The National Survey of Adult Oral Health 2004–06: 
Western Australia

2008

© Australian Institute of Health and Welfare 2008

This work is copyright. Apart from any use as permitted under the Copyright Act 1968, no part may be reproduced without prior written permission from the Australian Institute of Health and Welfare. Requests and enquiries concerning reproduction and rights should be directed to the Head, Business Promotion and Media Unit, Australian Institute of Health and Welfare, GPO Box 570, Canberra ACT 2601.

This publication is part of the Australian Institute of Health and Welfare’s Dental statistics and research series. A complete list of the Institute’s publications is available from the Institute’s website <www.aihw.gov.au>. 

ISSN 1321-0254 
ISBN 978 1 74024 788 7

Suggested citation 
AIHW Dental Statistics and Research Unit 2008. The National Survey of Adult Oral Health 2004–06: Western Australia. Cat. no. DEN182 Dental Statistics and Research Series no. 46. Canberra: Australian Institute of Health and Welfare.

Australian Institute of Health and Welfare 
Board Chair
Hon. Peter Collins, AM, QC

Director 
Penny Allbon

Published by the Australian Institute of Health and Welfare

Contents
Contents	iii
Acknowledgments	iv
Abbreviations	iv
Symbols	v
Overview of results	1
1	Introduction	1
Purpose and organisation of this report	2
Background to the survey	3
2	Methods	5
Study population and sampling	5
Computer‑assisted telephone interview	5
Oral epidemiological examination	6
Period of data collection	9
Ethical conduct of research	10
Target sample size	10
Participation in the survey	10
Data analysis	11
Distribution of sociodemographic and dental access characteristics	12
3	Oral health status	14
4	Oral health care	38
5	Oral health perceptions	60
References	78
Appendices	81
Glossary	84
List of tables	87

Abbreviations 
AAP	American Academy of Periodontology	
AHMAC	Australian Health Ministers’ Advisory Council 	
AIHW	Australian Institute of Health and Welfare	
ARCPOH	Australian Research Centre for Population Oral Health	
CAL 	clinical attachment loss	
CATI	computer‑assisted telephone interview	
CDC	US Centers for Disease Control and Prevention	
CEJ	cemento‑enamel junction	
DMFT	number of decayed, missing and filled permanent teeth	
DSRU	Dental Statistics and Research Unit	
IRSAD	Index of Relative Socioeconomic Advantage/Disadvantage	
NCHS	US National Center for Health Statistics	
NHANES	US National Health and Nutrition Examination Survey	
NHMRC	National Health and Medical Research Council	
NOHSA	National Oral Health Survey of Australia	
NSAOH	National Survey of Adult Oral Health 	
SEIFA	Socioeconomic Indices for Areas	
Place abbreviations
ACT	Australian Capital Territory	
NSW	New South Wales	
NT	Northern Territory	
Qld	Queensland	
SA	South Australia	
Tas	Tasmania	
UK	United Kingdom	
US	United States	
Vic	Victoria 	
WA	Western Australia	

Symbols 
$	Australian dollars
. .	not applicable
%	per cent
—	nil
>	greater than
<	less than
≥	greater than or equal to
≤	less than or equal to
<0	Estimate is less than zero
Acknowledgments 
This publication was prepared by the Australian Research Centre for Population Oral Health (ARCPOH). The authors were (in alphabetical order): Loc Do, Anne Ellershaw, Jane Harford, Liana Luzzi, Kaye Roberts-Thomson, Gary Slade and John Spencer.
WA Survey personnel
Survey manager		Mr Peter Jarman
Appointment coordinator	Ms Lynette Dominkovich
Dentist examiners		Dr Brian Sacks, Dr Graham Cawsey, Dr Lou Bogdanich
Dental recorders		Ms Virginia Knox, Ms Lynette Dominkovich, Ms Heather Pryce

Scientific Advisory Committee members
Associate Professor Peter Barnard, Australian Dental Association
Associate Professor Mike Morgan, University of Melbourne
Mr Gary Niedorfer, Australian Bureau of Statistics
Professor Brian Oldenburg, Monash University
Professor Eric Reynolds, University of Melbourne
Dr Ken Tallis, Australian Institute of Health and Welfare

Community and Professional Advisory Committee members
Dr Louise Brown, Australian and New Zealand Academy of Periodontists
Ms Samantha Edmonds, Council of Social Service of NSW (NCOSS)
Mr Errol Evans, Oral Health Unit, Queensland Health (alternate Dr Paul Wood)
Ms Chris Morris, South Australian Dental Service
Dr David Neesham, Dental Health Services, Western Australia (alternate Dr Martin Glick)
Dr Bill O’Reilly, Australian Dental Association Federal Executive
Ms Lindsay Simmons, Council of the Ageing
Ms Tracey Slater, Department of Human Services, Victoria
Funding sources for the 2004–06 National Survey of Adult Oral Health
National Health and Medical Research Council, Project Grant #299060
National Health and Medical Research Council, Project Grant #349514
National Health and Medical Research Council, Capacity Building Grant #349537
Australian Government Department of Health and Ageing, Population Health Division
Australian Institute of Health and Welfare
Colgate Oral Care
Australian Dental Association
US Centers for Disease Control and Prevention, Research Participation Program
Editorial team
Alison McLean and Lorna Lucas (ARCPOH) contributed to the editing of this publication and proofreading was by Jo Mason.  All three worked to improve the consistency, layout and readability of the text.

Overview of results
This report describes levels of oral health in the adult population of Western Australia (WA) at the beginning of the twenty first century. The findings are from the 2004–06 National Survey of Adult Oral Health (NSAOH).  In WA, 1,290 people were interviewed and 470 people were dentally examined for the Survey. This report presents percentages and means for 30 oral health indicators in tables that compare three age groups and which further classify people according to five sociodemographic characteristics: sex, residential locality, socioeconomic status of their residential postcode, government health card status, and dental insurance. 
Oral health status
•	5.6% of people had no natural teeth and among dentate people, an average of 5.0 teeth per person were missing. These and two other indicators of tooth loss were more frequent among government health card-holders compared with non-health-card-holders and among people with no dental insurance compared with the insured.
•	19.6% of people had untreated dental decay and an average of 13.1 teeth per person were decayed, missing or filled.  There was relatively little variation among sociodemographic groups in indicators of dental decay experience.
•	10.0% of people had inflamed gums and 12.6% had moderate or severe gum disease. Four indicators of gum disease displayed relatively little variation among sociodemographic groups.
Oral health care
•	60.3% of people had visited a dentist within the preceding 12 months, and 56.1% said they usually did so. These and two other measures of dental attendance varied according to socioeconomic status and dental insurance.
•	75.7% of people had a dentist that they usually attended, although 30.9% said that they avoided or delayed dental care due to its cost.  Barriers to dental care were most strongly associated with low socioeconomic status and a lack of dental insurance.
Oral health perceptions
•	14.7% of people said they had avoided some foods due to dental problems, while 12.9% had experienced toothache in the preceding 12 months. Perceptions of poor oral health were more likely the uninsured than insured.
•	32.0% of people felt they needed an extraction or filling, although only 5.1% said they needed dentures.  People without dental insurance were more likely to report dental treatment needs than the uninsured.
Age-standardised analysis revealed that government health card-holders had poorer outcomes for 13 of the 29 indicators reported, while the uninsured had poorer outcomes for 17 of the 30 indicators. 
1	Introduction
This report presents findings from the Western Australian (WA) component of the 2004–06 National Survey of Adult Oral Health (NSAOH). Information was collected using interviews and standardised dental examinations that were conducted among a random sample of WA residents aged 15 years or more. Three major themes are reported in chapters describing oral health status, oral health care and perceptions of oral health. Statistics summarising those themes are tabulated for the WA adult population and for three age groups that are further classified according to: sex, residential locality, socioeconomic status of the area in which they live, government health card-holder status and dental insurance. 
The 2004–06 NSAOH took place 17 years after the first oral examination survey of Australians conducted in the six states and the Australian Capital Territory (Barnard 1993). State/territory reports from that 1987–88 National Oral Health Survey of Australia (NOHSA) highlighted variations among age groups, between the sexes and between people living in or outside capital cities. However, the first survey did not collect information about government health card-holder status or socioeconomic status, and results were not contrasted between insured and uninsured. 
In the 17-year period since the NOHSA, there has been substantial growth in public sector dental care and dental insurance. Increasingly, national and state/territory health goals call for reductions in socioeconomic inequalities in health, including oral health. For those reasons, this report includes a focus on the relationship between oral health and indicators of socioeconomic status and access to dental care, as well as the traditional demographic markers of age, sex and residential location.
Purpose and organisation of this report
The purpose of this report is to provide a descriptive ‘snapshot’ of oral health in the adult population of WA. The findings are intended to provide up-to-date evidence that can contribute to the development of oral health policies and programs in WA.
This introductory chapter outlines the motives for undertaking the survey. Chapter 2 reviews the survey’s methods and describes the population distribution of sociodemographic and dental access characteristics presented in later tables. Statistical findings regarding oral health status are tabulated and described in Chapter 3, followed by statistical findings regarding oral health care (Chapter 4) and perceptions of oral health (Chapter 5). The Appendix contains additional tables of oral health statistics for conventional 10‑year age groups. These are narrower than the age ranges reported in the chapters, and are presented to permit comparisons with surveys conducted at other places and other times. 
The national report of the survey's findings (Slade et al. 2007) provides additional details about the survey, including participation rates and analysis of potential biases due to non-participation. The national report also presents qualitative findings from ‘oral histories‘ conducted with a small number of survey participants to document historical influences on the nation's oral health. Further appendix material is available at: 
<http://www.arcpoh.adelaide.edu.au/project/distribution/NSAOH.html>.
Background to the survey
Up-to-date information about population oral health is important because oral diseases have broad implications for the health of the public. Dental problems are ranked among the most frequently reported illness episodes by Australians (AIHW 2000), and provision of dental care accounts for 5.4% of total health expenditure (AHMAC 2001). In the United States the Surgeon General characterised oral disease as a ‘silent epidemic’ (Surgeon General 2000).
In the 17 years following the 1987–88 NOHSA, no state-wide oral examination surveys of adults have been conducted. Instead, published oral examination surveys were restricted to special groups of the adult population and often they were conducted within selected locations in states. They included studies of oral health in:
•	military recruits (Dawson & Smales 1994; Hopcraft & Morgan 2003a,b, 2005, 2006; Morgan et al. 1992)
•	adults in Melbourne (Wright et al. 1994)
•	community-dwelling elderly people (Bergman et al. 1991; Chalmers, Carter & Spencer 2002; Slade et al. 1993; Slade & Spencer 1995, 1997; Thomson et al. 1995)
•	elderly people living in nursing homes or hostels (Chalmers, Carter, Fuss et al. 2002; Chalmers, Hodge et al. 2002; Chalmers et al. 2005; Saub & Evans 2001)
•	Aboriginals and Torres Strait Islanders (Endean et al. 2004; Smith et al. 2007)
•	immigrants (Marino et al. 2001, 2007) or refugees (Kingsford Smith & Szuster 2000)
•	prisoners (Osborn et al. 2003)
•	patients receiving dental care in public dental services (Brennan et al. 2000, 2001, 2007; Brennan & Spencer 2004)
•	patients with selected medical conditions (Coates et al. 1996, 2000).
By the late 1990s, several collaborative efforts among federal and state/territory stakeholders attempted to secure support for a second national oral health survey, although none were funded. Renewed impetus for a national survey began with the work of the National Advisory Committee on Oral Health (AHMAC 2001). The committee formulated a National Oral Health Plan for the period 2004–13 comprising seven action areas:
•	promotion of oral health across the population
•	children and adolescents
•	older people
•	people with low income and social disadvantage
•	people with special needs
•	Aboriginal and Torres Strait Islander people
•	workforce development.
One of four short-term goals listed for the plan’s first action area was the conduct of a national survey of adult oral health. Fulfilment of that goal became possible in 2003 when researchers at the Australian Research Centre for Population Oral Health (ARCPOH) in The University of Adelaide sought project grant funding from the National Health and Medical Research Council (NHMRC). The proposal was for funding to support a collaborative project that pooled resources already committed or promised from the following sources: funding from the Australian Government's Department of Health to the Dental Statistics and Research Unit (DSRU) within ARCPOH to undertake a telephone interview survey; commitment of staff from oral health sections within state and territory health departments to conduct oral epidemiological examinations; and core funding from the Australian Institute of Health and Welfare (AIHW) to DSRU. Following peer review, the NHMRC awarded a project grant to ARCPOH in November 2003.
Aspects of oral health and dental care relevant to the National Oral Health Plan
The National Oral Health Plan outlined nine population indicators that were informative in developing the plan and that are cited as key performance indicators to evaluate the outcomes of the plan. This survey reports findings that relate to six of those key performance indicators:
•	The percentage of the dentate population reporting a social impact (for example toothache, difficulty chewing, concerned about appearance) because of problems with teeth, mouth or gums in the last 12 months, by age group, living circumstance, government health card-holder status, Indigenous identity and special needs.
•	The percentage of the population with untreated decay, by age group, living circumstance, government health card-holder status and Indigenous identity.
•	The proportion of the dentate population with a maximum periodontal pocketing of 3.5 mm and 5.5 mm, by age group.
•	The mean number of missing teeth and proportion of existing teeth with untreated decay, by age group, living circumstance, government health card-holder status and card status, and Indigenous identity.
•	The percentage of the dentate population who visited a dental practitioner in the last 2 years, by age group, living circumstance, government health card-holder status and Indigenous identity.
•	The percentage of the dentate population whose reason for visiting a dental practitioner in the last 12 months was for a check‑up, by age group, living circumstance, government health card-holder status and Indigenous identity.
2	Methods
Full details of the survey's methods have been described in Chapter 2 of the national report (Slade et al. 2007). The following summary highlights the main methodological features of the survey.
Study population and sampling
A three‑stage, stratified clustered sampling design was used to select people from the target population of Australian residents aged 15 years or more: 
•	Postcodes were sampled at random from capital city and non-capital city strata in six states and the Northern Territory, and from a single stratum in the Australian Capital Territory. Postcodes represented the geographic clustering in the design and were selected with probability proportional to size, where size was defined as the number of households listed in the ‘electronic white pages’ in each postcode. 
•	A systematic sample of households listed in the ‘electronic white pages’ was selected for each sampled postcode. Thirty households per metropolitan stratum and 40 households per ex‑metropolitan stratum were selected.
•	One person aged 15 years or more was randomly selected per household. In households with only one person aged 15 years or more, that person was selected. In other households telephone interviewers asked for the name of the person aged ≥15 years who most recently had had a birthday and the name of the person aged ≥15 years who would next have a birthday. A computer algorithm then selected one of those two people at random.
Sampled postcodes
In WA  the following postcodes were sampled: 6006, 6010, 6015, 6018, 6021, 6025, 6027, 6030, 6052, 6055, 6058, 6061, 6062, 6065, 6076, 6081, 6103, 6107, 6110, 6147, 6150, 6152, 6155, 6159, 6163, 6167, 6169, 6210, 6225, 6233, 6304, 6330, 6401, 6442, 6536, 6603, 6707.
Computer‑assisted telephone interview
Self‑reported information about oral health and characteristics associated with it was obtained though telephone interviews. Interviewers read questions from a computer screen and recorded answers directly onto the computer. They were conducted from a dedicated computer‑assisted telephone interview (CATI) suite at University of Adelaide research offices. The methods were based on those advocated by Dillman (2000), including the mailing of a letter to households prior to telephoning, a protocol for contacting each household and standardised procedures for asking questions and recording answers. Interviews were conducted by 29 interviewers, each of whom was trained in the survey methods. Every effort was made to interview the target person although, in certain circumstances, the questions were answered by another adult in the form of a proxy interview. 

The interview consisted of 79 questions, several with multiple response categories. A copy of the questions used is included in an Appendix available online:
<http://www.arcpoh.adelaide.edu.au/project/distribution/NSAOH.html>.
Oral epidemiological examination
Information about clinical oral status was collected during standardised dental examinations conducted by dentists who undertook training in the survey procedures. Examinations were limited to people who reported having some or all of their own natural teeth at the time of the interview. Examining dentists followed a standardised protocol to record levels of tooth loss, dental decay experience, tooth wear and—for subjects with no medical contraindications to periodontal probing—signs of gum disease. During data collection, replicate examinations were conducted for approximately five study participants per examiner to evaluate the consistency of their findings when judged against the principal survey examiner.
There were 30 examiners nationwide (Table 1). Prior to their work on the survey, they undertook a 2‑day training and calibration session at The University of Adelaide. Separate training sessions were held for the examination teams from each state and territory. Prior to the scheduled training session, each examiner was sent a 50‑page manual and a DVD detailing the survey protocol, including the criteria and coding for the examination.
 Table 1: Distribution of examiners and examinations among states and territories
			No. of examinations per examiner	
State	No. of examiners	No. of people examined	Minimum	Maximum	Mean	
NSW	11	1,113	32	164	101	
Vic	3	1,181	267	585	394	
Qld	3	824	217	305	275	
SA	2	629	241	388	315	
WA	3	470	134	196	157	
Tas	3	385	49	186	128	
ACT	2	386	125	261	193	
NT	3	517	154	203	172	
All states	30	5,505	32	585	184	
Scope of examination
Survey participants were examined in a supine position in standard dental chairs with illumination provided by the chair’s overhead dental light. Examiners used an intra‑oral mirror that additionally had its own battery-powered light source. A periodontal probe with 2-mm markings was used to record distances, for example when assessing periodontal destruction (described further below); however, sharp explorers were not used and no radiographs were taken. Full details of the examination protocol are provided online:
<http://www.arcpoh.adelaide.edu.au/project/distribution/NSAOH.html>.
The following overview summarises criteria used to assess the main oral health variables reported in this volume.
Tooth loss
For people aged less than 45 years, examiners distinguished between missing teeth that had been extracted due to decay or periodontal disease and teeth that were absent for any other reason (that is, congenitally missing; unerupted; or extracted for orthodontics, trauma or impaction). For people aged 45 years or more, no such distinction was made, so that an extracted or otherwise absent tooth was recorded as missing. Dental implants, root fragments and deciduous teeth were coded separately and not counted as missing or absent teeth.
Replacement teeth
All lost teeth were further classified as replaced or not replaced by a fixed bridge or a removable denture that was worn to the examination.
Decay experience of coronal tooth surfaces
All teeth present were subdivided into five tooth surfaces: mesial, buccal, distal, lingual, and either occlusal (for premolars or molars) or incisal (for incisors and canines). Each coronal surface was assessed and categorised using visual criteria (no explorer was used) and one of the following codes was assigned:
•	decay: cavitation of enamel or dentinal involvement or both are present 
•	recurrent caries: visible caries that is contiguous with a restoration
•	filled unsatisfactorily: a filling placed for any reason in a surface that requires replacement but that has none of the above conditions
•	filling to treat decay: a filling placed to treat decay in a surface that had none of the above conditions
•	filling placed for reasons other than decay: in a surface that has none of the above conditions (incisors and canines only)
•	fissure sealant: where none of the above conditions were found
•	sound: when none of the above conditions was found.
Decay experience of tooth root surfaces
All teeth present were subdivided into four root surfaces: medial, buccal, distal and lingual. Each root surface was assessed visually and, if necessary, using a ball‑ended periodontal probe. One of the following codes was assigned:
•	decay: a discrete, well‑defined or discoloured lesion on the root surface that is soft to exploration using the periodontal probe
•	recurrent caries: detectable caries that is contiguous with a restoration
•	filled unsatisfactorily: a filling placed for any reason in a surface that has unacceptable defects but none of the above conditions
•	filled root surface: one or more permanent restorations placed for any reason but none of the above conditions
•	wear of 2 mm or more: recorded only on buccal surfaces with none of the above conditions 
•	sound root surface: when none of the above conditions was found
•	no visible root surface.
Periodontal tissue destruction
The assessment of periodontal tissue destruction was based on methods used in the US National Health and Nutrition Examination Survey (NHANES 2005). Assessments were made of probing pocket depth and gingival recession, both recorded in millimetres using a periodontal probe that had 2-mm markings. Measurements were made at the mesio‑buccal, mid‑buccal and disto‑buccal aspects of all teeth present, except for third molars. All fractional millimetre measurements were rounded down to the lowest whole millimetre before calling the number. For recession, the cemento‑enamel junction (CEJ) was identified or its position was estimated (for example, if a filling obscured its position), and the distance from the CEJ to the free gingival margin was recorded in millimetres. When the CEJ was subgingival, the number called was negative; otherwise it was positive. For probing pocket depth, the distance from the free gingival margin to the bottom of the periodontal crevice/pocket was called.
Examiners did not make a direct measurement of clinical attachment loss; instead, it was computed during data analysis.

