Oral health and access to dental care by cardholder and insurance groups

Summary

Among Australian adults, more favourable patterns of dental attendance and better oral health were reported by those with dental insurance compared to the uninsured. Possession of a government concession card was associated with poorer outcomes for most indicators, but only among those without private dental insurance. Among the insured, the dental visiting patterns and oral health ratings of cardholders were very similar to those of non-cardholders. Compared with non-cardholders, cardholders had an older age profile and lower socioeconomic status-differences that at first appearance might account for lower rates of dental attendance and poorer oral health. Yet, those same sociodemographic differences between concession card groups were observed for insured adults, where there were few, if any, differences in oral health indicators. The implication is that dental insurance diminishes differences between cardholders and non-cardholders in their dental attendance and oral health for reasons other than sociodemographic factors. Detailed findings include:

• Uninsured adults were significantly more likely than insured adults to visit the dentist infrequently and to usually visit for a problem. Uninsured cardholders fared worst with almost one in two visiting a dentist less often than once every two years, and two in three usually visiting for a problem.
• Both uninsured groups were twice as likely to report that they had avoided or delayed dental care due to cost compared to those with dental insurance.
• Uninsured cardholders were significantly more likely than the other groups to rate their dental health as ‘poor or fair’, to have experienced toothache and to have received an extraction within the previous 12 months.
• Extractions were also more prevalent among uninsured non-cardholders than both insured groups.