The cost of dental services is frequently reported as a barrier to accessing services—in 2013, 29% of people aged 65 and over whose annual household income was below $30,000 reported avoiding or delaying dentist visits, compared with just 14% of people whose household income was $60,000–$90,000. Similarly, 32% of people aged 65 and over who had no insurance cover for dental services reported avoiding seeing a dentist—among people with insurance, the proportion was half of this (15%). Overall, more than half (51%) of older people with teeth, and one-quarter (25%) of older people without any teeth, had insurance cover for dental services in 2013 .
Publicly-funded dental care is targeted towards low-income groups, with aged pensioners and unemployed people eligible for services at minimal or no cost to the patient. However, public dental clinics may not routinely offer a full range of services, such as preventative dental care. Wait times for services, and their availability, can also be problematic and lead to poorer outcomes for people [5, 10].