Gingival inflammation around six index teeth
The Loe and Silness (1963) gingival index was used to assess inflammation of the marginal gingival tissues around six index teeth (if present)—the most anterior molar in each dental quadrant (up to four teeth), the right maxillary central incisor and the left mandibular central incisor. Pressure was applied to the free gingival margin on the buccal aspect of the tooth by swiping with the side of a periodontal probe that was held at approximately 90 degrees to the long axis of the tooth. One of the following codes was assigned:
•	severe inflammation: marked redness and oedema, ulceration or tendency to spontaneous bleeding
•	moderate inflammation: redness, oedema, glazing or bleeding after applying pressure with the probe
•	mild inflammation: slight change in colour or slight oedema but no bleeding after applying pressure with the probe
•	none of the above.
Data recording for examinations
Each code called by an examiner was recorded directly onto a laptop computer by state/territory staff who had experience in clinical dental procedures. They were trained in use of the software during the 2‑day training session for examination teams held at The University of Adelaide. 
Assessment of inter‑examiner reliability
In order to measure inter-examiner reliability, the principal survey examiner attended examination sessions for all but one examiner to conduct masked replicate examinations of survey participants. The remaining examiner withdrew from the survey after completing 32 examinations. Replicate examination entailed assessments of tooth presence, periodontal assessment of teeth in one jaw, and assessment of caries experience in both crowns and roots of teeth. The observed levels of agreement for most oral health indicators were equivalent to benchmarks reported for national oral health surveys conducted in the United Kingdom and the United States.
Period of data collection
Data collection began in July 2004 and was completed in September 2006 (Table 2). Interviews were timed to begin approximately 1 month prior to the planned start of examinations in each jurisdiction.
Table 2: Periods of data collection in states and territories
	Dates of interviews	Dates of examinations	
State/territory	Beginning	End	Beginning	End	
ACT	July 2004	October 2004	July 2004	October 2004	
SA	September 2004	December 2004	September 2004	May 2005	
WA	October 2004	March 2005	November 2004	May 2005	
Vic	January 2005	September 2005	February 2005	September 2005	
NSW	May 2005	November 2005	June 2005	July 2006	
NT	August 2005	October 2005	September 2005	March 2006	
Tas	January 2006	May 2006	March 2006	September 2006	
Qld	March 2006	September 2006	June 2006	September 2006	
Australia	July 2004	September 2006	July 2004	September 2006	

Ethical conduct of research
This project was reviewed and approved by The University of Adelaide's Human Research Ethics Committee. Interviewed subjects provided verbal consent prior to answering questions. All examined subjects provided signed, informed consent prior to the examination.
Target sample size
Sample size requirements were calculated for a range of key outcome variables to be reported nationally. One outcome, the capacity to detect a 25% or greater reduction in national age‑specific estimates of mean number of decayed teeth since 1987–88, was nominated as the critical threshold that should be detectable with standard statistical power of 80%. Another outcome was a capacity to detect a 10% or greater reduction in national age-specific mean DMFT. This identified a need for 7,500 examinations and 13,560 interviews, assuming a 65% participation rate in the examination. The sample size within each state and territory was planned to be approximately proportional to the population of the jurisdiction.
Participation in the survey
National participation rates were lower than intended, both in the interview, where 49.0% of sampled people participated, and the examination, where 43.7% of those eligible took part. Interview participation rates varied from 43.9% in NSW to 61.8% in SA. Examination rates varied from 33.2% in NSW to 57.5% in SA (Table 3).
Table 3: Number and percentage of people sampled, interviewed and examined(a)
	No. of
people
sampled	No. of
people
interviewed 	% of sampled
people
interviewed	No. of people
eligible
 for exam 	No. of
people
examined	% of eligible 
people 
examined	
Australia 	28,812	14,123	49.0	12,606	5,505	43.7	
NSW 	8,270	3,630	43.9	3,310	1,099	33.2	
Vic 	6,013	2,667	44.4	2,360	1,181	50.0	
Qld 	4,219	2,052	48.6	1,841	824	44.8	
SA 	2,159	1,335	61.8	1,093	629	57.5	
WA 	2,365	1,290	54.5	1,109	470	42.4	
Tas 	1,745	1,042	59.7	873	385	44.1	
ACT 	1,892	1,025	54.2	981	400	40.8	
NT 	2,149	1,082	50.3	1,039	517	49.8	
(a) Unweighted data

Data analysis 
The aim of the data analysis was to generate summary statistics describing oral health for the WA population. With the exception of data regarding participation rates, results in this report have been weighted to compensate for individuals’ different probabilities of selection and survey participation rates. For the telephone interview survey, weights were adjusted to ensure survey estimates were consistent with the 2005 Australian Bureau of Statistics Estimated Residential Population data. For the oral examination survey, which was restricted to dentate people aged 15 years or more, estimates of the dentate population were derived from the telephone interview survey and used to derive examination weights. This means that results can be generalised to the WA population. 
Tables 35 and 36 contain age-standardised estimates for each indicator presented in preceding tables.  Age-standardisation is a statistical procedure that aims to remove any effects of age that might account for differences in each oral health indicator between the two comparison groups: health card-holders versus non-health-card-holders (Table 35) and insured versus non-insured people (Table 36).  For these tables, percentages and means were standardised using the direct method.  The reference population was the 2005 Australian Estimated Residential Population classified into 14 five-year age categories within the range 15-84 years and a fifteenth category aged 85 years of more.  
Presentation of results
Oral health measures are tabulated for each of three age groups representing the survey participant's age reported in the telephone interview, plus an ‘all ages’ summary. The three age groups are: 15–34 years, 35–54 years and ≥55 years. The tables report estimates for mutually exclusive subgroups of people created for each of six characteristics based on responses to the telephone interview questions. The subgroups and unweighted number of respondents are listed in the Appendix to this volume and the six characteristics are described below:
Sex was classified as ‘Male’ or ‘Female’ recorded during the interview.
Residential location was classified as ‘Capital city’ or ‘Other places’ based on the sampling postcode used in selection of households.
Postcode socioeconomic status was used to classify individuals according to the Index of Relative Socioeconomic Advantage/Disadvantage (IRSAD) of the postcode in which they lived. The IRSAD is an aggregate measure of a postcode’s socioeconomic status based on characteristics of its residents recorded in the 2001 Population Census. A postcode that has a relatively high proportion of people with high incomes or a skilled labour force is assigned a relatively higher value on this index. Conversely, a low score on the index indicates that an area has a higher proportion of individuals with low incomes and more people who work in unskilled occupations. Postcodes were classified into three groups of ascending socioeconomic status, each group comprising approximately one-third of the WA population. This type of analysis is said to be ‘ecological’ because it is not based on individuals’ own socioeconomic status, but on the socioeconomic status of the area in which they live. Hence, care should be taken in the interpretation of results—because Socioeconomic Indices for Areas (SEIFA) scores refer to areas, not individuals, results are not interpretable at the level of the individual.
Government health card status identified whether or not people were covered either by a pensioner concession card or health care card. Both cards are issued according to a means test administered by Centrelink, an agency of the Australian Government’s Family Assistance Office. People with either card and their dependents are eligible for public-sector dental care in most states and territories.
Place of last dental visit further disaggregated health card-holders according to the location of their last dental visit. The latter was established during the interview by asking people ‘Where did you make your last dental visit?‘ Health card-holders who responded ‘Government dental clinic‘ or ‘School dental service‘ were classified as ‘Card-holder/Public‘. Otherwise, eligible people were classified as ‘Card-holder/Non-public/Non-public‘ if they reported any of the other locations: Private dental practice (including specialist); Dental technician; Clinic operated by health insurance fund; Armed Services/Defence Force clinic; Other site. People who were not health card-holders were classified as ‘Non-card-holder/Non-public‘ regardless of their reported visit location.
Dental insurance coverage was based on responses to the question ‘Do you have private insurance cover for dental expenses?’ People were classified as insured if they responded ‘yes’ and uninsured if they responded ‘no’. 
Criteria for determining statistical significance
As with any survey where data are collected from only some of the people in the population, proportions and means in this report are estimates of the true population values. The estimates have some degree of uncertainty, which is expressed in this report using 95% confidence intervals (95% CIs). The 95% CI signifies the likely lower and upper limits of the range of values within which the true population percentage would fall. In this context ‘likely’ means that there is a 95% probability that the true population value lies between those two values. 
In this report 95% CIs are used additionally as a guideline to identify differences between population subgroups that are statistically significant. Specifically, when there is no overlap between 95% CIs for two groups, the difference between the groups is deemed to be statistically significant. This criterion for judging statistical significance is more conservative than the alternative method of calculating P‑values. In fact, when 95% CIs do not overlap, it means that a test of statistical significance for the difference between the groups would have a P-value of less than 0.05 (the conventional threshold used in many reports), and it could be as small as less than 0.005. The ‘conservative‘ nature of the criterion used in this report comes about because 95% CIs that overlap to a small degree could, nevertheless, be found to differ to a statistically significant degree (at P<0.05 ) using a hypothesis test.
Data files were managed and summary variables computed using SAS software version 9.1. Means and their associated 95% CIs were generated using SUDAAN software release 9.0.0. The SUDAAN procedures used sampling weights to generate population estimates and calculated 95% CIs that allowed for the complex sampling design used in this survey. To do so, ‘with replacement’ sampling was specified with two levels of stratification (state and section of state). The subject's sampling postcode was specified as the primary sampling unit, which was used by SUDAAN as the clustering variable. 
Distribution of sociodemographic and dental access characteristics
Approximately one-half of the WA population was female, with little variation in the proportion among age groups (Table 4). Three-quarters lived in the capital city, a proportion that was quite consistent among age groups. By design, people of all ages were approximately evenly distributed among tertiles of postcode socioeconomic status, a pattern that was also observed within the three age groups. Approximately one-quarter of the population were government health card-holders, although the proportion was noticeably greater for people aged 55 years or more. People who had a government health card were less likely to have last attended a public dental clinic than other dental care providers, most noticeably in the oldest age group. A majority of people in the WA population had dental insurance, with older people more likely than younger people to be insured.
Table 4: Percentage of people with selected sociodemographic and dental access characteristics in the WA population and three age groups
 
 		Age group (years)	
	All ages	15–34	35–54	>=55	
Sex 					
Males	50.0	51.0	49.8	48.7	
Females	50.0	49.0	50.2	51.3	
Residential location					
Capital city 	74.7	75.8	73.7	74.5	
Other places 	25.3	24.2	26.3	25.5	
Postcode socioeconomic status 					
Lowest 	32.6	33.1	31.4	33.7	
Middle 	33.9	39.7	28.1	34.0	
Highest	33.6	27.3	40.6	32.3	
Government health card					
Health care card or pensioner concession card	23.0	12.5	15.7	50.6	
Neither card	77.0	87.5	84.3	49.4	
Place of last dental visit					
Card-holder/Public	7.8	4.4	7.0	14.3	
Card-holder/Non-public	15.2	8.1	8.7	36.3	
Non-card-holder/Non-public	77.0	87.5	84.3	49.4	
Dental insurance					
Insured	59.1	49.3	61.4	69.7	
Uninsured	40.9	50.7	38.6	30.3	
3	Oral health status
Complete tooth loss 
In NSAOH, complete tooth loss was assessed in the interview by asking people ‘Do you have any of your own natural teeth?’ People who answered ‘no’ were classified as edentulous. In WA, edentulous people represented 5.6% of the population aged 15 years or more (Table 5), which was similar to the national estimate of 6.4% (Slade et al. 2007). 
Key findings
•	The prevalence of edentulism was strongly associated with age, being negligible among 15–34‑year‑olds but affecting 17.5% of WA adults aged 55 years or more. 
•	Prevalence of complete tooth loss did not vary to a statistically significant degree between males and females, or between those living in Perth compared with the rest of the state.
•	While prevalence was more than twice as high among people living in postcodes with low socioeconomic status (8.4% for all ages) than high socioeconomic status (3.4% for all ages), there was overlap of the 95% CIs. A similar gradient was also observed in the oldest age group although, again, it was statistically non-significant. 
•	Among all ages, people who had a government health card were nine times more likely to be edentulous (16.7%) than people who did not (1.8%). Within age groups, government health card-holder status was statistically significantly associated with edentulism only among people aged 55 years or more.
•	Within the population of card-holders, there was no clear pattern of variation in prevalence of edentulism according to place of most recent dental visit.
•	The prevalence of complete tooth loss was lower for people with dental insurance compared with the uninsured, a difference that was statistically significant for all ages combined and for people aged 55 years or more.
Discussion
As emphasised in the national report, variation among age groups in prevalence of edentulism can be attributed primarily to the differing historical experiences of generations born in different time periods during the 20th century, rather than the effects of ageing. Because edentulism prevalence was so strongly dependent upon age group, comparisons between population groups were observed most clearly for the oldest age group. Among 15–34‑year‑olds, prevalence estimates were all zero, and therefore did not reveal any differences between population groups. 
In summary, complete tooth loss in WA was a condition observed infrequently below the age of 55 years, while among people aged 55 years or more, it was most likely to occur in people who had a government health card or who did not have dental insurance.

Table 5: Percentage of adults with complete tooth loss
		Population: all people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 5.6	 0.0	 1.8	 17.5	
	95% CI(a)	4.3–7.2	–	1.0–3.3	14.0–21.7	
Sex						
Males 	% of people	 5.3	 0.0	 2.2	 16.5	
	95% CI	3.7–7.5	–	1.0–5.1	11.8–22.7	
Females	% of people	 5.8	 0.0	 1.3	 18.4	
	95% CI	4.4–7.7	–	0.5–3.5	14.5–23.1	
Residential location						
Capital city	% of people	 5.0	 0.0	 1.3	 16.5	
	95% CI	3.6–7.0	–	0.4–3.4	12.4–21.7	
Other places	% of people	 7.0	 0.0	 3.2	 20.2	
	95% CI	4.9–10.0	–	1.8–5.8	14.4–27.6	
Postcode socioeconomic status						
Lowest	% of people	 8.4	 0.0	 2.3	 23.5	
	95% CI	6.3–11.2	–	1.0–5.0	18.6–29.2	
Middle	% of people	 5.1	 0.0	 2.9	 16.7	
	95% CI	3.5–7.4	–	1.2–6.8	13.3–20.7	
Highest	% of people	 3.4	 0.0	 0.3	 11.9	
	95% CI	1.8–6.4	–	0.0–2.2	6.1–21.9	
Government health card						
Health care card or pensioner concession card	% of people	 16.7	 0.0	 3.2	 26.9	
	95% CI	13.6–20.4	–	1.0–9.6	22.2–32.2	
Neither card	% of people	 1.8	 0.0	 1.6	 6.6	
	95% CI	1.2–2.8	–	0.8–3.3	3.9–11.0	
Place of last dental visit						
Card-holder/Public	% of people	 14.9	 0.0	 6.0	 26.8	
	95% CI	9.7–22.1	–	1.0–28.4	17.7–38.3	
Card-holder/Non-public	% of people	 17.5	 0.0	 2.1	 27.0	
	95% CI	13.5–22.4	–	0.6–7.7	21.3–33.6	
Non-card-holder/Non-public	% of people	 1.8	 0.0	 1.6	 6.6	
	95% CI	1.2–2.8	–	0.8–3.3	3.9–11.0	
Dental insurance						
Insured	% of people	 3.3	 0.0	 1.2	 10.3	
	95% CI	2.2–5.0	–	0.4–3.2	6.8–15.2	
Uninsured	% of people	 8.8	 0.0	 2.8	 26.6	
	95% CI	6.7–11.5	–	1.1–6.6	21.2–32.8	
(a) 95% CI = 95% confidence interval for estimated percentage

Inadequate natural dentition among dentate people
Adults who have approximately 20 teeth or more usually have satisfactory chewing function (Elias & Sheiham 1998), diet and nutritional status (Sheiham et al. 2002), whereas people with fewer teeth are more likely to suffer impaired quality of oral health (McGrath & Bedi 2002). In NSAOH, people were asked during the interview to report either the number of remaining teeth or the number of missing teeth in their upper jaw and lower jaw. Responses were used to classify people as having an inadequate natural dentition if they reported having fewer than 21 natural teeth, the same threshold that has been reported for the UK population. In WA, 11.0% of dentate adults had fewer than 21 teeth (Table 6), which was almost identical to the national figure of 11.4% (Slade et al. 2007). 
Key findings
•	The prevalence of an inadequate natural dentition was strongly associated with age, occurring in fewer than 1% of people aged 15–34 years but affecting approximately one-third of dentate people aged 55 years or more.
•	Differences between males and females were small and statistically non-significant, both for the population as a whole and within the three age groups.
•	Similarly, differences between people living in Perth and those in the rest of the state were small and statistically non-significant.
•	Among all ages combined, prevalence of an inadequate natural dentition was twice as high for people living in postcodes with low socioeconomic status (14.6%) compared with postcodes of high socioeconomic status (7.3%). Those living in postcodes with middle socioeconomic status had prevalence rates that were intermediate between the other two groups. The gradient was more pronounced among 35–54‑year‑olds, and the differences were statistically significant in that age group. 
•	The most pronounced differences in prevalence were associated with government health card-holder status, where an approximate four-fold difference was observed between people who had a government health card (27.1% for all ages) compared with people who did not (6.4%). The relative difference was smaller, though statistically significant, in the oldest age group.
•	Within the population of government health card-holders, there was no clear pattern of variation according to place of last dental visit.
•	Prevalence of an inadequate natural dentition was approximately two times greater among people with dental insurance than the uninsured, and the differences were statistically significant for all ages combined and for the oldest age group.
Discussion
A threshold of fewer than 21 teeth is used here as an indicator of likely impairment in oral function, nutrition and quality of life, rather than a cardinal sign of those problems. As observed for complete tooth loss, there was a pronounced age-gradient in prevalence of an inadequate natural dentition. Because of this age-association, valid comparisons between other sociodemographic groups should be made only within age groups. Those comparisons reveal that prevalence was associated with postcode socioeconomic status, government health card-holder status and dental insurance status. 
Table 6: Percentage of people with fewer than 21 teeth
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 11.0	 0.8	 4.8	 36.2	
	95% CI(a)	9.0–13.4	0.2–3.7	2.9–7.9	30.8–42.0	
Sex						
Males 	% of people	 10.3	 0.0	 4.6	 35.9	
	95% CI	8.2–13.0	–	2.2–9.7	27.1–45.8	
Females	% of people	 11.6	 1.6	 5.0	 36.5	
	95% CI	9.0–14.9	0.3–6.9	2.6–9.3	30.1–43.5	
Residential location						
Capital city	% of people	 10.5	 0.8	 3.8	 36.1	
	95% CI	8.1–13.5	0.1–5.3	1.9–7.4	29.2–43.7	
Other places	% of people	 12.4	 0.8	 7.8	 36.6	
	95% CI	9.1–16.6	0.1–6.0	3.8–15.4	31.6–41.9	
Postcode socioeconomic status						
Lowest	% of people	 14.6	 0.6	 8.4	 41.9	
	95% CI	11.9–17.8	0.1–4.7	4.9–14.1	37.0–46.9	
Middle	% of people	 11.7	 1.6	 4.8	 43.4	
	95% CI	8.4–16.1	0.2–10.3	2.0–11.1	36.2–50.7	
Highest	% of people	 7.3	 0.0	 2.3	 25.2	
	95% CI	4.5–11.5	–	0.5–9.1	16.1–37.2	
Government health card						
Health care card or pensioner concession card	% of people	 27.1	 1.2	 2.2	 50.0	
	95% CI	22.1–32.8	0.2–8.3	0.7–6.7	42.8–57.3	
Neither card	% of people	 6.4	 0.7	 5.2	 23.6	
	95% CI	4.9–8.4	0.1–4.8	3.1–8.6	17.5–31.0	
Place of last dental visit						
Card-holder/Public	% of people	 22.8	 2.8	 0.0	 48.5	
	95% CI	15.9–31.5	0.4–18.6	–	32.7–64.6	
Card-holder/Non-public	% of people	 29.1	 0.0	 3.1	 50.6	
	95% CI	22.2–37.0	–	1.0–8.8	40.3–60.8	
Non-card-holder/Non-public	% of people	 6.4	 0.7	 5.2	 23.6	
	95% CI	4.9–8.4	0.1–4.8	3.1–8.6	17.5–31.0	
Dental insurance						
Insured	% of people	 8.6	 0.0	 3.5	 28.0	
	95% CI	6.8–10.8	–	1.7–7.0	22.4–34.4	
Uninsured	% of people	 14.6	 1.7	 6.6	 48.4	
	95% CI	11.6–18.2	0.4–8.0	3.7–11.7	40.0–56.8	
(a) 95% CI = 95% confidence interval for estimated percentage

Denture wearing by dentate people
Removable dentures, also called ‘false teeth‘, are worn to replace missing teeth, with the objective to improve function (for example eating), appearance or both. Whereas virtually all edentulous people wear dentures, the decision of dentate people to wear dentures is influenced by numerous factors in addition to the number and location of missing teeth. In NSAOH, removable denture wearing was assessed during the interview by asking two similar questions, ‘Do you have a denture or false teeth for your upper (lower) jaw?‘ There were 13.0% of dentate adults in WA who reported wearing one or two dentures (Table 7), a figure that was similar to the 14.9% reported nationally (Slade et al. 2007).
Key findings
•	The frequency of denture wearing was strongly associated with age, ranging from 0.5% among 15–34‑year‑olds to 40.3% among people aged 55 years or more.
•	There were small and statistically non-significant differences between the sexes, and between residents of Perth and the rest of the state.
•	There was a socioeconomic gradient in denture wearing that was statistically significant in the oldest age group, with a higher percentage observed among people living in postcodes with low socioeconomic status (47.5%) compared with high socioeconomic status (31.2%). Although the relative difference was similar when all ages were combined (16.2% versus 9.8%), it was not statistically significant.
•	Pronounced differences were seen between people who had a government health card (31.3%) and those who did not (7.8%). The difference was statistically significant for all ages combined and for people aged 55 years or more.
•	Within the population of government health card-holders, there were no consistent differences between those who attended the public sector compared with people who attended non-public sources of dental care.
•	People without dental insurance were somewhat more likely to wear dentures than the insured, although differences were not statistically significant.
Discussion
The percentage of dentate adults in WA who wore dentures (13.0%) exceeded the percentage with fewer than 21 natural teeth (11.0%), illustrating that the decision to wear dentures is dictated by factors other than the number of missing teeth. The frequency of both denture wearing and an inadequate natural dentition was associated with postcode socioeconomic status and government health card-holder status. In contrast, dental insurance status was not significantly associated with denture wearing, while it was significantly associated with an inadequate natural dentition.

