Summary

The 1999 National Dental Telephone Interview Survey was conducted in all States and Territories and resulted in 7,829 participants, with a national participation rate of 56.6%.

Oral health status

The survey included questions on whether the respondent had any natural teeth, the number of teeth (or missing teeth) and denture wearing.

  • Edentulism (the loss of all natural teeth) was strongly associated with age-younger age groups experiencing lower edentulism rates than older age groups. After controlling for age the following groups experienced higher levels of edentulism-females, persons from low-income households, and cardholders-Table 3.1.1.
  • Among dentate persons, cardholders and persons from low-income households were more likely to experience higher levels of tooth loss and increased denture use- Tables 3.1.2 and 3.2.1.
  • People from Tasmania had the highest level of edentulism and among dentate persons the highest average number of missing teeth, and the greatest denture use-Tables 3.1.1, 3.1.2 and 3.2.1.

Access  to services

An examination of access problems encountered by survey respondents and barriers to the receipt of dental care is presented in Chapter 4. The range of measures of access to services are described by age groups, income levels, card status, location and State/Territory.

  • Children (5-11-year-olds) and adolescents (12-17-year-olds) were more likely to have made a dental visit in the previous 12 months than were older age groups-Table 4.1.1(a).
  • The majority of dentate adults who visited in the previous 12 months made their last dental visit in response to a dental problem rather than for a check-up-Table 4.3.1(b).
  • Although eligible for public-funded dental care, only 38.2% of dentate adult cardholders who had made a dental visit in the last 12 months last visited a public clinic, and 58.6% last visited a private practice-Table 4.4.1(b).
  • Among dentate adult cardholders whose last visit was to a private practice in the last two years, the main reason for not visiting a public clinic was that they prefer to see a private dentist (42.6%). A further 29.7% reported that their reason was that that they were not eligible for public dental care at the time of their last visit-Table 4.4.2
  • Dentate adult cardholders and non-cardholders who visited in the previous 12 months made on average almost the same number of visits (2.35 cf. 2.36 visits), however cardholders received a greater number of extractions per person (0.58 cf. 0.26 extracted teeth) than non-cardholders-Table 4.5.1(b). Regardless of the reason for the last dental visit, cardholders received more extractions than non-cardholders-Table 4.5.3(b).
  • Adults last visiting for a problem had on average a greater number of extractions per person than those last visiting for a check-up (0.49 cf. 0.09 extractions), similarly those last visiting for a problem received more fillings than those last visiting for a check-up (1.22 cf. 0.47 fillings)-Table 4.5.3(b).
  • Just under one-in-five cardholders whose last dental visit was for a check-up at a public clinic had to wait for longer than 12 months from the time of initial contact with the clinic-Table 4.7.1.

Social impact

The social impact of oral health on an individual was assessed with questions on toothache, dental appearance, and food avoidance.

  • Dentate adult cardholders were more likely than non-cardholders to have experienced toothache, felt uncomfortable with their dental appearance, or have avoided some foods because of problems with their teeth, mouth, or dentures-Table 5.1(b).

Dental insurance

A sizeable minority dentate Australian adults hold dental insurance. This includes both cardholders and non-cardholders. Dental insurance was associated with a more favourable pattern of visiting and types of treatment received.

  • Despite eligibility for public-funded dental care, one-in-five cardholders were covered by dental insurance-Table 6.1.1(a).
  • Among dentate adults who made a dental visit in the previous 12 months, persons without insurance were about twice as likely to have had one or more extractions than insured persons-Table 6.2.2.

Financial  burden

Affordability and hardship encountered in purchasing dental services influences the use of private dental services by cardholders and non-cardholders. While affordability and hardship will influence access, they will also reflect the coverage and continuity of public- funded dental care for cardholders.

  • Among dentate persons, cardholders were more likely than non-cardholders to:
    • have avoided or delayed visiting because of cost;
    • report that cost prevented recommended or wanted dental treatment; and
    • have a lot of difficulty in paying a $100 dental bill-Table 7.1.1(a).
  • Dentate adults with affordability and hardship difficulties were less likely to have made a dental visit in the previous 12 months, and more likely to usually visit for a dental problem, than persons without such difficulties-Table 7.2.2.
  • Among dentate adults who visited in the previous 12 months, those reporting affordability and hardship difficulties were more likely to have received fillings, and about twice as likely to have had extractions than those who reported no such level of difficulties-Table 7.2.3.

Perceived  needs

Perception of the need for dental treatment acts both as an important predictor of the use of dental services, and also as an outcome measure of the success of dental programs.

  • Persons who reported affordability and hardship difficulties were far more likely to perceive the need for a dental visit, and that visit was more likely to be for treatment, than persons who did not report such difficulties-Table 8.1.2.
  • Uninsured persons were more likely to perceive the need for extraction(s) and filling(s) than insured persons-Table 8.1.3(b).
  • Despite the greater perceived need for some form of treatment, the urgency of need for cardholders and uninsured adults was approximately the same as for non-cardholders and insured persons. This may indicate that the perceived urgency of dental treatment may be modified by the perceived ability to obtain the dental care perceived to be needed-Table 8.2.1(b).