Table 7: Percentage of dentate people who wear denture(s)
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 13.0	 0.5	 7.8	 40.3	
	95% CI(a)	11.0–15.4	0.2–1.6	6.0–10.1	35.0–45.9	
Sex						
Males	% of people	 12.1	 0.3	 6.4	 40.1	
	95% CI	9.7–15.0	0.0–2.3	3.7–10.9	31.4–49.5	
Females	% of people	 13.9	 0.7	 9.1	 40.5	
	95% CI	11.7–16.5	0.2–2.9	6.6–12.4	35.5–45.8	
Residential location						
Capital city	% of people	 12.8	 0.5	 6.9	 41.0	
	95% CI	10.4–15.7	0.1–1.9	4.7–10.1	34.4–48.0	
Other places	% of people	 13.7	 0.6	 10.2	 38.2	
	95% CI	10.1–18.2	0.1–4.1	7.9–13.1	30.3–46.8	
Postcode socioeconomic status						
Lowest	% of people	 16.2	 0.5	 8.9	 47.5	
	95% CI	13.0–20.0	0.1–3.2	6.6–11.7	40.2–54.9	
Middle	% of people	 13.5	 0.5	 10.6	 43.4	
	95% CI	10.1–17.9	0.1–3.0	7.2–15.5	33.5–53.8	
Highest	% of people	 9.8	 0.6	 4.4	 31.2	
	95% CI	7.2–13.4	0.1–4.5	2.5–7.6	24.6–38.7	
Government health card						
Health care card or pensioner concession card	% of people	 31.3	 1.3	 9.5	 55.1	
	95% CI	25.9–37.2	0.2–8.9	3.5–23.5	47.0–63.0	
Neither card	% of people	 7.8	 0.4	 7.6	 26.8	
	95% CI	6.4–9.6	0.1–1.5	5.7–10.0	20.9–33.5	
Place of last dental visit						
Card-holder/Public	% of people	 29.7	 0.0	 5.2	 64.2	
	95% CI	22.7–37.7	–	1.0–22.3	48.5–77.4	
Card-holder/Non-public	% of people	 32.0	 2.2	 11.1	 51.9	
	95% CI	25.1–39.7	0.3–15.0	4.3–25.9	42.6–61.1	
Non-card-holder/Non-public	% of people	 7.8	 0.4	 7.6	 26.8	
	95% CI	6.4–9.6	0.1–1.5	5.7–10.0	20.9–33.5	
Dental insurance						
Insured	% of people	 12.2	 0.4	 7.0	 36.0	
	95% CI	10.1–14.7	0.1–2.9	4.9–9.8	29.4–43.2	
Uninsured	% of people	 14.7	 0.7	 8.8	 47.4	
	95% CI	11.5–18.5	0.2–2.8	5.5–13.8	38.0–56.9	
(a) 95% CI = 95% confidence interval for estimated percentage
Average number of teeth per person missing due to pathology 
During NSAOH examinations of people aged less than 45 years, dentists counted the number of teeth judged to be missing due to decay or gum disease; for older age groups, dentists counted the number of teeth missing for any reason. The distinction according to age was made because often it is very difficult to judge in older people whether teeth have been extracted because of decay, gum disease or other causes (for example orthodontic reasons), or whether the teeth never developed or remain unerupted. Instead, the convention is to assume that teeth not present among people aged 45 years or more are missing due to pathology. In WA, dentate people had an average of 5.0 teeth per person missing due to pathology (Table 8), a figure that was similar to the national average of 4.5 (Slade et al. 2007). 
Key findings
•	The average number of missing teeth per person was strongly associated with age, ranging from 1.8 among 15–34‑year‑olds to 11.1 among people aged 55 years or more.
•	There was little difference between males and females, and the differences were inconsistent among the age groups.
•	Similarly, there were small and statistically non-significant differences between residents of Perth and the rest of the state.
•	There was no consistent gradient between average number of missing teeth and postcode socioeconomic status. Nor were there any statistically significant differences between categories of socioeconomic status, either for all ages combined or within specific age groups. 
•	Average levels of tooth loss tended to be higher among people who had a government health card compared with those who did not, and the differences were statistically significant in the oldest age group and among all ages combined.
•	Among the group of government health card-holders, there were no statistically significant differences in average number of missing teeth according to place of last dental visit.
•	There was little difference in the average number of missing teeth between people with dental insurance and the uninsured, and the pattern of differences was inconsistent among the age groups.
Discussion
Unlike previous tables summarising other indicators of tooth loss, there was much less sociodemographic variation in the average number of teeth per person missing due to pathology. The one sociodemographic marker that was significantly associated with this measure was government health card-holder status, where a three-fold difference was observed in the average number of teeth per person missing due to pathology. Yet there was no significant variation according to dental insurance status, which was associated with complete tooth loss and an inadequate natural dentition.

Table 8: Average number of teeth per person missing due to pathology 
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	mean	 5.0	 1.8	 4.2	 11.1	
	95% CI(a)	4.3–5.7	1.3–2.4	3.6–4.9	9.8–12.4	
Sex						
Males	mean	 4.6	 2.0	 3.6	 10.6	
	95% CI	3.7–5.5	1.3–2.7	2.6–4.5	8.7–12.5	
Females	mean	 5.4	 1.7	 4.9	 11.6	
	95% CI	4.4–6.3	1.1–2.2	4.1–5.7	9.9–13.3	
Residential location						
Capital city	mean	 5.0	 1.9	 4.2	 11.0	
	95% CI	4.1–5.8	1.3–2.5	3.3–5.0	9.4–12.5	
Other places	mean	 5.2	 1.7	 4.3	 11.5	
	95% CI	3.9–6.5	0.8–2.6	3.8–4.9	9.8–13.3	
Postcode socioeconomic status						
Lowest	mean	 5.3	 2.3	 3.9	 11.8	
	95% CI	4.4–6.2	1.5–3.2	3.3–4.5	10.1–13.5	
Middle	mean	 5.4	 1.8	 5.0	 12.3	
	95% CI	3.7–7.1	0.9–2.8	3.5–6.6	10.6–14.1	
Highest	mean	 4.3	 1.3	 3.9	 9.1	
	95% CI	3.6–5.1	0.7–1.8	3.0–4.9	7.0–11.3	
Government health card						
Health care card or pensioner concession card	mean	 8.9	 2.7	 3.8	 13.6	
	95% CI	7.0–10.8	1.5–4.0	2.9–4.7	11.9–15.4	
Neither card	mean	 3.9	 1.7	 4.3	 8.5	
	95% CI	3.3–4.5	1.2–2.3	3.6–5.0	6.9–10.2	
Place of last dental visit						
Card-holder/Public	mean	 7.9	 2.3	 3.7	 13.8	
	95% CI	5.3–10.5	0.6–4.1	2.8–4.5	10.2–17.4	
Card-holder/Non-public	mean	 9.3	 3.0	 3.9	 13.5	
	95% CI	7.1–11.6	0.6–5.3	2.6–5.2	11.4–15.7	
Non-card-holder/Non-public	mean	 3.9	 1.7	 4.3	 8.5	
	95% CI	3.3–4.5	1.2–2.3	3.6–5.0	6.9–10.2	
Dental insurance						
Insured	mean	 5.5	 1.6	 4.7	 10.5	
	95% CI	4.6–6.3	0.9–2.2	3.9–5.6	9.0–12.0	
Uninsured	mean	 4.5	 2.1	 3.4	 12.5	
	95% CI	3.7–5.3	1.5–2.8	2.8–4.1	10.5–14.6	
(a) 95% CI = 95% confidence interval for estimated mean

Prevalence of untreated coronal decay
The prevalence of untreated coronal dental decay is reported in Table 9 as the percentage of dentate people who have at least one or more decayed surfaces on the crowns of their teeth. Untreated coronal decay reflects both the prevalence of dental decay in the population and access to dental care for treatment. The prevalence of untreated coronal decay in WA was 19.6% (Table 9), which is slightly lower than the national estimate of 25.5% (Slade et al. 2007).
Key findings
•	The prevalence of untreated coronal decay was not significantly associated with age. 
•	The highest prevalence was seen among people who lived outside Perth (29.2%) and the lowest among females (12.4%).
•	Prevalence of untreated coronal decay was significantly higher among males (26.7%) compared with females (12.4%). 
•	Among people aged 35–54 years, significant differences in prevalence of coronal decay were found in relation to sex.
Discussion
Over one-quarter of all people in WA had untreated coronal decay. Prevalence was associated with sex, with more males than females having untreated decay. This may be related to differences in the use of dental services between the sexes.

Table 9: Percentage of people with untreated coronal decay
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 19.6	 13.3	 29.4	 13.9	
	95% CI(a)	14.9–25.2	7.7–22.0	21.2–39.0	8.8–21.3	
Sex						
Males	% of people	 26.7	 15.3	 43.4	 18.4	
	95% CI	19.3–35.6	7.3–29.2	28.8–59.1	11.2–28.8	
Females	% of people	 12.4	 11.2	 15.5	 9.6	
	95% CI	8.2–18.4	5.0–23.2	9.4–24.4	4.1–21.0	
Residential location						
Capital city	% of people	 16.3	 10.9	 25.4	 10.6	
	95% CI	11.2–23.1	5.7–19.8	16.7–36.6	5.4–19.7	
Other places	% of people	 29.2	 20.8	 40.4	 23.4	
	95% CI	19.8–40.8	7.1–47.5	24.8–58.3	12.2–40.3	
Postcode socioeconomic status						
Lowest	% of people	 24.7	 18.0	 39.3	 13.7	
	95% CI	16.1–35.9	6.6–40.4	25.5–55.1	6.1–28.0	
Middle	% of people	 19.7	 15.1	 29.7	 14.9	
	95% CI	11.9–30.7	8.5–25.3	15.9–48.6	7.2–28.4	
Highest	% of people	 14.4	 5.0	 21.4	 13.0	
	95% CI	9.0–22.4	0.8–26.1	11.8–35.6	4.9–30.6	
Government health card						
Health care card or pensioner concession card	% of people	 16.9	 10.5	 27.9	 14.1	
	95% CI	9.5–28.5	1.7–43.9	12.6–51.0	7.6–24.6	
Neither card	% of people	 20.3	 13.7	 29.6	 13.7	
	95% CI	15.1–26.8	7.9–22.8	20.7–40.4	6.8–25.8	
Place of last dental visit						
Card-holder/Public	% of people	 14.9	 30.0	 7.4	 13.6	
	95% CI	5.6–34.1	5.6–75.5	1.3–33.6	3.9–37.9	
Card-holder/Non-public	% of people	 18.0	 0.0	 44.6	 14.3	
	95% CI	10.3–29.6	–	23.7–67.6	6.7–27.9	
Non-card-holder/Non-public	% of people	 20.3	 13.7	 29.6	 13.7	
	95% CI	15.1–26.8	7.9–22.8	20.7–40.4	6.8–25.8	
Dental insurance						
Insured	% of people	 16.4	 9.7	 26.6	 9.3	
	95% CI	11.0–23.8	3.7–23.0	16.6–39.7	4.6–18.0	
Uninsured	% of people	 25.3	 18.6	 33.8	 24.5	
	95% CI	17.0–35.8	9.3–33.7	20.5–50.2	13.8–39.7	
(a) 95% CI = 95% confidence interval for estimated percentage

Percentage of people with untreated root decay
The prevalence of untreated root decay is reported as the percentage of people who had at least one natural tooth and one or more surfaces of the roots of their teeth decayed. Decay of the root surface requires that it be exposed in the mouth, usually by recession of the gums. The prevalence of untreated root decay in WA was 7.1% Table 10, which is slightly higher than the Australian population figure (6.7%) (Slade et al. 2007).
Key findings
•	Prevalence of untreated root decay was not significantly associated with age, although a trend was evident. 
•	Among people of all ages, the highest prevalence was recorded in people who had a government health card and who last visited a non-public provider (15.8%), and the lowest in those who lived in areas with the highest socioeconomic status (3.0%).
•	Prevalence of root decay was not significantly associated with any of the sociodemographic variables examined, as indicated by the overlapping of 95% CIs.
•	While not reaching statistical significance, a number of trends may be discerned in the results in relation to sociodemographic factors. More of those who had a government health card had root decay than non–card-holders (12.9% versus 5.4%), and more card-holders who last visited a non-public dental provider than non–card-holders who visited a non-public provider (15.8% versus 5.4%).
Discussion
There were no associations found between untreated root decay and any of the sociodemographic factors investigated.

Table 10: Percentage of people with untreated root decay
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 7.1	 2.4	 8.5	 12.3	
	95% CI(a)	4.6–10.7	0.7–7.3	4.5–15.3	7.2–20.2	
Sex						
Males	% of people	 9.4	 4.0	 9.2	 18.7	
	95% CI	5.7–15.2	1.2–12.7	3.3–23.3	9.3–33.9	
Females	% of people	 4.8	 0.6	 7.8	 6.4	
	95% CI	2.6–8.7	0.1–4.3	3.4–16.6	3.5–11.5	
Residential location						
Capital city	% of people	 7.2	 3.1	 8.5	 11.7	
	95% CI	4.4–11.6	1.0–9.3	4.2–16.1	6.1–21.3	
Other places	% of people	 6.8	 0.0	 8.5	 14.0	
	95% CI	3.0–14.8	–	2.0–29.6	5.7–30.7	
Postcode socioeconomic status						
Lowest	% of people	 7.5	 0.0	 10.7	 14.3	
	95% CI	3.7–14.5	–	3.8–27.0	5.9–30.7	
Middle	% of people	 10.8	 6.0	 13.3	 16.4	
	95% CI	6.4–17.7	2.2–15.1	6.0–26.9	6.9–34.0	
Highest	% of people	 3.0	 0.0	 3.4	 6.1	
	95% CI	1.3–6.8	–	0.8–13.5	3.1–11.5	
Government health card						
Health care card or pensioner concession card	% of people	 12.9	 2.5	 20.8	 13.0	
	95% CI	7.0–22.4	0.3–19.2	8.7–42.1	7.0–22.8	
Neither card	% of people	 5.4	 2.3	 6.2	 11.7	
	95% CI	3.3–8.8	0.6–8.5	2.4–14.7	5.7–22.4	
Place of last dental visit						
Card-holder/Public	% of people	 7.0	 7.2	 0.0	 12.8	
	95% CI	2.4–18.6	0.8–42.1	–	4.2–33.2	
Card-holder/Non-public	% of people	 15.8	 0.0	 37.8	 13.0	
	95% CI	8.2–28.1	–	18.6–61.8	6.2–25.4	
Non-card-holder/Non-public	% of people	 5.4	 2.3	 6.2	 11.7	
	95% CI	3.3–8.8	0.6–8.5	2.4–14.7	5.7–22.4	
Dental insurance						
Insured	% of people	 6.1	 0.0	 6.4	 11.7	
	95% CI	3.4–10.5	–	2.2–17.7	6.0–21.6	
Uninsured	% of people	 9.0	 5.0	 11.7	 13.7	
	95% CI	4.6–16.9	1.5–14.9	5.2–24.3	7.2–24.6	
(a) 95% CI = 95% confidence interval for estimated percentage

Percentage of people with one or more filled teeth
Fillings for treatment of tooth decay leave permanent marks on the teeth and are one measure of people’s lifetime experience of decay. Filled teeth also indicate patterns of dental treatment and access to dental care. The prevalence of filled teeth in WA was 82.5% (Table 11), which is slightly lower than the Australian population figure (83.9%) (Slade et al. 2007).
Key findings 
•	Prevalence of filled teeth was significantly associated with age; among people aged 55 years or more and 35–54 years, it was about 1.5 times that of those in the 15–34 years age group (95.0% and 93.3% versus 63.3% respectively).
•	Among people of all ages, the highest prevalence was seen in people who had a government health card and last visited a public dental clinic (94.0%), and the lowest among those living in the middle socioeconomic postcode (78.4%).
•	Prevalence of filled teeth was not significantly associated with any of the sociodemographic variables examined, as indicated by the overlapping of 95% CIs.
•	While not reaching statistical significance, a number of trends may be discerned in the results in relation to other sociodemographic factors. More females appeared to have filled teeth than males (85.1% versus 79.8%), and more of those who had a government health card and visited a public clinic than a non-public clinic (94.0% versus 80.9%).
Discussion
The percentage of people with filled teeth relates to lifetime experience of dental decay, and hence is associated with age. Prevalence also reflects access to timely dental care, and type of care used to treat caries being a restoration rather than an extraction.

Table 11: Percentage of people with one or more filled teeth
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 82.5	 63.3	 93.3	 95.0	
	95% CI(a)	75.6–87.7	51.1–74.0	86.8–96.7	88.9–97.8	
Sex						
Males	% of people	 79.8	 60.7	 91.1	 92.3	
	95% CI	70.7–86.5	46.7–73.2	78.6–96.6	80.8–97.2	
Females	% of people	 85.1	 66.0	 95.4	 97.5	
	95% CI	75.5–91.4	46.1–81.5	88.8–98.2	87.9–99.5	
Residential location						
Capital city	% of people	 82.7	 65.7	 92.3	 94.6	
	95% CI	74.9–88.5	50.5–78.2	83.6–96.6	86.9–97.9	
Other places	% of people	 81.6	 56.0	 95.9	 95.9	
	95% CI	64.7–91.5	39.1–71.6	87.4–98.7	80.2–99.3	
Postcode socioeconomic status						
Lowest	% of people	 84.6	 70.2	 90.7	 97.4	
	95% CI	72.1–92.1	46.1–86.6	78.5–96.3	88.4–99.5	
Middle	% of people	 78.4	 64.1	 90.9	 87.7	
	95% CI	66.8–86.7	51.3–75.2	71.5–97.6	73.0–95.0	
Highest	% of people	 84.5	 53.9	 96.9	100.0	
	95% CI	70.1–92.7	28.6–77.3	88.0–99.2	–	
Government health card						
Health care card or pensioner concession card	% of people	 85.3	 64.4	 92.0	 90.0	
	95% CI	70.6–93.4	20.7–92.6	73.5–98.0	78.8–95.6	
Neither card	% of people	 81.6	 63.2	 93.5	100.0	
	95% CI	73.8–87.5	52.4–72.8	85.3–97.2	–	
Place of last dental visit						
Card-holder/Public	% of people	 94.0	100.0	100.0	 86.6	
	95% CI	79.8–98.4	–	–	58.4–96.8	
Card-holder/Non-public	% of people	 80.9	 45.3	 85.6	 91.4	
	95% CI	60.7–92.1	7.5–89.4	58.3–96.2	78.0–96.9	
Non-card-holder/Non-public	% of people	 81.6	 63.2	 93.5	100.0	
	95% CI	73.8–87.5	52.4–72.8	85.3–97.2	–	
Dental insurance						
Insured	% of people	 86.3	 63.0	 97.1	 95.2	
	95% CI	77.8–91.9	44.1–78.5	91.3–99.1	86.9–98.3	
Uninsured	% of people	 80.3	 68.8	 87.1	 94.4	
	95% CI	72.1–86.6	54.5–80.2	72.8–94.5	82.3–98.4	
(a) 95% CI = 95% confidence interval for estimated percentage

Average number of decayed, missing and filled teeth per person
The number of decayed, missing because of pathology, and filled teeth (DMFT) reflects a person’s lifetime experience of dental caries. In this survey all missing teeth in people aged 45 years or more were counted as missing due to pathology, while for people aged less than 45 years, the count only included teeth where the examiner judged that dental decay or gum disease was the likely reason for the extraction. The average DMFT number in WA was 13.1 (Table 12), which is slightly higher than that for the Australian population (12.8) (Slade et al. 2007).
Key findings 
•	The average number of affected teeth was significantly associated with age, being highest in people aged 55 years or more (22.7 teeth). This was 1.6 times that of the 35–44‑year‑olds (14.5 teeth) and five times that of the 15–34 years age group (5.4 teeth).
•	Among people of all ages, the highest average was recorded in non–government health card-holders who last attended a non-public clinic (17.7 teeth), and the lowest among people who did not have a government health card and uninsured people (11.2 teeth).
•	Government health card-holder status was significantly associated with average DMFT, with card-holders having 1.4 times the number compared with non–card-holders (17.1 versus 11.9 teeth).
•	The average DMFT was significantly associated with place of last dental visit, with people who had a government health card who last visited a non-public practitioner having significantly higher scores than non–card-holders whose last visit was at a non-public clinic (17.7 versus 11.9 teeth).
•	Private dental insurance was significantly associated with average DMFT, with insured people having 1.3 times the number compared with the uninsured (14.8 versus 11.2 teeth).
•	Among people aged 35–54 years, significant differences in prevalence of coronal decay were found in relation to dental insurance.
Discussion
The average number of teeth with caries experience over a lifetime is a cumulative score, and hence is strongly associated with age. Disease experience is related to disadvantage, as evidenced by associations with government health card-holder status and place of last dental visit.
In summary, the average number of teeth affected by caries varied by age, government health card-holder status, place of last dental visit and dental insurance status.

Table 12: Average number of decayed missing or filled teeth per person
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	mean	 13.1	 5.4	 14.5	 22.7	
	95% CI(a)	11.6–14.6	4.1–6.6	13.1–16.0	21.8–23.5	
Sex						
Males	mean	 12.4	 6.0	 13.1	 21.7	
	95% CI	10.4–14.4	4.2–7.9	10.8–15.5	20.2–23.2	
Females	mean	 13.7	 4.7	 16.0	 23.6	
	95% CI	11.8–15.7	3.4–5.9	14.3–17.7	22.8–24.4	
Residential location						
Capital city	mean	 12.9	 5.1	 14.3	 22.8	
	95% CI	11.2–14.6	3.6–6.5	12.5–16.1	21.8–23.9	
Other places 	mean	 13.7	 6.2	 15.2	 22.3	
	95% CI	10.6–16.9	3.4–9.0	13.1–17.3	20.9–23.7	
Postcode socioeconomic status						
Lowest	mean	 13.6	 7.8	 13.0	 23.1	
	95% CI	11.5–15.7	5.4–10.1	10.7–15.4	22.2–24.0	
Middle	mean	 12.2	 4.5	 14.6	 22.9	
	95% CI	9.1–15.3	3.2–5.9	11.7–17.4	21.4–24.4	
Highest	mean	 13.5	 3.6	 15.7	 22.0	
	95% CI	11.2–15.8	1.9–5.3	14.0–17.4	20.4–23.6	
Government health card						
Health care card or pensioner concession card	mean	 17.1	 6.3	 12.1	 23.5	
	95% CI	14.1–20.0	1.9–10.7	9.3–14.8	22.3–24.8	
Neither card	mean	 11.9	 5.2	 15.0	 21.8	
	95% CI	10.2–13.6	4.0–6.5	13.6–16.5	20.7–23.0	
Place of last dental visit						
Card-holder/Public	mean	 15.7	 5.1	 11.6	 23.9	
	95% CI	11.0–20.4	2.1–8.0	6.7–16.4	22.1–25.7	
Card-holder/Non-public	mean	 17.7	 7.0	 12.5	 23.4	
	95% CI	14.4–21.1	<0–15.0	9.6–15.4	21.7–25.1	
Non-card-holder/Non-public	mean	 11.9	 5.2	 15.0	 21.8	
	95% CI	10.2–13.6	4.0–6.5	13.6–16.5	20.7–23.0	
Dental insurance						
Insured	mean	 14.8	5.0	 16.3	 22.8	
	95% CI	13.0–16.6	3.6–6.4	14.7–18.0	21.7–23.8	
Uninsured	mean	 11.2	6.1	 11.7	 22.5	
	95% CI	9.7–12.7	4.5–7.8	9.8–13.7	21.2–23.8	
(a) 95% CI = 95% confidence interval for estimated mean

Prevalence of moderate or severe periodontitis
A case definition of periodontitis has been developed jointly by the US Centers for Disease Control and Prevention (CDC) and the American Academy of Periodontology (AAP) to describe prevalence of moderate and severe periodontitis. The CDC/AAP defines moderate periodontitis as the presence of either two sites between adjacent teeth where the gum has lost its attachment to the tooth for 4 mm or more, or at least two such sites that have pockets of 5 mm or more. Severe periodontitis has been defined as having at least two sites between adjacent teeth where the gum has lost its attachment to the tooth for 6 mm or more, and there is at least one pocket of 5 mm or greater depth. Table 13 reports estimates of a combined moderate or severe periodontitis. In WA, a total of 12.6% of the dentate population had moderate or severe periodontitis (Table 13), which was significantly lower than the national estimate of 22.9% (Slade et al. 2007).
Key findings
•	The prevalence of moderate or severe periodontitis was strongly associated with age, being 1.8% in 15–34‑year‑olds but affecting 15.2% of the middle-aged group and 29% of WA adults aged 55 years or more. The differences between the youngest age group and the other two groups were statistically significant.
•	People who had a government health card were more than twice as likely to have periodontitis. However, the difference was borderline non-significant.
Discussion
Components of periodontal disease measurement reflect both concurrent disease state and historical accumulation of the disease. Therefore, a strong association with age was fully expected.
In summary, moderate or severe periodontitis affected one‑tenth of the WA adult population, with the highest proportion of those affected being in the older age group. The disease was more likely to be observed in the socioeconomically disadvantaged groups.

Table 13: Percentage of people with moderate or severe periodontitis
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 12.6	 1.8	 15.2	 29.0	
	95% CI(a)	9.7–16.3	0.4–7.6	10.0–22.5	21.2–38.2	
Sex						
Males	% of people	 14.0	 2.6	 19.2	 27.8	
	95% CI	9.4–20.4	0.4–14.0	10.0–33.7	17.3–41.4	
Females	% of people	 11.3	 0.9	 11.5	 30.1	
	95% CI	8.0–15.7	0.1–6.0	6.3–19.9	20.5–41.9	
Residential location						
Capital city	% of people	 13.3	 1.8	 14.8	 33.2	
	95% CI	9.9–17.8	0.3–10.7	8.9–23.5	24.2–43.7	
Other places	% of people	 10.6	 1.7	 16.5	 16.4	
	95% CI	6.1–17.9	0.2–13.1	7.6–32.2	4.9–42.8	
Postcode socioeconomic status						
Lowest	% of people	 12.8	 1.3	 21.5	 21.5	
	95% CI	8.3–19.2	0.2–9.5	11.6–36.4	10.0–40.4	
Middle	% of people	 12.4	 3.4	 12.6	 32.4	
	95% CI	7.3–20.3	0.6–17.1	4.7–29.8	20.7–46.8	
Highest	% of people	 12.8	 0.0	 12.8	 32.9	
	95% CI	8.5–18.8	–	7.0–22.2	19.1–50.5	
Government health card						
Health care card or pensioner concession card	% of people	 22.3	 3.3	 22.9	 31.7	
	95% CI	14.2–33.1	0.4–22.8	8.4–49.1	21.2–44.4	
Neither card	% of people	 10.2	 1.5	 14.1	 26.5	
	95% CI	7.2–14.3	0.2–9.4	8.8–21.8	17.1–38.7	
Place of last dental visit						
Card-holder/Public	% of people	 19.0	 0.0	 40.6	 20.7	
	95% CI	7.5–40.3	–	7.0–86.1	7.6–45.4	
Card-holder/Non-public	% of people	 23.6	 5.0	 15.6	 35.5	
	95% CI	13.8–37.4	0.6–33.5	4.3–43.1	23.0–50.4	
Non-card-holder/Non-public	% of people	 10.2	 1.5	 14.1	 26.5	
	95% CI	7.2–14.3	0.2–9.4	8.8–21.8	17.1–38.7	
Dental insurance						
Insured	% of people	 13.3	 0.0	 15.3	 26.9	
	95% CI	9.5–18.4	–	8.4–26.3	18.4–37.6	
Uninsured	% of people	 12.5	 3.7	 15.1	 34.0	
	95% CI	7.8–19.6	0.8–16.0	8.0–26.6	19.9–51.6	
(a) 95% CI = 95% confidence interval for estimated percentage

Prevalence of deep pocket depth 
Deep periodontal pockets have been defined as 4 mm or more. The depth of the pocket, measured in millimetres using a periodontal probe, is an indication of the severity of the destructive process. In WA, a total of 13.9% of the dentate adult population had at least one site with periodontal pocket depth of 4 mm or more (Table 14), which was lower, but not significantly, than the national estimate of 19.8% (Slade et al. 2007).
Key findings
•	There was a tendency that people with lower socioeconomic status had higher prevalence of deep periodontal pocket. However, the differences were not statistically significant.
•	There were no statistically significant differences between the other population groups.
Discussion
The depth of periodontal pockets reflects a more current activity of periodontal inflammation. This activity may be more dependent on oral hygiene status, which was found to not vary widely between groups.
In summary, deep periodontal pocketing affected just over one-tenth of the WA dentate population. The tendency of higher prevalence of deep periodontal pocket among people with lower socioeconomic status was not statistically significant due to a relatively small number of participants.

Table 14: Percentage of people with 4+ mm periodontal pocket depth
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 13.9	 10.0	 17.1	 15.7	
	95% CI(a)	10.1–18.7	4.8–19.8	10.8–25.9	10.3–23.3	
Sex						
Males	% of people	 17.6	 11.0	 23.9	 19.6	
	95% CI	11.4–26.0	3.5–29.7	13.7–38.3	10.9–32.8	
Females	% of people	 10.2	 9.0	 10.6	 11.9	
	95% CI	6.8–15.1	3.8–19.9	4.7–22.3	6.6–20.4	
Residential location						
Capital city	% of people	 14.2	 10.9	 17.6	 14.9	
	95% CI	9.6–20.5	4.6–23.5	10.3–28.5	9.2–23.3	
Other places	% of people	 12.9	 7.5	 15.6	 18.1	
	95% CI	8.3–19.6	2.1–23.2	6.3–33.8	7.5–37.5	
Postcode socioeconomic status						
Lowest	% of people	 18.1	 14.5	 23.3	 17.0	
	95% CI	11.0–28.3	3.9–41.5	13.2–37.9	7.4–34.7	
Middle	% of people	 11.8	 13.3	 7.1	 15.8	
	95% CI	6.7–19.9	6.7–24.5	2.1–21.1	7.3–30.7	
Highest	% of people	 12.2	 0.0	 20.0	 14.3	
	95% CI	7.0–20.5	–	9.2–38.2	7.8–24.7	
Government health card						
Health care card or pensioner concession card	% of people	 18.6	 27.8	 11.8	 17.0	
	95% CI	8.8–35.0	6.3–68.8	1.9–48.2	9.1–29.6	
Neither card	% of people	 12.7	 7.4	 17.8	 14.5	
	95% CI	8.9–17.8	3.7–14.2	10.9–27.9	8.3–24.0	
Place of last dental visit						
Card-holder/Public	% of people	 20.0	 0.0	 40.6	 23.0	
	95% CI	7.8–42.5	–	7.0–86.1	7.4–52.6	
Card-holder/Non-public	% of people	 18.1	 42.8	 0.0	 14.9	
	95% CI	6.7–40.3	6.8–88.5	–	7.1–28.7	
Non-card-holder/Non-public	% of people	 12.7	 7.4	 17.8	 14.5	
	95% CI	8.9–17.8	3.7–14.2	10.9–27.9	8.3–24.0	
Dental insurance						
Insured	% of people	 12.4	 2.5	 19.3	 14.1	
	95% CI	8.3–18.0	0.4–15.8	10.9–31.8	9.1–21.1	
Uninsured	% of people	 17.0	 18.7	 13.4	 19.7	
	95% CI	10.6–26.1	9.0–34.8	5.7–28.5	9.6–36.1	
(a) 95% CI = 95% confidence interval for estimated percentage

Prevalence of 4+‑mm clinical attachment loss 
Clinical attachment loss (CAL) is the loss of supporting periodontal structure around the tooth. Attachment may be lost through gum recession or the development of periodontal pockets from the inflammatory disease periodontitis. In NSAOH, CAL was measured using a combination of gum recession and periodontal probing depth on three sites per tooth. In WA, a total of 32.8% of dentate adults had at least one site with 4 mm or more CAL (Table 15), which was significantly lower than the national estimate of 42.5% (Slade et al. 2007).
Key findings
•	The prevalence of 4+ mm CAL was strongly associated with age, being 10.0% in 15–34‑year‑olds adults but affecting 64.4% of WA adults aged 55 years or more. 
•	There was a tendency that males had higher prevalence of CAL of 4+ mm compared with females. However, the difference was not statistically significant.
•	People who had a government health card were significantly more likely to have CAL of 4+ mm compared with non–card-holders. This trend remained significant between card-holders who visited a non-public care service and non–card-holders.
Discussion
Clinical attachment loss reflects an accumulation of activity of periodontal inflammation as well as a physiological process in the gums. Therefore, a strong age effect was observed.
In summary, clinical attachment loss was prevalent in this population, and was more likely to occur in the older population and among people with lower socioeconomic status.

Table 15: Percentage of people with 4+ mm clinical attachment loss
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 32.8	 10.0	 39.8	 64.4	
	95% CI(a)	26.6–39.7	4.6–20.4	30.8–49.5	55.6–72.3	
Sex						
Males	% of people	 35.6	 14.2	 38.6	 73.1	
	95% CI	25.8–46.7	5.4–32.5	24.7–54.7	56.2–85.2	
Females	% of people	 30.1	 5.7	 40.9	 55.9	
	95% CI	24.1–36.9	2.2–13.9	31.4–51.1	41.2–69.7	
Residential location						
Capital city	% of people	 32.2	 12.2	 34.1	 67.3	
	95% CI	25.8–39.3	5.4–25.2	24.0–45.8	57.7–75.7	
Other places	% of people	 34.9	 3.4	 55.4	 55.7	
	95% CI	20.7–52.4	0.4–24.2	41.9–68.1	34.3–75.1	
Postcode socioeconomic status						
Lowest	% of people	 41.0	 20.6	 54.3	 59.6	
	95% CI	28.0–55.4	7.5–45.3	42.1–66.0	42.1–75.0	
Middle	% of people	 29.8	 6.3	 37.3	 71.1	
	95% CI	21.3–39.9	2.0–18.2	23.6–53.4	60.5–79.8	
Highest	% of people	 28.5	 2.8	 31.6	 62.3	
	95% CI	20.8–37.7	0.5–13.7	18.4–48.6	46.7–75.7	
Government health card						
Health care card or pensioner concession card	% of people	 50.3	 33.8	 43.6	 61.9	
	95% CI	38.9–61.7	12.3–65.1	26.8–62.0	47.8–74.3	
Neither card	% of people	 28.4	 6.6	 39.2	 66.6	
	95% CI	21.7–36.2	2.7–15.3	29.6–49.8	51.4–79.0	
Place of last dental visit						
Card-holder/Public	% of people	 43.0	 0.0	 62.0	 62.6	
	95% CI	22.7–65.9	–	20.7–91.1	38.9–81.5	
Card-holder/Non-public	% of people	 53.4	 51.9	 36.0	 61.7	
	95% CI	37.9–68.2	14.9–86.9	17.9–59.1	44.3–76.5	
Non-card-holder/Non-public	% of people	 28.4	 6.6	 39.2	 66.6	
	95% CI	21.7–36.2	2.7–15.3	29.6–49.8	51.4–79.0	
Dental insurance						
Insured	% of people	 36.4	 4.4	 45.7	 62.3	
	95% CI	29.0–44.6	0.6–25.6	33.4–58.6	51.9–71.7	
Uninsured	% of people	 29.8	 17.0	 30.1	 69.4	
	95% CI	21.7–39.4	7.6–33.8	20.5–41.8	53.9–81.5	
(a) 95% CI = 95% confidence interval for estimated percentage

Prevalence of gingival inflammation 
The gingival index is a measure of gingivitis, inflammation of the gums. Gingivitis occurs as a response to the bacteria in plaque accumulation near the gum line. In NSAOH, gingivitis was assessed on six index teeth. A gingival index score of 2 or more indicated bleeding on probing or spontaneous bleeding, and was classified as indicating gingival inflammation (gingivitis). In WA, a total of 10.9% of the dentate adult population had at least one site with a gingival score of 2 or more (Table 16), which was significantly lower than the national estimate of 19.7% (Slade et al. 2007).
Key findings
•	Males were more likely to have gingival inflammation compared with females.
•	There was a tendency that people with lower socioeconomic status were more likely to have gingival inflammation. However, none of the differences were statistically significant.
Discussion
Gingival inflammation is a condition observed in people of all ages at a similar rate. There was a tendency that people with lower socioeconomic status had higher prevalence of gingival inflammation. However, the differences were small and relatively low numbers of people in each population group made the confidence intervals wide, overlapping between groups.
In summary, gingival inflammation was a condition that affected males at a higher rate.

Table 16: Percentage of people with gingival inflammation
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 10.9	 15.8	 6.7	 8.9	
	95% CI(a)	7.2–16.1	9.1–25.8	3.3–13.1	4.7–16.3	
Sex						
Males	% of people	 16.5	 26.1	 9.5	 9.4	
	95% CI	9.9–26.2	13.3–44.8	3.6–22.6	4.0–20.4	
Females	% of people	 5.3	 4.8	 4.0	 8.5	
	95% CI	2.8–9.7	1.6–13.4	1.8–8.8	3.4–19.5	
Residential location						
Capital city	% of people	 10.5	 15.9	 6.5	 6.8	
	95% CI	6.5–16.5	8.2–28.6	2.7–15.1	3.2–13.8	
Other places	% of people	 12.0	 15.2	 7.0	 15.2	
	95% CI	5.4–24.6	6.2–32.9	2.3–19.8	4.3–41.5	
Postcode socioeconomic status						
Lowest	% of people	 12.7	 19.3	 6.6	 9.2	
	95% CI	5.9–25.1	7.1–42.9	2.2–18.6	2.5–28.5	
Middle	% of people	 11.3	 16.6	 5.7	 7.9	
	95% CI	5.6–21.5	7.3–33.4	1.8–16.9	2.5–22.5	
Highest	% of people	 8.8	 10.3	 7.4	 9.6	
	95% CI	4.8–15.8	3.9–24.6	2.1–22.7	3.8–22.4	
Government health card						
Health care card or pensioner concession card	% of people	 5.3	 0.0	 6.9	 7.4	
	95% CI	2.5–10.8	–	2.0–21.2	2.9–17.4	
Neither card	% of people	 12.3	 18.1	 6.7	 10.3	
	95% CI	8.0–18.4	10.7–28.9	3.0–14.1	4.3–22.9	
Place of last dental visit						
Card-holder/Public	% of people	 7.3	 0.0	 11.5	 10.0	
	95% CI	2.1–22.3	–	1.3–55.8	2.3–34.6	
Card-holder/Non-public	% of people	 4.5	 0.0	 4.9	 6.4	
	95% CI	1.9–10.4	–	1.3–16.6	1.9–19.2	
Non-card-holder/Non-public	% of people	 12.3	 18.1	 6.7	 10.3	
	95% CI	8.0–18.4	10.7–28.9	3.0–14.1	4.3–22.9	
Dental insurance						
Insured	% of people	 8.7	 12.3	 7.1	 6.6	
	95% CI	4.9–15.1	5.4–25.5	3.2–14.9	2.3–17.5	
Uninsured	% of people	 14.7	 21.3	 6.0	 14.3	
	95% CI	7.7–26.2	9.6–40.7	2.0–16.5	6.2–29.9	
(a) 95% CI = 95% confidence interval for estimated percentage

4	Oral health care
Dental attendance within the preceding 12 months 
Time since last visiting a dentist is a key indicator of access to dental care. In NSAOH, the time since last dental visit was assessed in the interview by asking, ‘How long ago did you last see a dental professional about your teeth, dentures or gums?’ Five responses were possible including ‘Less than 12 months.’ In WA, 60.3% of people aged 15 years or more had visited a dentist within the last 12 months (Table 17), a figure that was slightly higher than the national estimate of 59.4% (Slade et al. 2007). 
Key findings
•	The percentage of adults visiting a dentist within the last 12 months varied from 57.0% for young adults to 63.2% for adults aged 55 years or more.
•	A similar percentage of males and females reported visiting a dentist within the last 12 months (56.9% versus 63.7%). Differences by gender were largest in the 55 years or more age group (57.8% versus 68.2%), although this was not statistically significant.
•	The percentage was higher among Perth residents than those living in the rest of WA (62.4% versus 54.2%). Similar results were observed within each age group.
•	There was some variation by socioeconomic status although differences were not statistically significant. The largest difference between high and low socioeconomic postcodes occurred in the 55 years or more age group (70.9% versus 54.9%). 
•	People with a government health card were equally likely to have visited a dentist in the last 12 months as those without (59.9% versus 60.4%). There was some variation between card-holders and non–card-holders within the older age groups but no consistent pattern emerged. 
•	Among people who had a government health card, those who attended a public practice at their last dental visit were more likely to have attended within the preceding year than those who attended a private practice (64.3% versus 58.1%). This was mainly due to card-holders aged 35–54 years (89.8% versus 61.4%).
•	Insured people were more likely to have recently visited a dentist than uninsured persons (68.7% versus 50.8%). This difference was mainly attributable to adults aged 15–34 years (71.0% versus 44.8%).
Discussion
Six out of 10 WA residents aged 15 years or more visited a dentist within the preceding 12 months. Dental insurance was the only sociodemographic characteristic associated with recent dental visiting. Differences between insured and uninsured groups were most evident for young adults.

Table 17: Percentage of people visiting dentist within last 12 months
		Population: all people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 60.3	 57.0	 61.4	 63.2	
	95% CI(a)	56.8–63.8	50.9–62.8	56.0–66.5	57.9–68.2	
Sex						
Males	% of people	 56.9	 56.0	 57.0	 57.8	
	95% CI	53.1–60.6	47.3–64.5	49.6–64.1	50.0–65.2	
Females	% of people	 63.7	 57.9	 65.7	 68.2	
	95% CI	58.9–68.4	50.4–65.0	59.0–71.9	62.0–73.9	
Residential location						
Capital city	% of people	 62.4	 59.2	 63.0	 66.0	
	95% CI	58.6–66.2	52.6–65.5	57.1–68.6	59.3–72.0	
Other places	% of people	 54.2	 50.0	 56.9	 55.5	
	95% CI	45.9–62.2	36.3–63.6	45.1–67.9	47.6–63.2	
Postcode socioeconomic status						
Lowest	% of people	 53.7	 51.3	 55.1	 54.9	
	95% CI	46.4–60.9	39.9–62.5	43.6–66.1	49.1–60.5	
Middle	% of people	 60.2	 55.4	 62.3	 64.6	
	95% CI	55.8–64.4	44.9–65.4	53.6–70.2	58.4–70.3	
Highest	% of people	 66.4	 64.0	 65.2	 70.9	
	95% CI	60.7–71.6	55.2–72.0	57.4–72.2	58.1–81.0	
Government health card						
Health care card or pensioner concession card	% of people	 59.9	 58.1	 69.3	 57.9	
	95% CI	53.5–66.1	43.7–71.3	56.0–80.1	51.5–64.1	
Neither card	% of people	 60.4	 56.5	 60.3	 69.4	
	95% CI	56.3–64.4	50.1–62.8	54.6–65.7	60.5–77.0	
Place of last dental visit						
Card-holder/Public	% of people	 64.3	 52.5	 89.8	 63.7	
	95% CI	53.7–73.7	28.3–75.6	71.6–96.8	50.6–75.0	
Card-holder/Non-public	% of people	 58.1	 62.2	 61.4	 55.9	
	95% CI	51.1–64.7	40.7–79.8	45.6–75.0	48.4–63.1	
Non-card-holder/Non-public	% of people	 60.4	 56.5	 60.3	 69.4	
	95% CI	56.3–64.4	50.1–62.8	54.6–65.7	60.5–77.0	
Dental insurance						
Insured	% of people	 68.7	 71.0	 67.7	 67.4	
	95% CI	63.7–73.3	62.9–78.0	60.5–74.1	59.3–74.6	
Uninsured	% of people	 50.8	 44.8	 51.0	 58.2	
	95% CI	45.5–56.0	35.0–54.9	42.7–59.3	50.4–65.5	
(a) 95% CI = 95% confidence interval for estimated percentage

Attendance at private dental practice 
While most Australians obtain dental care at private dental practices, alternatives exist in the public sector for targeted population groups. The two largest public programs are school dental services targeted to children; and adult public programs provided through dental hospitals, community health centres and regional facilities, and targeted to adults holding a government concession card. In NSOAH, people were asked ‘Where did you make your last dental visit?’, and seven responses were offered. People who reported having visited a general dental practice, a specialist dental practice or a dental clinic associated with a health insurance fund were classified as having attended a private dental practice. In WA, 83.2% of people aged 15 years or more attended a private practice at their last dental visit (Table 18), which was almost identical to the national estimate of 83.1% (Slade et al. 2007). 
Key findings
•	Adults aged 35–54 years were more likely to have visited a private dental practice at their last dental visit (91.6%) than those aged 15–34 years (75.9%) or 55 years or more (81.5%).
•	The percentages of males and females were very similar for all ages combined (81.9% versus 84.5%) and within age groups.
•	Perth residents were more likely to have visited a private dentist than those living in the rest of WA (85.6% versus 76.2%) although this difference was not statistically significant. The largest difference was observed in adults aged 15–34 years (80.5% versus 61.2%).
•	Residents living in high socioeconomic postcodes were more likely to have visited a private practice than those living in postcodes of low socioeconomic status (91.1% versus 77.8%). This difference was mainly attributable to the 15–34 years age group (90.4% versus 65.7%).
•	Despite having a government health card, 67.6% of card-holders reported that they visited a private practice at their last dental visit. The percentage was lower, although not significantly so,  for card-holders aged 15–34 years (57.5%) compared to other ages.
•	Insured people were more likely to have visited a private practice at their last dental visit than those without dental insurance (91.5% versus 73.4%). Within age groups, the largest difference was observed for those aged 55 years or more (93.2% versus 67.0%). 
Discussion
Over eight out of ten WA residents visited a private practice at their last dental visit. Having dental insurance, being aged 35–54 years and living in areas of high socioeconomic status were associated with private visiting. Differences by socioeconomic status were most evident in young adults, whereas differences between insurance groups were largest for adults aged 55 years or more. Despite having a government health card, two-thirds of card-holders attended a private practice at their last dental visit, which is most likely due to long public waiting lists.

Table 18: Percentage of people who attended a private dental practice at last dental visit
		Population: all people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 83.2	 75.9	 91.6	 81.5	
	95% CI(a)	79.5–86.4	69.1–81.6	85.2–95.3	77.3–85.1	
Sex						
Males	% of people	 81.9	 73.9	 90.6	 80.7	
	95% CI	77.1–85.9	65.3–80.9	82.6–95.2	74.6–85.5	
Females	% of people	 84.5	 78.0	 92.5	 82.4	
	95% CI	80.1–88.2	68.5–85.2	86.4–96.0	76.9–86.8	
Residential location						
Capital city	% of people	 85.6	 80.5	 94.1	 81.2	
	95% CI	82.1–88.6	73.3–86.2	91.0–96.2	75.7–85.7	
Other places	% of people	 76.2	 61.2	 84.5	 82.5	
	95% CI	65.8–84.3	44.7–75.5	62.2–94.8	76.9–86.9	
Postcode socioeconomic status						
Lowest	% of people	 77.8	 65.7	 90.2	 78.3	
	95% CI	73.1–81.8	52.6–76.8	83.8–94.2	71.3–84.0	
Middle	% of people	 80.2	 71.6	 87.9	 81.5	
	95% CI	71.7–86.6	60.4–80.6	69.4–95.9	75.2–86.5	
Highest	% of people	 91.1	 90.4	 96.0	 85.0	
	95% CI	87.6–93.7	81.4–95.3	92.8–97.8	76.9–90.6	
Government health card						
Health care card or pensioner concession card	% of people	 67.6	 57.5	 70.2	 70.7	
	95% CI	62.4–72.4	43.0–70.9	55.4–81.8	64.6–76.1	
Neither card	% of people	 88.4	 79.3	 94.4	 94.1	
	95% CI	84.2–91.6	72.3–85.0	88.0–97.5	89.8–96.6	
Dental insurance						
Insured	% of people	 91.5	 82.3	 97.6	 93.2	
	95% CI	87.9–94.2	74.3–88.2	92.6–99.2	89.1–95.8	
Uninsured	% of people	 73.4	 71.5	 81.4	 67.0	
	95% CI	68.7–77.6	61.4–79.8	72.2–88.1	60.8–72.7	
(a) 95% CI = 95% confidence interval for estimated percentage

Payments by patients for dental care 
While the place of last dental visit was dominated by private practice, some visits made to private dentists are paid for by public funds. In order to identify such visits, NSAOH participants who had a government health card and who had visited a dentist within the last 5 years were asked ‘Did the government or an insurance fund pay any part of the expense for your last dental visit?’ A number of response options were available including ‘Paid all own expenses‘, ‘Insurance paid some – patient paid some‘, ‘Insurance paid all’, ‘Government paid some – patient paid some‘ and ‘Government paid all’. People who reported one of the first three payment mechanisms were classified as having paid for their care, together with people who were non–government health card-holders and had visited within the last 5 years. In WA, 90.0% of people aged 15 years or more who had seen a dentist within the preceding 5 years paid for that visit (Table 19, which was slightly lower than the national estimate of 91.4% (Slade et al. 2007).
Key findings 
•	WA residents aged 55 years or more were less likely to have paid for their last dental visit (78.8%) than those aged 35–54 years (95.5%) or 15–34 years (92.8%).
•	The percentage was similar for males and females (91.2% versus 88.8%). Within age groups, variations between the sexes remained small.
•	People living outside the metropolitan area were equally likely to have paid for their last dental visit as Perth residents (88.5% versus 90.5%). Within age groups, there was some variation among young adults (86.9% versus 94.7%) but this difference was not statistically significant.
•	People living in high socioeconomic postcodes were more likely to have paid for their last dental visit than those living in low socioeconomic postcodes (94.1% versus 84.2%). This difference was mainly attributable to the 55 years or more age group (87.8% versus 73.1%).
•	Despite having a government health card, 59.2% of card-holders who visited a dentist within the preceding 5 years paid for their last dental visit. 
•	Over 96% of people with dental insurance paid for their last dental visit compared with 80.5% of uninsured people. Within the uninsured population, the percentage was lowest for those aged 55 years or more (60.4%). 
Discussion
The majority of adults with a government health card paid for their own dental care. 

Table 19: Percentage of people who paid for their last dental visit

 		Population: people who visited dentist within last 5 years
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 90.0	 92.8	 95.5	 78.8	
	95% CI(a)	87.3–92.2	88.4–95.6	92.6–97.3	73.3–83.5	
Sex						
Males	% of people	 91.2	 95.4	 96.0	 78.6	
	95% CI	87.4–94.0	88.9–98.2	89.7–98.5	72.1–84.0	
Females	% of people	 88.8	 90.0	 95.1	 79.0	
	95% CI	85.3–91.5	82.7–94.5	91.3–97.2	71.4–85.0	
Residential location						
Capital city	% of people	 90.5	 94.7	 94.8	 79.1	
	95% CI	87.2–93.0	90.0–97.2	90.9–97.1	71.6–85.0	
Other places	% of people	 88.5	 86.9	 97.3	 78.1	
	95% CI	83.4–92.2	74.9–93.7	94.3–98.8	74.6–81.2	
Postcode socioeconomic status						
Lowest	% of people	 84.2	 85.8	 92.8	 73.1	
	95% CI	78.9–88.3	75.4–92.3	85.0–96.7	66.2–79.0	
Middle	% of people	 90.8	 95.2	 96.6	 74.1	
	95% CI	87.6–93.3	89.6–97.8	92.6–98.4	62.0–83.4	
Highest	% of people	 94.1	 96.6	 96.4	 87.8	
	95% CI	90.7–96.3	88.4–99.1	91.0–98.6	80.5–92.6	
Government health card						
Health care card or pensioner concession card	% of people	 59.2	 58.0	 62.3	 58.8	
	95% CI	53.6–64.7	42.0–72.5	48.5–74.3	51.5–65.7	
Neither card	% of people	100.0	100.0	100.0	100.0	
	95% CI	–	–	–	–	
Place of last dental visit						
Card-holder/Public	% of people	 15.8	 19.0	 17.2	 13.2	
	95% CI	8.7–27.1	4.7–52.9	5.1–44.4	6.3–25.7	
Card-holder/Non-public	% of people	 79.5	 87.1	 81.2	 76.4	
	95% CI	73.0–84.8	68.6–95.4	61.4–92.2	67.8–83.3	
Non-card-holder/Non-public	% of people	100.0	100.0	100.0	100.0	
	95% CI	–	–	–	–	
Dental insurance						
Insured	% of people	 96.5	 95.6	100.0	 92.4	
	95% CI	94.3–97.9	88.6–98.4	–	89.1–94.8	
Uninsured	% of people	 80.5	 90.0	 87.2	 60.4	
	95% CI	75.8–84.4	82.0–94.7	80.3–92.0	51.9–68.2	
(a) 95% CI = 95% confidence interval for estimated percentage
Government-subsidised dental care in private sector
In some states and territories, public sector dental programs provide care to people eligible for their services by referring them to private practitioner dentists. The cost of such care is then subsidised by the state or territory dental program. In WA, 4.3% of the adult population received state-subsidised dental care in the private sector (Table 20). This statistic was not reported nationally.
•	People aged 55 years or more were more likely than younger people to receive state-subsidised dental care in private practice, although the difference was statistically significant only in comparison with 35‑54‑year‑olds. 
•	In contrast, the age-related pattern was not significant in the group of people who had a government health card, among whom 17.4% received state-subsidised dental care in private practice. 
•	The percentage was higher for people living in postcodes with the lowest socioeconomic status than in postcodes with the highest socioeconomic status.
•	Dental insurance status was associated with a significantly lower likelihood of state-subsidised dental care in private practice.
Discussion
Variation in this statistic according to postcode socioeconomic status and dental insurance status reflected similar variation in the distribution of people who were eligible for state dental services. Age trends conflicted according to whether the data were for the entire WA population or the subgroup of the population that had a government health card.

Table 20: Percentage of people who received government-subsidised dental care in private sector

		Population: people who visited dentist within last 5 years
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	  4.3	  3.7	  1.6	  8.7	
	95% CI(a)	3.0–6.1	1.7–7.8	0.6–3.9	5.9–12.8	
Sex						
Males	% of people	  4.4	  3.7	  1.6	  9.5	
	95% CI	2.6–7.5	1.2–10.6	0.5–5.0	5.4–16.1	
Females	% of people	  4.2	  3.7	  1.6	  8.1	
	95% CI	2.5–6.9	1.3–10.4	0.4–5.9	4.2–15.0	
Residential location						
Capital city	% of people	  4.1	  3.5	  2.1	  7.6	
	95% CI	2.7–6.3	1.4–8.4	0.8–5.2	4.2–13.2	
Other places	% of people	  4.8	  4.2	  0.0	 12.3	
	95% CI	2.4–9.3	1.0–16.9	–	9.0–16.5	
Postcode socioeconomic status						
Lowest	% of people	  7.1	  7.1	  1.7	 12.7	
	95% CI	4.6–10.7	2.7–17.3	0.5–5.8	9.6–16.7	
Middle	% of people	  4.3	  2.5	  1.8	 11.4	
	95% CI	2.3–7.9	0.6–9.7	0.4–7.5	4.9–24.5	
Highest	% of people	  1.9	  1.8	  1.3	  3.0	
	95% CI	0.9–4.2	0.2–12.5	0.2–8.5	1.1–7.8	
Government health card						
Health care card or pensioner concession card	% of people	 17.4	 21.4	 13.2	 17.0	
	95% CI	12.9–23.1	10.0–39.9	5.5–28.5	12.0–23.6	
Neither card	% of people	  0.0	  0.0	  0.0	  0.0	
	95% CI	–	–	–	–	
Dental insurance						
Insured	% of people	  1.6	  1.1	  0.0	  4.7	
	95% CI	0.9–2.9	0.2–8.0	–	2.9–7.5	
Uninsured	% of people	  7.6	  5.7	  4.5	 13.8	
	95% CI	5.1–11.3	2.4–13.0	1.8–10.6	8.9–20.6	
 (a) 95% CI = 95% confidence interval for estimated percentage

People’s usual pattern of dental visits	
While time since last visiting a dentist provides a snapshot of dental visiting behaviour, people’s usual dental attendance patterns reflects longer term behaviours and intentions. In NSAOH, people who were dentate were asked ‘How often on average do you seek care from a dental professional?’, and four categories of response were offered. In WA, 56.1% of people aged 15 years or more usually visit a dentist at least once a year (Table 21), which was slightly higher than the national estimate of 53.1% (Slade et al. 2007).
Key findings
•	Among age groups, people aged 55 years or more were most likely to attend one or more times a year (61.0%) but this was not significantly different from younger age groups (54%). 
•	The percentage was slightly higher for females than males (59.9% versus 52.2%), and similar small differences were observed within each age group.
•	Perth residents were far more likely to usually visit one or more times a year than other residents of WA (61.2% versus 40.8%). Large differences by residential location were also evident within each age group.
•	Socioeconomic status was strongly associated with dental visiting behaviour, with residents of high socioeconomic postcodes much more likely to usually visit one or more times a year than those in low socioeconomic postcodes (67.0% versus 45.3%). Similar differences between socioeconomic groups were evident in all age groups.
•	People holding a government health were less likely to attend annually than non-health-card-holders (51.7% versus 57.2%). Within age groups, the largest difference occurred in the 35–54 years age group (42.8% versus 56.2%) although this difference was not significant. 
•	Among government health card-holders, people who visited a public practice at their last dental visit were nearly as likely to usually visit one or more times a year as those who visited a private practice (49.1% versus 52.9%). A large difference was evident for 35–54‑year‑olds (29.1% versus 48.0%), although this difference was not statistically significant due to large confidence intervals around these estimates.
•	Insured people were far more likely to usually visit a dentist one or more times a year than uninsured people (67.1% versus 40.0%). Large differences by insurance status were evident in all age groups.
Discussion
Over 55% of WA residents aged 15 years or more usually visit the dentist at least once a year. Residing in the metropolitan region, living in areas of high socioeconomic status and having dental insurance were all associated with regular dental visiting. The fact that residents living outside the metropolitan area are less likely to regularly visit the dentist than Perth residents may reflect difficulty in accessing dental services in country areas.

Table 21: Percentage of people who usually visit a dental professional at least once a year
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 56.1	 54.3	 54.6	 61.0	
	95% CI(a)	52.5–59.6	50.0–58.5	48.2–60.9	54.3–67.2	
Sex						
Males	% of people	 52.2	 51.4	 50.2	 56.7	
	95% CI	48.0–56.3	43.6–59.2	42.4–57.9	46.4–66.4	
Females	% of people	 59.9	 57.3	 59.1	 65.0	
	95% CI	54.4–65.2	49.2–65.1	51.2–66.6	57.3–72.0	
Residential location						
Capital city	% of people	 61.2	 59.5	 60.2	 65.2	
	95% CI	56.7–65.4	54.8–64.1	52.5–67.5	56.6–73.0	
Other places	% of people	 40.8	 37.5	 39.0	 48.5	
	95% CI	35.4–46.5	27.9–48.3	30.2–48.7	40.3–56.8	
Postcode socioeconomic status						
Lowest	% of people	 45.3	 47.0	 42.9	 46.1	
	95% CI	39.1–51.6	38.2–55.9	32.3–54.1	39.2–53.2	
Middle	% of people	 54.1	 53.7	 50.2	 61.8	
	95% CI	47.9–60.1	45.7–61.4	38.3–62.1	50.4–72.0	
Highest	% of people	 67.0	 61.7	 67.2	 74.0	
	95% CI	61.7–71.9	54.6–68.4	57.8–75.4	62.7–82.9	
Government health card						
Health care card or pensioner concession card	% of people	 51.7	 48.5	 42.8	 56.8	
	95% CI	46.1–57.3	34.7–62.6	31.7–54.7	48.9–64.4	
Neither card	% of people	 57.2	 55.2	 56.2	 64.9	
	95% CI	53.3–61.0	50.5–59.9	49.4–62.7	55.0–73.6	
Place of last dental visit						
Card-holder/Public	% of people	 49.1	 46.0	 29.1	 59.8	
	95% CI	38.4–59.9	24.9–68.7	12.6–53.9	45.9–72.2	
Card-holder/Non-public	% of people	 52.9	 50.4	 48.0	 55.7	
	95% CI	46.4–59.3	33.1–67.5	33.8–62.5	47.0–64.1	
Non-card-holder/Non-public	% of people	 57.2	 55.2	 56.2	 64.9	
	95% CI	53.3–61.0	50.5–59.9	49.4–62.7	55.0–73.6	
Dental insurance						
Insured	% of people	 67.1	 67.1	 66.0	 68.9	
	95% CI	62.7–71.2	59.7–73.7	58.5–72.8	61.8–75.2	
Uninsured	% of people	 40.0	 38.4	 35.5	 49.1	
	95% CI	35.5–44.6	30.4–47.0	28.1–43.7	39.4–58.9	
(a) 95% CI = 95% confidence interval for estimated percentage

Usual attendance at the same dentist
In NSAOH, usual source of care was assessed in the interview by asking people ‘Is there a dentist you usually go to for dental care?’. People who answered ‘yes, have a usual source of care’ were classified as having a dentist they usually attend. In WA, 75.7% of the dentate population aged 15 years or more who visited a dentist within the last 5 years reported having a dentist they usually attend (Table 22), which was lower than the national estimate of 78.6% (Slade et al. 2007).
Key findings
•	Across age groups, the percentage who replied ‘yes’ to having a dentist they usually attend was lowest for those adults in the 15–34 years age group (71.5%), and increased toward the oldest (55 years or more) age group (81.0%). However, differences between age groups were not statistically significant.
•	For all ages combined and across age groups, there were no significant differences by sex or among groups classified by residential location.
•	For all ages combined, those living in postcodes with low socioeconomic status were less likely to report a usual source of care compared with those in postcodes with high socioeconomic status (73.7% versus 85.5%). Similarly, the percentage was lower among people living in middle socioeconomic postcodes than those in high socioeconomic postcodes for all ages combined (66.9% versus 85.5%) and for people aged 15–34 years (63.6% versus 82.9%) and 35–54 years (66.0% versus 86.6%).
•	Among those aged 35–54 years, government health card-holders recorded significantly lower percentages than non–card-holders (58.6% versus 78.7%).
•	Within the population of government health card-holders, people whose last dental visit was to the public sector were less likely to report having a dentist they usually attend than those who visited elsewhere (44.1% versus 78.3%). This difference was mainly attributable to those aged 35–54 years (24.4% versus 72.3%). 
•	The percentage of adults who reported having a dentist they usually attend was significantly higher among people with dental insurance than those without (85.1% versus 61.5%). Statistically significant differences were observed in the 35–54 years (87.0% versus 56.6%) and 55 years or more (90.2% versus 67.3%) age groups.
Discussion
In summary, just over three-quarters of WA adults reported that they usually visit the same dentist. This type of visiting was more frequent among the older age groups, government health card-holders who last visited non-publicly, those living in high socioeconomic postcodes and the insured.
Choice of an individual dentist is not possible within most public dental clinics.

Table 22: Percentage of people who have a dentist they usually attend
		Population: dentate people who visited dentist within last 5 years
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 75.7	 71.5	 76.4	 81.0	
	95% CI(a)	71.6–79.4	65.1–77.1	71.1–81.0	75.4–85.6	
Sex						
Males	% of people	 72.0	 66.4	 71.3	 82.2	
	95% CI	66.0–77.3	55.8–75.6	63.0–78.3	75.2–87.6	
Females	% of people	 79.3	 76.8	 81.1	 80.0	
	95% CI	75.0–83.0	69.8–82.6	74.5–86.3	72.2–86.0	
Residential location						
Capital city	% of people	 77.4	 73.8	 78.0	 81.9	
	95% CI	72.4–81.8	66.4–80.0	72.5–82.7	75.1–87.2	
Other places	% of people	 70.5	 64.3	 71.5	 78.1	
	95% CI	64.1–76.1	50.8–75.9	58.1–81.9	68.1–85.6	
Postcode socioeconomic status						
Lowest	% of people	 73.7	 67.6	 75.5	 80.1	
	95% CI	68.5–78.3	56.1–77.3	68.7–81.3	70.5–87.2	
Middle	% of people	 66.9	 63.6	 66.0	 74.2	
	95% CI	61.1–72.2	53.0–73.1	57.8–73.3	61.3–83.9	
Highest	% of people	 85.5	 82.9	 86.6	 87.0	
	95% CI	80.6–89.3	74.7–88.9	79.5–91.5	80.7–91.5	
Government health card						
Health care card or pensioner concession card	% of people 	 67.4	 57.8	 58.6	 76.0	
	95% CI	59.8–74.2	40.1–73.7	42.6–72.9	66.9–83.2	
Neither card	% of people	 78.1	 74.2	 78.7	 85.5	
	95% CI	73.8–81.9	66.3–80.8	73.5–83.2	79.5–90.0	
Place of last dental visit						
Card-holder/Public	% of people	 44.1	 34.3	 24.4	 59.9	
	95% CI	30.0–59.3	12.5–65.8	8.1–54.1	41.6–75.9	
Card-holder/Non-public	% of people	 78.3	 74.8	 72.3	 82.1	
	95% CI	70.4–84.5	50.9–89.4	54.6–85.0	72.1–89.1	
Non-card-holder/Non-public	% of people	 78.1	 74.2	 78.7	 85.5	
	95% CI	73.8–81.9	66.3–80.8	73.5–83.2	79.5–90.0	
Dental insurance						
Insured	% of people	 85.1	 79.0	 87.0	 90.2	
	95% CI	80.9–88.6	71.6–84.8	81.7–91.0	84.3–94.0	
Uninsured	% of people	 61.5	 62.2	 56.6	 67.3	
	95% CI	55.5–67.1	50.9–72.4	47.6–65.1	57.4–75.8	
(a) 95% CI = 95% confidence interval for estimated percentage
Usual dental attendance for a check-up
In NSAOH, dentate people were asked ‘Is your usual reason for visiting a dental professional for check-ups or when you have a dental problem?’ In WA, 59.8% of the adult dentate population reported usually visiting a dentist for a check-up (Table 23), which was higher than the national estimate of 56.2% (Slade et al. 2007).
Key findings
•	Although a higher percentage of adults aged 15–34 years reported usually visiting for a check-up (64.9%) compared with those aged 35–54 years (55.1%) and 55 years or more (59.4%), differences between age groups were not statistically significant.
•	The percentage was higher among females than males (63.4% versus 56.2%). This pattern was consistent across all age groups although differences within age groups were not statistically significant.
•	Adults living in Perth were more likely to report usually visiting a dentist for a check-up than those living in the rest of the state (65.0% versus 44.4%). This difference was mainly attributable to those aged 35–54 years (60.9% versus 38.8%).
•	The percentage of adults reporting usually visiting for a check-up was significantly lower for adults living in low socioeconomic postcodes (49.7%) than high socioeconomic postcodes (73.4%). Statistically significant differences were observed in the 35–54 years (43.3% versus 69.0%) and 55 years or more (50.9% versus 71.6%) age groups. The percentage among those living in postcodes with middle socioeconomic status was also significantly lower compared with those living in postcodes with high socioeconomic status, both for all ages combined (54.5% versus 73.4%) and for people aged 35–54 years (49.3% versus 69.0%).
•	For all ages combined and across all age groups there was little variation among groups classified by government health card-holder status. Percentages were lower for card-holders compared with non–card-holders (55.7% versus 60.9%).
•	Within the population of government health card-holders, people whose last dental visit was to the public sector recorded a lower percentage than those who attended elsewhere. This pattern was consistent across all age groups although differences within age groups were not statistically significant due to large CIs. 
•	The percentage was significantly higher among adults with dental insurance than for the uninsured (68.0% versus 48.0%). Statistically significant differences were observed in the 15–34 years (77.3% versus 50.2%) and 35–54 years (62.2% versus 43.1%) age groups.
Discussion
In summary, just over half of the adult population usually visit the dentist for a check-up, with this percentage being slightly higher for adults aged 15–34 years. Usually visiting for a check-up was significantly associated with living in Perth, living in high socioeconomic postcodes and having dental insurance. The strongest association was with dental insurance status, with check-up visiting markedly more frequent among those with dental insurance.

Table 23: Percentage of people who usually visit a dentist for a check-up
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 59.8	 64.9	 55.1	 59.4	
	95% CI(a)	55.3–64.2	57.6–71.5	49.3–60.8	53.4–65.1	
Sex						
Males	% of people	 56.2	 63.7	 50.4	 53.3	
	95% CI	51.1–61.2	53.4–72.8	42.8–58.0	45.8–60.7	
Females	% of people	 63.4	 66.1	 59.7	 65.1	
	95% CI	57.5–69.0	57.1–74.1	51.2–67.7	57.9–71.7	
Residential location						
Capital city	% of people	 65.0	 70.7	 60.9	 62.4	
	95% CI	59.5–70.2	63.0–77.4	54.3–67.1	54.8–69.5	
Other places	% of people	 44.4	 46.6	 38.8	 50.5	
	95% CI	36.8–52.4	30.2–63.7	29.2–49.3	44.8–56.1	
Postcode socioeconomic status						
Lowest	% of people	 49.7	 54.8	 43.3	 50.9	
	95% CI	44.0–55.4	41.6–67.4	33.7–53.3	44.0–57.8	
Middle	% of people	 54.5	 59.7	 49.3	 53.9	
	95% CI	47.8–61.0	48.7–69.8	40.1–58.6	45.0–62.6	
Highest	% of people	 73.4	 80.0	 69.0	 71.6	
	95% CI	65.1–80.4	67.3–88.6	59.2–77.4	61.3–80.0	
Government health card						
Health care card or pensioner concession card	% of people	 55.7	 61.5	 48.6	 55.4	
	95% CI	49.3–61.9	42.9–77.2	36.3–61.1	47.8–62.8	
Neither card	% of people	 60.9	 65.4	 55.9	 63.1	
	95% CI	56.1–65.5	58.3–71.8	49.8–61.9	54.6–71.0	
Place of last dental visit						
Card-holder/Public	% of people	 46.1	 49.8	 19.9	 53.4	
	95% CI	32.7–60.2	24.9–74.9	6.9–45.5	37.2–69.0	
Card-holder/Non-public	% of people	 60.0	 70.0	 59.4	 56.1	
	95% CI	52.4–67.1	45.2–86.9	44.0–73.1	45.3–66.3	
Non-card-holder/Non-public	% of people	 60.9	 65.4	 55.9	 63.1	
	95% CI	56.1–65.5	58.3–71.8	49.8–61.9	54.6–71.0	
Dental insurance						
Insured	% of people	 68.0	 77.3	 62.2	 65.4	
	95% CI	62.4–73.1	68.0–84.5	55.0–68.9	57.6–72.4	
Uninsured	% of people	 48.0	 50.2	 43.1	 51.2	
	95% CI	44.1–52.0	41.8–58.6	35.3–51.4	41.9–60.5	
(a) 95% CI = 95% confidence interval for estimated percentage

Dental care avoided or delayed due to cost
In NSAOH, cost as a barrier to receipt of dental care was assessed with the question ‘During the last 12 months, have you avoided or delayed visiting a dental professional because of the cost?’ People who answered ‘yes’ were classified as having delayed or avoided dental care due to cost. In WA, they represented 30.9% of the population aged 15 years or more (Table 24), which was only slightly higher than the national estimate of 30.0% (Slade et al. 2007).
Key findings
•	There was some age variation in the percentage reporting cost as a barrier to receipt of dental care (33.7% of adults aged 15–34 years and 36.5% of those aged 35–54 years compared with 20.1% in the 55 years or more age group). 
•	The percentage was higher among females than males (35.5% versus 26.3%) but this difference and differences within age groups were not statistically significant.
•	For all ages combined and across all age groups, there was little variation in the percentages among groups classified by residential location or postcode socioeconomic status. 
•	For all ages combined and across all age groups, there was little variation in the percentage of people reporting that they had avoided or delayed care due to cost among groups classified by government health card-holder status. The percentage was only slightly lower for card-holders than non–card-holders (31.0% versus 30.7%).
•	Within the population of government health card-holders, the percentage reporting that they had avoided or delayed care due to cost was greater for people whose last dental visit was to the public sector compared with those who attended elsewhere. However, 95% CIs were large in these groups, with the consequence that differences were not statistically significant. 
•	For all ages combined, the percentage was significantly higher among uninsured than insured adults (42.2% versus 23.5%). Statistically significant differences were observed in the 15–34 years (51.1% versus 21.7%) and 35–54 years (47.2% versus 30.0%) age groups.
Discussion
Adults aged 55 years or more were less likely to report that they had avoided or delayed dental care due to cost compared with their younger counterparts. Dental insurance showed a strong association with having avoided or delayed receipt of dental care due to cost.

Table 24: Percentage of people who avoided or delayed dental care
		Population: all people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 30.9	 33.7	 36.5	 20.1	
	95% CI(a)	27.2–34.8	28.1–39.7	31.2–42.1	16.5–24.1	
Sex						
Males	% of people	 26.3	 27.2	 33.1	 15.8	
	95% CI	21.7–31.4	20.3–35.5	26.3–40.6	11.2–21.7	
Females	% of people	 35.5	 40.4	 39.9	 24.0	
	95% CI	30.8–40.4	32.7–48.6	32.6–47.7	19.5–29.3	
Residential location						
Capital city	% of people	 31.3	 33.0	 37.0	 21.9	
	95% CI	26.9–36.1	27.3–39.2	30.6–43.8	17.6–26.8	
Other places	% of people	 29.6	 35.8	 35.2	 15.0	
	95% CI	23.7–36.3	22.5–51.7	26.5–45.0	9.7–22.6	
Postcode socioeconomic status						
Lowest	% of people	 33.8	 38.0	 43.6	 19.6	
	95% CI	27.5–40.7	27.2–50.1	36.5–51.0	13.1–28.3	
Middle	% of people	 28.6	 30.4	 33.3	 18.6	
	95% CI	23.7–34.2	23.3–38.6	26.0–41.5	13.4–25.2	
Highest	% of people	 30.4	 33.2	 34.2	 21.8	
	95% CI	23.9–37.9	24.1–43.7	24.7–45.3	16.6–28.2	
Government health card						
Health care card or pensioner concession card	% of people	 30.7	 40.7	 55.5	 19.7	
	95% CI	24.7–37.4	26.3–56.9	39.8–70.1	14.3–26.6	
Neither card	% of people	 31.0	 32.4	 33.9	 20.2	
	95% CI	27.0–35.2	26.9–38.6	28.6–39.8	15.2–26.4	
Place of last dental visit						
Card-holder/Public	% of people	 27.2	 38.6	 44.0	 15.0	
	95% CI	17.7–39.3	16.5–66.7	19.2–72.1	7.2–28.8	
Card-holder/Non-public	% of people	 32.2	 42.3	 60.0	 21.4	
	95% CI	25.2–40.0	25.8–60.7	42.9–75.0	15.1–29.5	
Non-card-holder/Non-public	% of people	 31.0	 32.4	 33.9	 20.2	
	95% CI	27.0–35.2	26.9–38.6	28.6–39.8	15.2–26.4	
Dental insurance						
Insured	% of people	 23.5	 21.7	 30.0	 15.9	
	95% CI	19.9–27.5	15.8–29.0	23.5–37.4	11.6–21.5	
Uninsured	% of people	 42.2	 51.1	 47.2	 25.4	
	95% CI	36.3–48.2	40.4–61.8	38.8–55.7	19.4–32.5	
(a) 95% CI = 95% confidence interval for estimated percentage
Recommended dental treatment foregone due to cost
In NSAOH, treatment foregone due to cost was assessed with the question ‘Has the cost prevented you from having any dental treatment that was recommended during the last 2 years?’ People who answered ‘yes’ were classified as having foregone dental treatment due to cost. In WA, they represented 22.4% of the population aged 15 years or more (Table 25), which was higher than the national estimate of 20.6% (Slade et al. 2007).
Key findings
•	There was some age variation in the percentage of people reporting that they had forgone recommended treatment due to cost (29.7% of adults aged 35–54 years compared with 16.5% of those aged 55 years or more). 
•	For all ages combined and across age groups, there were no significant differences by sex or among groups classified by residential location.
•	Among adults aged 15–34 years, those living in postcodes with low socioeconomic status were significantly more likely to report forgoing recommended dental treatment due to cost than those in postcodes with middle socioeconomic status (31.3% versus 12.7%).
•	For all ages combined and across all age groups, there were no significant differences by government health card-holder status. Note that because 95% CIs were large in some groups, the differences observed were not statistically significant.
•	Within the population of government health card-holders, no statistically significant differences were observed among groups classified by place of last dental visit, both for all ages combined and across all age groups. Lack of statistically significant differences was a consequence of large 95% CIs in these groups. Among those aged 15–34 years, the percentage was higher for people whose last dental visit was to the public sector than for those who attended elsewhere (37.7% versus 19.9%). However, among the two older age groups, the percentage was lower for people whose last dental visit was to the public sector than for those who attended elsewhere (25.8% versus 39.4% among those aged 35–54‑year‑olds; 12.4% versus 13.8% among those aged 55 years or more). 
•	For all ages combined, the percentage of adults reporting that they had forgone recommended dental care due to cost was significantly higher among people with no dental insurance than for the insured (29.3% versus 18.6%). This difference was mainly attributable to those aged 15–34 years (32.4% versus 10.8%).
Discussion
In summary, having foregone recommended dental treatment due to cost was moderately associated with age and dental insurance status.

Table 25: Percentage of people who reported that cost had prevented recommended dental treatment
		Population: people who visited dentist within last 2 years
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 22.4	 19.1	 29.7	 16.5	
	95% CI(a)	19.6–25.5	14.3–25.0	24.6–35.4	12.5–21.4	
Sex						
Males	% of people	 21.0	 16.8	 30.3	 13.7	
	95% CI	17.5–25.1	10.2–26.4	23.3–38.2	8.6–21.1	
Females	% of people	 23.7	 21.6	 29.2	 18.8	
	95% CI	20.1–27.8	15.6–29.2	22.8–36.6	13.4–25.6	
Residential location						
Capital city	% of people	 21.2	 16.9	 29.1	 15.9	
	95% CI	17.8–25.1	11.9–23.3	22.9–36.2	11.3–21.9	
Other places	% of people	 26.3	 26.5	 31.6	 18.3	
	95% CI	22.6–30.3	16.6–39.5	23.5–41.0	11.9–27.1	
Postcode socioeconomic status						
Lowest	% of people	 29.1	 31.3	 36.1	 18.8	
	95% CI	23.0–36.0	22.5–41.6	25.9–47.8	12.7–26.9	
Middle	% of people	 19.5	 12.7	 27.6	 16.4	
	95% CI	16.3–23.1	7.6–20.3	22.1–34.0	10.5–24.7	
Highest	% of people	 19.7	 15.1	 27.1	 14.3	
	95% CI	16.0–23.9	9.5–23.3	18.4–38.1	8.1–24.2	
Government health card						
Health care card or pensioner concession card	% of people	 21.0	 28.0	 34.9	 13.3	
	95% CI	16.2–26.7	13.8–48.5	22.3–49.9	9.1–19.1	
Neither card	% of people	 22.9	 17.5	 29.0	 19.5	
	95% CI	19.3–27.0	12.4–24.2	23.8–34.9	13.2–28.0	
Place of last dental visit						
Card-holder/Public	% of people	 22.9	 37.7	 25.8	 12.4	
	95% CI	12.3–38.6	13.7–69.9	6.8–62.5	5.4–25.7	
Card-holder/Non-public	% of people	 20.0	 19.9	 39.4	 13.8	
	95% CI	15.0–26.1	6.8–45.9	25.4–55.3	8.6–21.4	
Non-card-holder/Non-public	% of people	 22.9	 17.5	 29.0	 19.5	
	95% CI	19.3–27.0	12.4–24.2	23.8–34.9	13.2–28.0	
Dental insurance						
Insured	% of people	 18.6	 10.8	 25.8	 16.9	
	95% CI	15.1–22.8	7.2–16.0	19.4–33.4	10.9–25.4	
Uninsured	% of people	 29.3	 32.4	 37.7	 15.9	
	95% CI	24.0–35.2	23.1–43.3	29.1–47.1	10.1–24.1	
(a) 95% CI = 95% confidence interval for estimated percentage
Difficulty paying a $100 dental bill
In NSAOH, difficulty paying for dental care was assessed with the question ‘At most times of the year, how much difficulty would you have paying a $100 dental bill? Would you say none, hardly any, a little, a lot of difficulty, don’t know?’ People who answered ‘a lot’ were classified as having difficulty paying a $100 dental bill. They represented 15.4% of the WA population aged 15 years or more (Table 26), which was lower than the national estimate of 18.2% (Slade et al. 2007).
Key findings
•	Across age groups, there was little variation in the percentage of adults who reported difficulty paying a $100 dental bill. There was a higher percentage in the youngest 15–34 years) age group (18.0%) compared with those aged 35–54 years (14.6%) and 55 years or more (13.2%). However, differences between age groups were not statistically significant.
•	For all ages combined, a significantly greater percentage of females reported that they would have difficulty paying a $100 dental bill compared with males (19.5% versus 11.3%). This difference was mainly attributable to those aged 55 years or more (18.6% versus 7.4%).
•	For people of all ages and across age groups, there was little variation among groups classified by residential location or postcode socioeconomic status.
•	Government health card-holder status was associated with some of the largest differences observed between population groups in the percentage of adults reporting that they would have difficulty paying a $100 dental bill. For those aged 15–34 years and 35–54 years, the percentage was almost four-fold greater among people who had a government health card compared with people who did not. For those aged 55 years or more, the percentage was almost five-fold greater among card-holders compared with non–card-holders.
•	Within the population of government health card-holders, there was a tendency for the percentage to be greater among people whose last dental visit was to the public sector than those who attended elsewhere. However, among card-holders aged 15–34 years, percentages were lower among people who last visited publicly compared with those who attended elsewhere (40.5% versus 50.6%). Note that because 95% CIs were large in these groups, the differences were not statistically significant. 
•	The percentage of adults reporting that they had would have difficulty paying a $100 dental bill was significantly higher among people with no dental insurance than for the insured (23.4% versus 9.3%). This pattern was consistent across all age groups.
Discussion
In summary, government health card-holder status and dental insurance status were strongly associated with having a lot of difficulty paying a $100 dental bill. 

Table 26: Percentage of people who would have a lot of difficulty paying a $100 dental bill
		Population: all people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 15.4	 18.0	 14.6	 13.2	
	95% CI(a)	13.3–17.8	14.0–22.8	11.3–18.8	10.4–16.7	
Sex						
Males	% of people	 11.3	 14.2	 11.5	 7.4	
	95% CI	8.7–14.7	9.8–20.1	7.1–18.2	4.7–11.6	
Females	% of people	 19.5	 22.1	 17.7	 18.6	
	95% CI	16.7–22.6	15.9–29.8	13.4–23.0	14.7–23.3	
Residential location						
Capital city	% of people	 15.3	 16.4	 14.5	 14.7	
	95% CI	12.7–18.2	12.0–22.1	10.5–19.7	11.3–19.0	
Other places	% of people	 15.9	 23.1	 15.0	 9.0	
	95% CI	12.2–20.4	15.6–32.9	9.8–22.3	5.2–15.1	
Postcode socioeconomic status						
Lowest	% of people	 15.9	 16.2	 18.6	 13.0	
	95% CI	13.3–19.0	9.3–26.6	14.4–23.6	8.4–19.5	
Middle	% of people	 17.9	 22.1	 15.0	 16.2	
	95% CI	14.0–22.7	16.8–28.4	8.4–25.3	10.9–23.3	
Highest	% of people	 12.5	 15.2	 11.3	 11.0	
	95% CI	9.3–16.5	8.5–25.5	7.7–16.5	7.3–16.1	
Government health card						
Health care card or pensioner concession card	% of people	 30.1	 46.3	 42.4	 20.6	
	95% CI	25.1–35.7	33.8–59.1	29.7–56.3	15.8–26.4	
Neither card	% of people	 10.4	 12.6	 10.9	 4.5	
	95% CI	8.2–13.2	8.8–17.7	7.6–15.5	2.4–8.4	
Place of last dental visit						
Card-holder/Public	% of people	 39.1	 40.5	 58.4	 32.2	
	95% CI	28.2–51.1	20.1–64.9	28.0–83.5	21.4–45.4	
Card-holder/Non-public	% of people	 26.3	 50.6	 36.2	 16.5	
	95% CI	20.4–33.1	32.4–68.7	24.5–49.9	12.0–22.1	
Non-card-holder/Non-public	% of people	 10.4	 12.6	 10.9	 4.5	
	95% CI	8.2–13.2	8.8–17.7	7.6–15.5	2.4–8.4	
Dental insurance						
Insured	% of people	 9.3	 11.1	 9.4	 7.0	
	95% CI	7.2–11.9	6.8–17.8	6.5–13.5	4.4–10.9	
Uninsured	% of people	 23.4	 25.4	 23.4	 21.1	
	95% CI	20.4–26.8	19.2–32.7	17.2–31.0	15.9–27.3	
(a) 95% CI = 95% confidence interval for estimated percentage

Percentage of people avoiding foods due to dental problems
Avoiding food due to dental problems is a sign of poor oral health and may reflect an inability to eat properly. This reduces enjoyment of food and could affect the ability to maintain a healthy nutritional status.
In NSAOH, avoiding food was assessed in the interview by asking people ‘How often have you had to avoid eating some foods because of problems with your teeth, mouth or dentures during the last 12 months? Was it: very often, often, sometimes, hardly ever, never during the last 12 months, don't know?‘ People who answered ‘very often‘, ‘often‘ or ‘sometimes‘ were classified as having avoided certain foods. They represented 14.7% of the WA population aged 15 years or more (Table 27), which was lower than the national estimate of 17.4% (Slade et al. 2007). The difference was not statistically significant.
Key findings
•	The percentage who avoiding food was higher among people who had a government health card (20.8%) than non–card-holders (12.7%). The difference was greatest in the youngest age group, and attenuated with age.
•	Within the population of government health card-holders, there was no difference in avoiding foods between people who last visited a public dental clinic and those who visited a private dentist. However, those who last visited a public dentist (25.8%) were twice as likely as non–card-holders (12.7%) to avoid food.
•	People with no dental insurance were more likely (19.7%) than those with insurance (11.4%) to avoid foods.
Discussion
Residents of Western Australia were equally as likely as the rest of the Australian population to avoid some foods because of problems with their teeth, mouth or gums. Avoiding some foods because of dental problems was associated with having a government health card, having last visited a public clinic and not having dental insurance.

Table 27: Percentage of people avoiding foods due to dental problems
		Population: all people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 14.7	 13.4	 14.7	 16.2	
	95% CI(a)	12.7–16.9	9.8–18.1	11.9–18.1	13.0–20.1	
Sex						
Males	% of people	 11.9	 9.7	 10.7	 16.4	
	95% CI	8.8–16.0	5.4–16.9	7.0–16.0	11.2–23.4	
Females	% of people	 17.5	 17.3	 18.7	 16.1	
	95% CI	14.8–20.5	11.9–24.6	14.2–24.2	12.3–20.8	
Residential location						
Capital city	% of people	 14.0	 11.8	 13.5	 17.4	
	95% CI	11.9–16.3	8.3–16.6	10.2–17.7	13.2–22.6	
Other places	% of people	 16.8	 18.6	 18.0	 13.1	
	95% CI	12.4–22.4	10.2–31.5	13.0–24.4	10.5–16.2	
Postcode socioeconomic status						
Lowest	% of people	 18.8	 18.1	 20.0	 18.3	
	95% CI	15.2–23.0	11.0–28.4	15.9–24.9	13.3–24.7	
Middle	% of people	 12.4	 10.7	 13.4	 13.5	
	95% CI	9.1–16.7	5.9–18.5	9.1–19.4	8.8–20.2	
Highest	% of people	 13.3	 12.2	 12.0	 16.4	
	95% CI	11.3–15.5	7.3–19.6	7.4–18.7	11.1–23.6	
Government health card						
Health care card or pensioner concession card	% of people	 20.8	 26.2	 23.6	 18.0	
	95% CI	16.7–25.7	14.8–42.2	14.2–36.4	13.8–23.1	
Neither card	% of people	 12.7	 11.0	 13.5	 14.3	
	95% CI	10.2–15.6	7.4–16.2	10.5–17.3	9.8–20.4	
Place of last dental visit						
Card-holder/Public	% of people	 25.8	 29.2	 41.9	 18.9	
	95% CI	17.0–37.2	11.4–57.0	19.3–68.4	11.3–29.8	
Card-holder/Non-public	% of people	 18.7	 24.0	 16.4	 17.7	
	95% CI	14.8–23.2	11.5–43.6	7.6–32.0	12.8–23.9	
Non-card-holder/Non-public	% of people	 12.7	 11.0	 13.5	 14.3	
	95% CI	10.2–15.6	7.4–16.2	10.5–17.3	9.8–20.4	
Dental insurance						
Insured	% of people	 11.4	 9.6	 10.7	 14.6	
	95% CI	9.5–13.8	6.0–15.0	7.4–15.4	10.6–19.7	
Uninsured	% of people	 19.7	 19.3	 21.4	 18.5	
	95% CI	16.3–23.7	12.8–28.1	16.2–27.8	13.6–24.6	
(a) 95% CI = 95% confidence interval for estimated percentage

5	Oral health perceptions
Percentage of people rating their oral health fair or poor
Self-reported global measures of oral health reflect an individual's own experience of their oral health. Single-item, self-rated oral health measures are associated with functional impairment and discomfort as well as clinical measures of dental health. They are used widely in research and provide a summary measure of oral symptoms and functioning (Benyamini et al. 2004).
In NSAOH, self-rated oral health was assessed in the interview by asking people, ‘And how would you rate your own DENTAL health. Would you say that it is: excellent, very good, good, fair, poor, don't know?‘ People who answered ‘fair‘ or ‘poor‘ were classified as having fair or poor self-rated oral health. They represented 16.0% of the WA population aged 15 years or more (Table 28), which is very close to the national estimate of 16.4% (Slade et al. 2007). The difference was not statistically significant.
Key findings
•	People with no dental insurance were more than twice as likely (24.8%) as those with insurance (10.2%) to report fair or poor oral health.
Discussion
Dentate residents of Western Australia were equally as likely as other Australians to report that their oral health was ‘fair‘ or ‘poor‘. Reporting fair or poor oral health was associated with not having dental insurance. While there were large differences in the point estimates for some other comparisons, small numbers in the sample resulted in wide confidence intervals, and no conclusions about differences can be drawn.

Table 28: Percentage of people rating their oral health fair or poor
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 16.0	 12.5	 18.6	 17.1	
	95% CI(a)	13.7–18.5	9.0–17.3	15.7–21.9	12.9–22.4	
Sex						
Males	% of people	 16.5	 15.8	 18.2	 14.9	
	95% CI	13.4–20.1	10.6–22.9	14.2–22.9	10.0–21.8	
Females	% of people	 15.5	 9.1	 19.1	 19.2	
	95% CI	12.6–18.9	5.4–15.1	14.9–24.1	13.8–26.1	
Residential location						
Capital city	% of people	 15.1	 11.0	 17.1	 18.6	
	95% CI	12.6–18.0	7.2–16.4	13.6–21.3	13.9–24.4	
Other places	% of people	 18.4	 17.3	 22.9	 12.9	
	95% CI	14.0–24.0	9.9–28.6	18.5–28.0	5.4–27.8	
Postcode socioeconomic status						
Lowest	% of people	 19.7	 19.6	 19.2	 20.7	
	95% CI 	15.7–24.5	13.1–28.2	14.2–25.4	13.0–31.3	
Middle	% of people	 15.4	 11.2	 20.1	 14.7	
	95% CI	12.8–18.3	6.9–17.6	15.7–25.3	8.4–24.4	
Highest	% of people	 13.4	 7.5	 16.9	 15.9	
	95% CI	9.5–18.4	2.9–18.0	12.0–23.2	10.1–24.0	
Government health card						
Health care card or pensioner concession card	% of people	 19.6	 15.2	 29.2	 18.2	
	95% CI	14.0–26.7	6.3–32.7	18.9–42.1	12.2–26.2	
Neither card	% of people	 15.0	 12.1	 17.2	 16.0	
	95% CI	13.1–17.0	8.7–16.5	14.3–20.7	10.6–23.2	
Place of last dental visit						
Card-holder/Public	% of people	 27.2	 22.9	 50.2	 21.7	
	95% CI	15.9–42.6	6.6–55.7	24.5–75.8	11.7–36.8	
Card-holder/Non-public	% of people	 16.2	 9.6	 21.3	 16.9	
	95% CI	11.6–22.1	2.7–28.8	11.7–35.7	10.7–25.7	
Non-card-holder/Non-public	% of people	 15.0	 12.1	 17.2	 16.0	
	95% CI	13.1–17.0	8.7–16.5	14.3–20.7	10.6–23.2	
Dental insurance						
Insured	% of people	 10.2	 3.8	 13.5	 13.0	
	95% CI	8.0–12.9	1.8–7.8	9.8–18.4	8.9–18.5	
Uninsured	% of people	 24.8	 23.8	 27.4	 22.8	
	95% CI	20.4–29.8	16.3–33.3	20.9–35.0	16.8–30.3	
(a) 95% CI = 95% confidence interval for estimated percentage

Percentage of people experiencing toothache
Toothache is caused when the nerve root of a tooth is irritated. It is most commonly caused by infection, decay, injury or loss of a tooth. However, pain sometimes originates from other areas, most commonly the jaw joint and the ear, and radiates to the jaw, thus appearing to be tooth pain. 
In NSAOH, experience of toothache was assessed in the interview by asking dentate people, ‘During the last 12 months how often have you had toothache? Was it: very often, often, sometimes, hardly ever, never during the last 12 months, don't know?‘ People who answered ‘very often‘, ‘often‘ or ‘sometimes‘ were classified as having experienced toothache. They represented 12.9% of the dentate WA population aged 15 years or more (Table 29), which was lower than the national estimate of 15.1% (Slade et al. 2007). The difference was not statistically significant.
Discussion
Residents of Western Australia were equally as likely as the rest of the Australian population to experience toothache. There were no statistically significant differences between the groups presented in Table 28. In some cases this reflects wide confidence intervals around the estimates, which are due to the small size of the sample in Western Australia. 

Table 29: Percentage of people experiencing toothache
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 12.9	 13.8	 13.7	 10.1	
	95% CI(a)	10.7–15.4	10.0–18.8	11.0–16.9	7.5–13.5	
Sex						
Males	% of people	 13.9	 16.2	 14.9	 8.5	
	95% CI	10.9–17.5	10.2–24.9	11.2–19.7	4.8–14.4	
Females	% of people	 11.8	 11.3	 12.4	 11.7	
	95% CI	9.3–15.0	7.3–17.0	8.7–17.4	8.1–16.6	
Residential location						
Capital city	% of people	 12.7	 13.6	 13.2	 10.4	
	95% CI	10.0–16.0	9.2–19.7	9.9–17.5	7.1–15.1	
Other places	% of people	 13.3	 14.2	 14.9	 9.4	
	95% CI	10.9–16.1	8.1–23.9	12.1–18.3	7.4–11.7	
Postcode socioeconomic status						
Lowest	% of people	 14.2	 14.0	 16.9	 11.0	
	95% CI	10.0–19.7	7.8–23.7	11.1–24.8	7.8–15.2	
Middle	% of people	 12.7	 14.2	 13.3	 8.8	
	95% CI	9.0–17.6	8.0–23.7	9.5–18.4	4.9–15.3	
Highest	% of people	 11.9	 13.2	 11.7	 10.5	
	95% CI	9.2–15.3	7.6–22.0	8.1–16.6	5.7–18.4	
Government health card						
Health care card or pensioner concession card	% of people	 15.0	 20.9	 19.2	 10.4	
	95% CI	10.2–21.6	9.8–39.1	10.4–32.7	6.6–16.0	
Neither card	% of people	 12.2	 12.5	 13.0	 9.7	
	95% CI	9.9–15.1	8.7–17.6	10.1–16.5	6.1–15.1	
Place of last dental visit						
Card-holder/Public	% of people	 19.5	 23.3	 20.7	 15.9	
	95% CI	10.3–34.0	6.6–56.4	6.4–50.2	7.6–30.1	
Card-holder/Non-public	% of people	 13.0	 19.1	 18.6	 8.5	
	95% CI	8.2–20.0	7.5–40.9	9.2–33.9	5.1–13.6	
Non-card-holder/Non-public	% of people	 12.2	 12.5	 13.0	 9.7	
	95% CI	9.9–15.1	8.7–17.6	10.1–16.5	6.1–15.1	
Dental insurance						
Insured	% of people	 10.7	 10.8	 10.5	 10.9	
	95% CI	8.0–14.2	5.6–20.0	7.0–15.3	7.7–15.1	
Uninsured	% of people	 15.9	 17.3	 18.9	 9.2	
	95% CI	12.5–20.0	11.7–24.8	14.2–24.6	5.7–14.4	
(a) 95% CI = 95% confidence interval for estimated percentage

 Percentage of people experiencing orofacial pain
Orofacial pain can be debilitating and indicates temporomandibular joint dysfunction.
In NSAOH, orofacial pain was assessed in the interview by asking people, ‘During the last month, have you had pain in the face, jaw, temple, in front of the ear, or in the ear?’ People who answered ‘yes‘ were classified as having orofacial pain. They represented 21.4% of the WA population aged 15 years or more (Table 30), which was slightly lower than the national estimate of 22.6% (Slade et al. 2007). The difference was not statistically significant.
Discussion
Residents of Western Australia were equally as likely as the rest of the Australian population to experience orofacial pain. There were no statistically significant differences between the groups presented in Table 29. In some cases this reflects wide confidence intervals around the estimates, which are due to the small size of the sample in Western Australia.

Table 30: Percentage of people experiencing orofacial pain 
		Population: all people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 21.4	 22.8	 22.7	 17.9	
	95% CI(a)	18.8–24.3	17.9–28.7	18.5–27.4	14.4–22.1	
Sex						
Males	% of people	 17.6	 19.5	 18.9	 13.4	
	95% CI	13.8–22.2	13.8–26.8	14.0–25.2	8.8–20.0	
Females	% of people	 25.1	 26.3	 26.4	 22.1	
	95% CI 	21.7–29.0	19.7–34.3	20.4–33.4	17.5–27.6	
Residential location						
Capital city	% of people	 20.3	 22.0	 20.8	 17.5	
	95% CI	17.3–23.7	16.4–29.0	15.7–27.1	13.7–22.1	
Other places	% of people	 24.5	 25.4	 27.8	 19.2	
	95% CI	19.2–30.7	16.6–36.8	22.0–34.3	11.9–29.3	
Postcode socioeconomic status						
Lowest	% of people	 23.4	 17.5	 30.2	 22.9	
	95% CI	18.7–29.0	10.7–27.4	25.3–35.7	16.6–30.7	
Middle	% of people	 19.6	 25.8	 17.5	 13.1	
	95% CI	15.5–24.5	18.5–34.8	10.6–27.5	8.3–20.2	
Highest	% of people	 21.3	 24.4	 21.9	 16.8	
	95% CI	16.9–26.6	15.6–35.9	15.8–29.6	12.4–22.4	
Government health card						
Health care card or pensioner concession card	% of people	 23.8	 27.0	 29.6	 20.9	
	95% CI	18.1–30.6	14.0–45.5	19.6–42.1	15.6–27.4	
Neither card	% of people	 20.7	 22.1	 21.7	 14.6	
	95% CI	17.7–23.9	17.1–28.2	17.6–26.5	11.2–18.7	
Place of last dental visit						
Card-holder/Public	% of people 	 27.2	 24.5	 43.8	 23.7	
	95% CI	16.9–40.6	8.6–52.8	20.3–70.5	13.6–38.0	
Card-holder/Non-public	% of people	 22.3	 28.8	 24.1	 19.9	
	95% CI	16.7–29.2	13.1–52.1	14.1–38.2	14.1–27.4	
Non-card-holder/Non-public	% of people	 20.7	 22.1	 21.7	 14.6	
	95% CI	17.7–23.9	17.1–28.2	17.6–26.5	11.2–18.7	
Dental insurance						
Insured	% of people	 21.5	 25.6	 20.9	 17.9	
	95% CI	18.5–24.9	18.6–34.0	15.8–27.0	14.0–22.6	
Uninsured	% of people	 21.7	 20.8	 25.9	 18.2	
	95% CI	17.3–26.9	14.3–29.3	19.1–34.0	12.7–25.5	
(a) 95% CI = 95% confidence interval for estimated percentage

Perceived need for dentures
In NSAOH, people were asked at the time of the interview, ‘Currently, which of the following dental treatments do you think you need to have?‘ The possible responses varied for dentate and edentulous people. All people were asked if they felt they needed dentures. In WA, 5.1% of people thought they needed dentures (Table 31), which was very similar to the national estimate of 7.2% (Slade et al. 2007).
Key findings
•	The percentage of adults who thought they needed dentures was strongly age-related, increasing from 0.6% among 15–34‑year‑olds to 3.7% among adults aged 35–54 years and 12.8% among those aged 55 years or more.
•	There were no significant differences in the perceived need for dentures by sex, residential location in the capital city or other places, or socioeconomic status of postcodes.
•	The need for a denture was more than three times higher among people who had a government health card (11.3%) compared with those who did not (3.0%).
•	Those adults who had a government health card and last visited a public clinic were most likely to report needing a denture (13.9%). The percentage was similar among card-holders who last visited a private dentist (10.2%) and lowest among non–card-holders who last visited a private dentist (3.0%).
•	Uninsured people were more likely to need dentures (8.1%), but among those with dental insurance the figure was lower (3.1%).
•	The age-relatedness of the need for dentures was evident within subgroups of adults formed by socioeconomic characteristics. For instance, among adults without dental insurance, the percentage rose from 0.7% in the 15–43 years age group to 5.5% in 35–54‑year‑olds and 20.6% in those aged 55 years or more.
Discussion
The percentage of people who said they needed dentures was low. It is related to the observed pattern for complete tooth loss and numbers of missing teeth. However, the level of need for dentures was considerably lower than the percentage of people with either complete tooth loss or reasonable numbers of missing teeth. The relationship between perceived need and professional judgement of the need for dentures is complex, but people generally express a lower need than is assessed by dentists.

Table 31: Percentage of people who need dentures
		Population: all people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 5.1	 0.6	 3.7	 12.8	
	95% CI(a)	3.9–6.7	0.2–1.7	2.1–6.3	9.8–16.6	
Sex						
Males	% of people	 5.2	 0.3	 4.5	 12.9	
	95% CI	3.5–7.8	0.0–2.3	1.9–10.3	8.2–19.6	
Females	% of people	 5.0	 0.8	 2.9	 12.8	
	95% CI	3.8–6.7	0.2–3.0	1.8–4.7	9.3–17.4	
Residential location						
Capital city	% of people	 4.6	 0.2	 2.7	 12.7	
	95% CI	3.1–6.6	0.0–1.5	1.1–6.8	9.1–17.5	
Other places	% of people	 6.7	 1.6	 6.4	 13.2	
	95% CI	4.8–9.3	0.4–6.0	3.8–10.4	8.7–19.4	
Postcode socioeconomic status						
Lowest	% of people	 6.6	 0.5	 5.8	 14.2	
	95% CI	4.5–9.6	0.1–3.2	3.6–9.1	8.9–21.7	
Middle	% of people	 5.8	 1.1	 5.3	 13.9	
	95% CI	3.5–9.3	0.3–4.1	2.2–12.4	9.5–20.0	
Highest	% of people	 3.1	 0.0	 0.7	 10.5	
	95% CI	2.0–4.9	–	0.1–4.4	6.2–17.1	
Government health card						
Health care card or pensioner concession card	% of people	 11.3	 0.0	 2.3	 18.2	
	95% CI	8.5–14.9	–	0.8–6.7	13.7–23.9	
Neither card	% of people	 3.0	 0.7	 3.9	 6.4	
	95% CI	2.0–4.5	0.2–2.0	2.2–6.9	3.8–10.4	
Place of last dental visit						
Card-holder/Public	% of people	 13.9	 0.0	 0.0	 27.0	
	95% CI	8.2–22.7	–	–	16.5–40.9	
Card-holder/Non-public	% of people	 10.2	 0.0	 3.2	 15.2	
	95% CI	7.1–14.4	–	1.1–9.1	10.5–21.5	
Non-card-holder/Non-public	% of people	 3.0	 0.7	 3.9	 6.4	
	95% CI	2.0–4.5	0.2–2.0	2.2–6.9	3.8–10.4	
Dental insurance						
Insured	% of people	 3.1	 0.5	 2.7	 6.7	
	95% CI	2.1–4.6	0.1–3.4	1.3–5.4	4.3–10.2	
Uninsured	% of people	 8.1	 0.7	 5.5	 20.6	
	95% CI	6.1–10.7	0.2–2.8	3.0–9.8	15.7–26.6	
(a) 95% CI = 95% confidence interval for estimated percentage
Perceived need for dental extraction or filling
Dentate adults were asked about other dental services, including extractions or fillings that they might need. The responses to the options ‘Any extractions‘ or ‘Any fillings‘ have been combined so that the response indicates a perceived dental problem for which one or other of these two aspects of routine dental care is thought to be required, most likely as a sequelae for dental caries. Which of these two dental services was provided would be determined by a process of negotiation between patient and provider, influenced by both provider and patient circumstances. In WA, 32.0% of dentate adults perceived a need for an extraction or filling (Table 32), which was similar to the national estimate of 32.9% (Slade et al. 2007).
Key findings
•	The percentage of dentate adults who thought they needed extractions or fillings was similar among the youngest and oldest age groups (29.3 and 27.8%) but higher among people aged 35–54 years (37.4%). However, these differences were not statistically significant.
•	There were no significant differences by sex, residential location in a capital city or other place, government health card-holder status or place of last dental visit.
•	The percentage of dentate adults who thought they needed an extraction or filling was significantly lower among those living in the highest socioeconomic status postcodes compared with the middle and lowest socioeconomic status postcodes (24.6% compared with 34.7% and 37.6% respectively).
•	Those adults who did not have dental insurance were more likely to report a need for extractions or fillings (39.9%) than those who were insured (27.2%).
•	The lack of an age-related pattern was repeated within nearly all subgroups of adults formed by socioeconomic characteristics. Two exceptions occurred where the oldest age group within a subgroup defined by a socioeconomic characteristic had a significantly lower percentage. 
Discussion
Just under one-third of dentate adults perceived a need for an extraction or filling. This percentage was similar among the three age groups, and showed few socioeconomic characteristic variations. Perceived need for an extraction or filling was lower among those dentate adults who lived in the highest socioeconomic status postcodes compared with the middle and lower socioeconomic status postcodes, and higher among those who were uninsured compared with the insured.

Table 32: Percentage of people who need an extraction or filling
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 32.0	 29.3	 37.4	 27.8	
	95% CI(a)	29.0–35.2	24.2–35.0	32.9–42.1	22.7–33.5	
Sex						
Males	% of people	 32.4	 26.7	 39.0	 30.9	
	95% CI	28.0–37.0	19.8–35.0	33.2–45.1	23.9–38.9	
Females	% of people	 31.6	 32.0	 35.7	 24.9	
	95% CI	27.1–36.5	24.3–40.8	28.7–43.5	19.1–31.8	
Residential location						
Capital city	% of people	 30.3	 27.2	 35.6	 26.8	
	95% CI	26.8–34.0	21.9–33.2	30.3–41.4	20.9–33.6	
Other places	% of people	 37.1	 35.7	 42.2	 30.8	
	95% CI	30.9–43.7	23.0–50.8	35.0–49.8	21.9–41.5	
Postcode socioeconomic status						
Lowest	% of people	 37.6	 37.0	 41.8	 33.1	
	95% CI	32.3–43.3	27.1–48.2	34.9–49.1	24.6–42.9	
Middle	% of people	 34.7	 32.3	 42.3	 25.4	
	95% CI	30.1–39.6	24.8–40.9	39.1–45.7	16.2–37.4	
Highest	% of people	 24.6	 18.5	 29.5	 24.9	
	95% CI	21.0–28.5	12.0–27.5	21.2–39.5	17.9–33.6	
Government health card						
Health care card or pensioner concession card	% of people	 29.1	 27.7	 42.6	 24.7	
	95% CI	23.0–36.0	15.6–44.2	30.4–55.8	17.9–33.1	
Neither card	% of people	 32.8	 29.7	 36.7	 30.4	
	95% CI	28.9–37.1	24.3–35.8	31.6–42.1	22.2–40.1	
Place of last dental visit						
Card-holder/Public	% of people	 35.5	 36.5	 57.0	 26.3	
	95% CI	24.5–48.3	16.2–63.0	31.6–79.2	15.6–40.7	
Card-holder/Non-public	% of people	 26.1	 21.2	 37.1	 24.1	
	95% CI	20.4–32.8	9.1–42.0	23.7–52.7	16.9–33.3	
Non-card-holder/Non-public	% of people	 32.8	 29.7	 36.7	 30.4	
	95% CI	28.9–37.1	24.3–35.8	31.6–42.1	22.2–40.1	
Dental insurance						
Insured	% of people	 27.2	 19.7	 33.4	 26.6	
	95% CI	23.7–31.0	14.6–26.0	26.8–40.7	20.4–33.9	
Uninsured	% of people	 39.9	 41.9	 44.4	 30.0	
	95% CI	35.4–44.7	33.6–50.7	37.8–51.2	23.0–38.1	
(a) 95% CI = 95% confidence interval for estimated percentage
Perceived need for a dental check-up
Dentate adults were asked about their perceived need for a check-up. This is regarded as an indicator of compliance with the recommendation of dentists to visit regularly when asymptomatic so as to detect disease earlier and receive prompt treatment for any dental problems. A check-up also provides an opportunity for preventive services to be received. 
In WA, 61.0% of adults perceived a need for a check-up (Table 33), which was very similar to the national estimate of 59.6% (Slade et al. 2007).
Key findings
•	The percentage of dentate adults who thought they needed a check-up was similar across the two younger age groups (65.8% and 64.1%) and lower among people 55 years old or more (48.9%).
•	There were no significant differences among dentate adults by sex, residential location, postcode socioeconomic status, government health card-holder status or place of last dental visit.
•	The percentage of dentate adults who thought they needed a check-up was significantly higher among those who were uninsured (66.1%) than the insured (56.5%).
•	The age-related pattern of perceived need for a check-up was repeated within subgroups of adults formed by most of the socioeconomic characteristics. The percentage was significantly lower among people aged 55 years or more. For instance, among dentate adults with dental insurance, percentages were lower in the 55 years or more age group (44.8%) compared with 35–54‑year‑olds (61.9%) and those aged 15–34 years (58.7%). 
Discussion
About 6 out of 10 dentate adults perceived a need for a check-up. The percentage was similar for the two younger age groups but significantly lower among those adults aged 55 years or more. There was little variation by socioeconomic characteristics, which might reflect a confounding of perceived need for a check-up by time since last dental visit. Those dentate adults with a higher likelihood of compliance with the recommendation for a regular check-up visit may have last visited more recently, and hence not perceive a need for a further check-up at the time of the interview. 

Table 33: Percentage of people perceiving a need for a check-up
		Population: dentate people
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 61.0	 65.8	 64.1	 48.9	
	95% CI(a)	57.6–64.4	60.2–71.0	58.3–69.5	42.8–55.1	
Sex						
Males	% of people	 63.5	 66.9	 67.9	 51.1	
	95% CI	58.6–68.2	57.7–75.1	59.8–75.0	43.0–59.0	
Females	% of people	 58.5	 64.7	 60.3	 46.9	
	95% CI 	53.9–63.0	57.7–71.1	53.0–67.1	39.7–54.2	
Residential location						
Capital city	% of people	 61.0	 68.2	 62.0	 48.2	
	95% CI	57.1–64.8	62.2–73.7	54.8–68.7	41.6–54.9	
Other places	% of people	 61.1	 58.3	 69.8	 51.1	
	95% CI	53.6–68.0	46.6–69.1	60.5–77.7	37.0–65.0	
Postcode socioeconomic status						
Lowest	% of people	 62.2	 61.9	 70.4	 52.3	
	95% CI	55.2–68.8	51.7–71.1	61.2–78.2	39.4–64.9	
Middle	% of people	 62.9	 71.6	 63.0	 46.6	
	95% CI	58.3–67.4	63.1–78.8	52.5–72.3	38.9–54.5	
Highest	% of people	 58.2	 63.1	 60.5	 47.7	
	95% CI	52.1–64.0	52.8–72.3	50.4–69.8	38.4–57.1	
Government health card						
Health care card or pensioner concession card	% of people	 54.3	 66.6	 67.4	 42.7	
	95% CI	45.7–62.6	49.2–80.4	51.7–80.1	33.9–52.0	
Neither card	% of people	 62.9	 65.5	 63.6	 54.3	
	95% CI	58.8–66.8	59.5–71.1	57.0–69.8	47.1–61.4	
Place of last dental visit						
Card-holder/Public	% of people	 53.0	 60.4	 56.4	 45.5	
	95% CI	38.1–67.4	31.9–83.3	30.7–79.1	27.3–65.0	
Card-holder/Non-public	% of people	 54.8	 71.2	 71.6	 41.7	
	95% CI	44.4–64.9	48.4–86.7	51.2–85.8	31.5–52.7	
Non-card-holder/Non-public	% of people	 62.9	 65.5	 63.6	 54.3	
	95% CI	58.8–66.8	59.5–71.1	57.0–69.8	47.1–61.4	
Dental insurance						
Insured	% of people	 56.5	 58.7	 61.9	 44.8	
	95% CI	51.9–61.0	50.8–66.2	54.2–69.1	36.7–53.2	
Uninsured	% of people	 66.1	 71.2	 68.1	 54.4	
	95% CI	61.3–70.6	61.5–79.3	60.7–74.7	45.5–63.0	
(a) 95% CI = 95% confidence interval for estimated percentage
Perceived urgency of dental treatment needs
Dentate adults who perceived a need for an extraction or filling were asked about their perceived urgency of needed dental treatment. Dental problems vary from truly urgent problems like dental trauma, swelling in or around the jaws, or bleeding (usually as a complication of dental treatment); through situations where treatment is highly desirable in a short period of time (usually associated with pain); to problems that can wait reasonable periods of time to be treated. In NSAOH, dentate adults who perceived a need for an extraction or filling were asked at the time of the interview, ‘How soon do you think you need this dental treatment?‘ The possible responses included a wide range of time periods. These have been collapsed to perceiving a need for treatment within 3 months or longer than 3 months. In WA, 73.4% of dentate adults needing an extraction or filling perceived a need for dental treatment within 3 months (Table 34), which was a little higher than, but not significantly different from, the national estimate of 69.3% (Slade et al. 2007).
Key findings
•	The percentage of dentate adults needing an extraction or filling who thought they needed treatment within 3 months showed no trend by age group. The percentage varied only from 69.8% to 78.1% across the three age groups.
•	There were no significant differences among subgroups formed by any social characteristic.
Discussion
Just over 7 out of 10 dentate adults who needed an extraction or filling perceived a need for dental treatment within 3 months. The percentage was not significantly different across the three age groups, and there was no significant variation by socioeconomic characteristics. This might reflect a confounding of perceived need for dental treatment within 3 months by time since last dental visit.

Table 34: Percentage of people perceiving a need for treatment within 3 months
		Population: dentate people who need an extraction or filling
Age (years)	
		All ages	15–34	35–54	≥55	
All people	% of people	 73.4	 78.1	 69.8	 73.4	
	95% CI(a)	68.5–77.8	66.8–86.3	60.8–77.5	64.2–81.0	
Sex						
Males	% of people	 70.7	 75.7	 66.6	 71.7	
	95% CI	63.3–77.1	56.0–88.4	55.0–76.4	53.9–84.6	
Females	% of people	 76.2	 80.2	 73.3	 75.4	
	95% CI	69.2–82.0	68.4–88.4	61.8–82.3	60.5–85.9	
Residential location						
Capital city	% of people	 74.4	 79.7	 69.9	 75.0	
	95% CI	68.0–79.9	65.2–89.1	58.3–79.4	63.5–83.8	
Other places	% of people	 70.9	 73.7	 69.6	 69.3	
	95% CI	63.7–77.2	53.9–87.0	56.1–80.4	52.2–82.3	
Postcode socioeconomic status						
Lowest	% of people	 75.5	 84.0	 72.2	 68.3	
	95% CI	66.9–82.5	67.3–93.0	54.5–84.9	53.0–80.4	
Middle	% of people	 70.3	 73.5	 66.4	 75.7	
	95% CI	62.2–77.3	52.7–87.4	51.6–78.6	57.4–87.8	
Highest	% of people	 74.8	 76.5	 72.2	 77.9	
	95% CI	65.6–82.3	59.5–87.8	56.0–84.1	60.6–89.0	
Government health card						
Health care card or pensioner concession card	% of people	 69.4	 74.7	 59.4	 72.9	
	95% CI	54.7–81.0	51.7–89.0	32.7–81.5	56.7–84.7	
Neither card	% of people	 74.4	 78.7	 71.4	 73.5	
	95% CI	69.3–78.9	67.1–87.0	62.9–78.7	60.4–83.5	
Place of last dental visit						
Card-holder/Public	% of people	 79.9	 88.8	 54.3	 94.4	
	95% CI	54.4–92.9	58.5–97.8	16.5–87.7	69.9–99.2	
Card-holder/Non-public	% of people	 63.3	 56.8	 62.5	 66.1	
	95% CI	47.6–76.7	23.3–85.1	33.3–84.8	46.9–81.2	
Non-card-holder/Non-public	% of people	 74.4	 78.7	 71.4	 73.5	
	95% CI	69.3–78.9	67.1–87.0	62.9–78.7	60.4–83.5	
Dental insurance						
Insured	% of people	 71.0	 77.6	 67.1	 72.5	
	95% CI	63.8–77.3	63.1–87.6	55.8–76.8	58.5–83.2	
Uninsured	% of people	 76.3	 79.7	 73.2	 74.6	
	95% CI	68.8–82.4	65.2–89.2	60.7–82.8	59.0–85.7	
(a) 95% CI = 95% confidence interval for estimated percentage
Age-standardised comparison between government health card-holders and non-card-holders.
Findings from the 29 of the preceding tables are summarised in Table 35 to compare oral health indicators between people with a government health card and non-card-holders.  Percentages and means for the two groups are age-standardised, a statistical procedure that aims to remove any effects of age that might account for differences in each oral health indicator between the two groups.  As noted in Table 4, much smaller percentages of people in the two younger age groups had a health care card or pensioner concession card than in the oldest age group.  Age-adjustment seeks to compensate for that difference in age distribution, so that differences in any single indicator between the two groups are not confounded by age. 
•	For 13 indicators reported in Table 35, health-card-holders had significantly poorer oral health status, oral health care or perceived oral health. 
•	For measures relating to tooth loss, the magnitude of difference in age-adjusted estimates between the two groups was noticeably smaller than the difference between the same two groups noted in preceding tables that had no adjustment for age.  For example, health-card-holders had 2.5-fold-greater prevalence of complete tooth loss when the comparison was age-adjusted (Table 35), whereas prevalence differed by a factor of 9.1 when all ages were contrasted in Table 5 (16.7% for health-card-holders compare with 1.8% for non-card-holders). This degree of attenuation indicates that age was an important confounder of the relationship between health card status and complete tooth loss.  
•	Marked attenuation of the difference between the two groups also occurred for average number of DMF teeth per person and for periodontal attachment loss.
•	In contrast, the relative difference between the two groups was amplified in the age-standardised result compared with the un-standardised results for the percentage who avoided dental care because of cost.
•	However, for most other indicators in , relative differences in age-standardised indicators the two groups were similar in magnitude to preceding tables.  This is because there was only a weak association between age and indicators such as dental attendance, with the consequence that there was little age-confounding of the difference between the two groups. 
In summary, the findings in Table 35 confirm that health card-holders are disadvantaged with respect to several indicators of oral health status, oral health care or perceived oral health, and that the disadvantage is not due to the older age profile of health card-holders compared to non-health-card-holders. Exceptions occurred for some indicators relating to tooth loss and periodontal disease, where age-adjustment produced attenuated differences between the two groups.

Table 35: age standardised comparison of health card-holders and non-health-card-holders
	Card-holders	Non-card-holders	
Variable	estimate (95%CI)	estimate (95%CI)	
% of people with complete tooth loss 	9.8 (7.6–12.0)	4.0 (2.0–6.0)	
% of people with fewer than 21 teeth 	15.1 (12.3–18.0)	9.2 (6.6–11.9)	
% of dentate people who wear denture(s) 	19.6 (15.5–23.7)	11.1 (8.9–13.4)	
Average number of missing teeth per person 	6.2 (5.5–6.8)	4.7 (4.1–5.2)	
% of people with untreated coronal decay 	20.6 (11.0–30.1)	20.9 (15.7–26.1)	
% of people with untreated root decay 	11.6 (6.0–17.2)	6.8 (3.2–10.5)	
% of people with one or more filled teeth 	83.4 (73.8–93.1)	84.8 (81.4–88.2)	
Average number of DMF teeth per person 	13.7 (12.7–14.8)	13.9 (13.1–14.6)	
% of people with moderate or severe periodontitis 	20.7 (14.6–26.7)	13.4 (9.8–17.1)	
% of people with 4+ mm periodontal pocket depth 	15.9 (10.3–21.4)	12.5 (8.8–16.1)	
% of people with 4+ mm clinical attachment loss 	45.5 (37.9–53.1)	37.5 (31.9–43.2)	
% of people with gingival inflammation 	4.7 (1.0–8.4)	11.6 (6.9–16.4)	
% of people visiting dentist within last 12 months 	59.8 (53.1–66.5)	62.6 (58.6–66.6)	
% of people who attended a private dental practice at last dental visit 	66.0 (59.6–72.4)	89.4 (86.0–92.7)	
% of people who paid for their last dental visit 	62.6 (57.0–68.2)	100.0 (100.0–100.0)	
% of people who usually visit a dental professional at least once a year 	47.6 (41.7–53.6)	60.8 (57.3–64.4)	
% of people who have a dentist they usually attend 	63.9 (56.2–71.5)	80.1 (76.4–83.9)	
% of people who usually visit a dentist for a check up 	52.2 (44.3–60.1)	63.6 (59.3–67.8)	
% of people who avoided or delayed dental care 	43.2 (35.8–50.6)	27.6 (24.2–30.9)	
% of people who reported that cost had prevented recommended dental treatment 	29.9 (21.0–38.7)	21.2 (17.8–24.5)	
% of people who would have a lot of difficulty paying a $100 dental bill 	38.9 (33.4–44.4)	9.3 (7.2–11.3)	
% of people avoiding foods due to dental problems 	23.9 (18.4–29.5)	13.0 (10.1–15.9)	
% of people rating their oral health fair or poor 	24.5 (16.5–32.6)	14.1 (12.3–15.8)	
% of people experiencing toothache 	19.2 (11.2–27.2)	11.2 (8.7–13.7)	
% of people experiencing orofacial pain 	26.5 (18.6–34.4)	19.2 (16.4–22.1)	
% of people who need dentures 	6.6 (4.7–8.5)	4.0 (2.7–5.4)	
% of people who need an extraction or filling 	34.0 (26.2–41.8)	32.1 (27.7–36.6)	
% of people perceiving a need for a check up 	61.4 (52.3–70.5)	61.0 (56.9–65.1)	
% of people perceiving a need for treatment within 3 months 	68.7 (57.8–79.6)	76.5 (71.7–81.2)	

Age-standardised comparison dentally insured and uninsured.
Age-standardisation has been used in Table 36 to make comparisons between dentally insured and uninsured people on  each of the 30 oral health indicators presented in Tables 5‑34.  These comparisons are based on the same principles noted for Table 35. That is, age-standardisation aims to compare insured and uninsured people after adjusting for potential differences in the age-distribution between the two groups.  In principle, however, there should be little confounding of these effects because there were only small differences in dental insurance coverage among the three age groups (Table 4).
•	The results in Table 36 show statistically significantly poorer outcomes for uninsured people on 17 of the 30 indicators.  For those 17 indicators, statistically significant differences were also observed in the preceding tables. 
•	Conversely, 12 of the indicators that did not differ to a statistically significantly degree between insured and uninsured people in Table 36 were similarly non-significant when contrasted between the two groups in previous tables that did not use age-standardisation. 
•	Overall, age-standardisation produced very little attenuation of the relative difference between the two groups.
In summary, the findings in Table 36 confirm generally poorer oral health outcomes for uninsured people compared to insured people. Age-standardisation did not appreciably alter the relationship between insurance status and any of the indicators, indicating that there was very little confounding of the effects of insurance due to age.

Table 36: age standardised comparison of dentally insured and uninsured people
	Uninsured	Insured	
Variable	estimate (95%CI)	estimate (95%CI)	
% of people with complete tooth loss 	3.8 (2.4–5.2)	8.6 (6.2–11.0)	
% of people with fewer than 21 teeth 	10.4 (8.6–12.3)	17.6 (14.3–21.0)	
% of dentate people who wear denture(s) 	14.5 (12.4–16.7)	17.9 (14.2–21.6)	
Average number of missing teeth per person 	5.3 (4.7–5.9)	5.8 (5.0–6.5)	
% of people with untreated coronal decay 	17.0 (10.5–23.4)	23.9 (16.0–31.8)	
% of people with untreated root decay 	5.8 (2.7–8.8)	10.1 (4.8–15.4)	
% of people with one or more filled teeth 	86.4 (82.4–90.4)	84.8 (81.0–88.5)	
Average number of DMF teeth per person 	14.2 (13.5–14.8)	13.4 (12.5–14.3)	
% of people with moderate or severe periodontitis 	13.9 (10.1–17.8)	21.5 (16.6–26.3)	
% of people with 4+ mm periodontal pocket depth 	11.8 (7.4–16.2)	17.5 (12.4–22.6)	
% of people with 4+ mm clinical attachment loss 	37.7 (31.2–44.1)	40.3 (33.9–46.6)	
% of people with gingival inflammation 	9.5 (4.1–14.9)	13.9 (6.6–21.2)	
% of people visiting dentist within last 12 months 	67.9 (63.3–72.5)	51.5 (46.4–56.7)	
% of people who attended a private dental practice at last dental visit 	91.0 (87.6–94.4)	72.8 (68.6–77.1)	
% of people who paid for their last dental visit 	96.0 (94.2–97.7)	80.5 (76.3–84.8)	
% of people who received government-subsidised dental care in private sector 	1.9 (1.0–2.8)	7.6 (4.7–10.4)	
% of people who usually visit a dental professional at least once a year 	66.6 (62.9–70.3)	42.1 (37.7–46.6)	
% of people who have a dentist they usually attend 	84.3 (80.5–88.2)	62.6 (57.1–68.1)	
% of people who usually visit a dentist for a check up 	68.5 (63.3–73.7)	49.7 (45.9–53.5)	
% of people who avoided or delayed dental care 	23.1 (19.5–26.7)	41.5 (35.7–47.3)	
% of people who reported that cost had prevented recommended dental treatment 	18.0 (14.3–21.7)	29.7 (24.5–34.8)	
% of people who would have a lot of difficulty paying a $100 dental bill 	9.3 (6.9–11.7)	23.4 (20.2–26.7)	
% of people avoiding foods due to dental problems 	11.2 (9.0–13.3)	20.0 (16.3–23.7)	
% of people rating their oral health fair or poor 	9.7 (7.5–11.9)	24.7 (20.6–28.8)	
% of people experiencing toothache 	10.3 (7.3–13.4)	15.5 (11.9–19.1)	
% of people experiencing orofacial pain 	21.5 (18.1–24.9)	21.9 (17.0–26.7)	
% of people who need dentures 	3.2 (1.9–4.6)	8.6 (6.3–10.9)	
% of people who need an extraction or filling 	25.5 (22.0–29.1)	39.1 (34.7–43.6)	
% of people perceiving a need for a check up 	54.9 (50.4–59.3)	64.8 (60.5–69.1)	
% of people perceiving a need for treatment within 3 months 	73.2 (66.9–79.4)	74.3 (66.2–82.4)	

References
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Appendices
Sample counts
Table A.1: Table counts of interviewed people
	Age group (years)	
	All ages	15–34	35–54	≥55	
All people	1,290	306	496	488	
Sex					
Males 	539	134	209	196	
Females	751	172	287	292	
Residential location					
Capital city	843	217	302	324	
Other places	447	89	194	164	
Postcode socioeconomic status					
Lowest	470	99	170	201	
Middle	412	113	169	130	
Highest	408	94	157	157	
Government health card 					
Blank but applicable	2	1	.	1	
Health care card or pensioner concession card 	398	51	69	278	
Neither card 	890	254	427	209	
Place of last dental visit					
Card-holder/Public 	113	22	17	74	
Card-holder/Non-public 	285	29	52	204	
Dental insurance					
Blank but applicable	16	12	2	2	
Insured	714	159	296	259	
Uninsured	560	135	198	227	

Table A.2: Sample counts of examined people
 	Age group (years)	
	All ages	15–34	35–54	≥55	
All people	470	98	179	193	
Sex					
Males 	170	37	58	75	
Females	300	61	121	118	
Residential location					
Capital city	310	65	114	131	
Other places	160	33	65	62	
Postcode socioeconomic status					
Lowest	168	35	62	71	
Middle	150	40	51	59	
Highest	152	23	66	63	
Government health card 					
Blank but applicable	0	0	.	0	
Card-holder/Public 	153	12	30	111	
Card-holder/Non-public 	317	86	149	82	
Place of last dental visit					
Card-holder/Public 	42	5	10	27	
Card-holder/Non-public 	111	7	20	84	
Dental insurance					
Blank but applicable	3	3	0	0	
Insured	282	47	110	125	
Uninsured	185	48	69	68	

Glossary
95% confidence interval Defines the uncertainty around an estimated value—there is a 95% probability that the true value falls within the range of the upper and lower limits
Attachment loss The distance in millimetres measured from the edge of the enamel of a tooth to the gum tissue that is adherent to its root
Calibration A procedure to promote standardisation between examiners performing the oral examinations
Canine One of four ‘eye teeth’ positioned next to the incisors and used for tearing food
Capital city The administrative seat of government of each of Australia’s six states and two territories—each capital city also represents the most populous location of its respective state or territory
Cemento‑enamel junction Point on a tooth surface where the tooth crown joins the tooth root
Census The Census of Population and Housing conducted every 5 years by the Australian Bureau of Statistics 
Complete tooth loss Loss of all natural teeth (also referred to as edentulism)
Coronal Pertaining to the crown of a tooth
Crown The portion of tooth covered by white enamel that usually is visible in the mouth
Dental attendance Behaviour related to the use of dental services
Dental caries The process in which tooth structure is destroyed by acid produced by bacteria in the mouth—see dental decay
Dental caries experience The cumulative effect of the caries process through a person’s lifetime, manifesting as teeth that are decayed, missing or filled
Dental decay Cavity resulting from dental caries
Dental insurance Dental care is not covered under Australia’s universal public health insurance vehicle, Medicare, and consequently people seeking cover can elect to carry private dental insurance
Dentate Having one or more natural teeth
Dentition The set of teeth—a complete dentition comprises 32 adult teeth
Denture A removable dental prosthesis that substitutes for missing natural teeth and adjacent tissues
DMFT An index of dental caries experience measured by counting the number of decayed (D), missing (M) and filled (F) teeth (T) 
Edentulous A state of complete loss of all natural teeth
Enamel Hard white mineralised tissue covering the crown of a tooth
Epidemiology The study of the distribution and causes of health and disease in populations
Examination protocol Methods and guidelines for conducting standardised oral examinations in a survey
Extraction Removal of a natural tooth 
Generation A group of people born during a defined period of time (also referred to as a birth cohort)
Gingiva Gum tissue
Gingivitis Redness, swelling or bleeding of the gums caused by inflammation
Government health card A concession card issued by the Australian Government that entitles the holder to services including public dental care
Incisor One of eight front teeth used during eating for cutting food 
Index of Relative Socioeconomic Advantage/Disadvantage (IRSAD) One of four indices measuring area‑level disadvantage derived by the Australian Bureau of Statistics—the IRSAD is derived from attributes such as low income, low educational attainment, high unemployment and jobs in relatively unskilled occupations 
Indigenous identity A person who states that they are of Aboriginal and/or Torres Strait Islander descent is an Indigenous Australian
Mean The arithmetic average of a set of values
Molar One of 12 back teeth used in grinding food
Natural teeth Refers to a person’s own teeth as opposed to artificial teeth
Orofacial pain Pain located in the face, jaw, temple, in front of the ear or in the ear
Participation rate The proportion of people from whom survey information is collected from among the total number of people selected as intended study participants
Periodontal disease Disease of the gums and other tissues that attach to and anchor teeth to the jaws
Periodontal pocket A space below the gum line that exists between the root of a tooth and the gum surrounding that tooth
Periodontitis Disease of the gums caused by bacteria, characterised by swelling and bleeding of the gums and loss of tissue that attaches the tooth to the jaw
Permanent teeth Adult teeth (secondary teeth) 
Plaque A film composed of bacteria and food debris that adheres to the tooth surface
Prevalence The proportion of people with a defined disease within a defined population
Probing pocket depth The measured depth of the periodontal pocket 
Recorder A person, usually a dental assistant, who recorded the results of an oral examination onto a laptop computer
Relative difference The difference between two values calculated as a ratio of one value divided by another
Restoration A filling to repair a tooth damaged by decay or injury
Root That part of the tooth below the crown which is anchored to the jaw
Root surface The surface of the root of a tooth 
Socioeconomic Indices for Areas (SEIFA) A set of four indices derived by the Australian Bureau of Statistics from population census data to measure aspects of socioeconomic position for geographic areas
Socioeconomic position Descriptive term for a position in society and usually measured by attributes such as income, education, occupation or characteristics of residential area 
State/territory Geographic regions of Australia—the nation has six states and two territories 
Statistical significance An indication from a statistical test that an observed association is unlikely (usually less than 5% probability) to be due to chance created when a random sample of people is selected from a population
Trend The general direction in which change over time is observed
Weights Numbers applied to groups of study participants to correct for differences in probability of selection and in participation
Wisdom tooth One of four molars, each positioned at the back of the mouth
List of tables
Table 1: Distribution of examiners and examinations among states and territories
Table 2: Periods of data collection in states and territories
Table 3: Number and percentage of people sampled, interviewed and examined(a)
Table 4: Percentage of people with selected sociodemographic and dental access characteristics in the WA population and three age groups
Table 5: Percentage of adults with complete tooth loss
Table 6: Percentage of people with fewer than 21 teeth
Table 7: Percentage of dentate people who wear denture(s)
Table 8: Average number of teeth per person missing due to pathology
Table 9: Percentage of people with untreated coronal decay
Table 10: Percentage of people with untreated root decay
Table 11: Percentage of people with one or more filled teeth
Table 12: Average number of decayed missing or filled teeth per person
Table 13: Percentage of people with moderate or severe periodontitis
Table 14: Percentage of people with 4+ mm periodontal pocket depth
Table 15: Percentage of people with 4+ mm clinical attachment loss
Table 16: Percentage of people with gingival inflammation
Table 17: Percentage of people visiting dentist within last 12 months
Table 18: Percentage of people who attended a private dental practice at last dental visit
Table 19: Percentage of people who paid for their last dental visit
Table 20: Percentage of people who received government-subsidised dental care in private sector
Table 21: Percentage of people who usually visit a dental professional at least once a year
Table 22: Percentage of people who have a dentist they usually attend
Table 23: Percentage of people who usually visit a dentist for a check-up
Table 24: Percentage of people who avoided or delayed dental care
Table 25: Percentage of people who reported that cost had prevented recommended dental treatment
Table 26: Percentage of people who would have a lot of difficulty paying a $100 dental bill
Table 27: Percentage of people avoiding foods due to dental problems
Table 28: Percentage of people rating their oral health fair or poor
Table 29: Percentage of people experiencing toothache
Table 30: Percentage of people experiencing orofacial pain
Table 31: Percentage of people who need dentures
Table 32: Percentage of people who need an extraction or filling
Table 33: Percentage of people perceiving a need for a check-up
Table 34: Percentage of people perceiving a need for treatment within 3 months