Oral health and dental care in Australia

Many Australians face financial barriers in accessing dental services (COAG 2015). Overall, individuals directly fund a significant proportion of total expenditure on dental services (58% in 2016–17). 

Expenditure

Dental services expenditure data presented in this section are derived from AIHW analysis of the Health Expenditure Database.

• Recurrent expenditure on dental services in Australia was $10.2 billion in 2016–17, up from $6.6 billion in 2006–07, adjusted for inflation.
• Total expenditure on dental services increased every year from 2006–07 to 2016–17, at an average annual growth rate of 4.4%.
• Australian Government expenditure on dental services steadily increased from $551 million in 2006–07 to $1,717 million in 2011–12, before falling to $1,273 million in 2013–14. Expenditure then increased again to just over $1,500 million annually in the period 2014–15 to 2016–17.
• Non-government expenditure on dental services increased steadily overall, from $5,411 million in 2006–07 to $7,799 million in 2016–17.

Explore the data using the Costs interactive 1 below.

• Per capita expenditure on dental services steadily increased from $319 in 2006–07 to $416 in 2016–17, adjusted for inflation.
• Per capita expenditure on dental services by the non-government sector increased from $262 in 2006–07 to $320 in 2016–17, adjusted for inflation. This represents an average annual growth rate of 2.0%.
• Between 2006–07 and 2016–17, Australian Government per capita expenditure on dental services increased from $27 to $62, at an average annual growth rate of 8.8%. 
• State/territory and local government per capita expenditure fluctuated during the period 2006–07 to 2016–17, ranging from $29 in 2012–13 to $36 in 2008–09 and 2010–11. Across the period, expenditure grew at an average annual rate of 1.5%.

Explore the data using the Costs interactive 2 below.

Household expenditure

Data presented in this section was sourced from the 2003–04, 2009–10 and 2015–16 Australian Bureau of Statistics (ABS) Household Expenditure Survey  (HES) (ABS 2006; ABS 2011; ABS 2017).  The ABS HES collects information on household expenditure patterns using variables such as income levels, sources, employment, family kinship, age and geographic location, to help provide a better understanding on living standards and economic wellbeing of Australians.

• In 2015–16, Australian households spent an average of $7.62 per week on dental fees, compared to $5.74 in 2003–04 and $7.23 in 2009–10.
• Households in the Australian Capital Territory spent an average of $13.73 per week on dental fees in 2015–16, more than any other jurisdiction. 
• In 2015–16, South Australian households spent an average of $5.88 per week on dental fees, less than any other jurisdiction.

Explore the data using the Costs interactive 3 below.

Financial barriers

Data in this section were sourced from the National Dental Telephone Interview Survey, 2013. Respondents were asked a range of questions relating to the financial burden of dental care. 

People who avoided or delayed visiting a dentist due to cost

• Females had higher rates of avoidance due to cost than males, 34% compared to 29%. 
• People with insurance had lower rates of avoidance due to cost than those without insurance, 20% and 44% respectively.  
• People ineligible for public dental care (29%) were more likely than those eligible for public dental care (38%) to avoid or delay visiting a dentist due to cost. 
• Those in the lowest annual household income group (41%) had higher rates of avoiding or delaying a visit to a dentist due to cost than those in the highest annual household income group (17%).
• There was an overall increase in the proportion of adults aged 15 years and over who avoided or delayed visiting a dentist due to cost between 1994 and 2013, from 25% to 35%.

People who reported that cost prevented recommended dental treatment 

• Cost was less likely to prevent recommended dental treatment for children aged 5–14 years (6.0%) than for adults aged 25–44 years (28%).
• Adults aged 25–44 years and 45–64 years were the most likely to not receive recommended dental treatment due to cost, 28% and 26% respectively. 
• People without insurance (25%) were more likely to report that cost prevented recommended dental treatment than those with insurance (16%).
• People eligible for public dental care (23%) reported higher rates of cost preventing recommending dental treatment than those ineligible for public dental care (18%).
• Those people in the lowest annual household income group (28%) were more likely to report that cost prevented recommended dental treatment than those in the highest annual household income group (11%).
• The proportion of adults aged 15 years and over who visited a dentist in the previous 12 months and reported that cost prevented recommended dental treatment fluctuated between 1994 and 2013, from 14% in 2002 to 23% in 2013.

People stating dental visits were a large financial burden

• Females (13%) were more likely to report that dental visits were a large financial burden than males (10%).
• People aged 45–64 years (16%) were more likely to report that dental visits were a large financial burden than any other age group.
• Across remoteness areas, those living in Remote and very remote areas (5.3%) were less likely to report that dental visits were a large financial burden than those living in Outer regional (9.6%), Inner regional (12%) and Major cities (12%). 
• People with insurance were less likely to report that dental visits were a large financial burden (10%) than those without insurance (14%).
• Those people eligible for public dental care (13%) were more likely to report that dental visits were a large financial burden that those ineligible for dental care (11%).
• The proportion of people reporting that dental visits were a large financial burden was higher for people in the lowest two annual household income groups (both 15%) than those in the highest annual household income groups (6.6%).
• The proportion of adults aged 15 years and over who visited a dentist in the previous 12 months and reported that dental visiting was a large financial burden fluctuated from 9.8% in 1994, to 14% in 1999 and 12% in 2013.

People who stated they would have a lot of difficulty paying for a basic preventive visit

• The proportion of females (34%) reporting difficulty in paying for a basic preventive visit was greater than the proportion of males (23%).
• More than twice as many people without insurance (40%) stated they would have difficulty paying for a basic preventive visit than those with insurance (17%).
• Around twice as many people eligible for public dental care (46%) stated they would have difficulty paying for a basic preventive visit than those ineligible for public dental care (22%).
• Around 1 in 2 (54%) of those people in the lowest annual household income group reported they would have difficulty in paying for a basic preventive visit compared to around 1 in 10 (9.9%) of those people in the highest annual household income group.

Explore the data using the Costs interactives 4 and 5 below.

References

• ABS (Australian Bureau of Statistics) 2006. Household expenditure survey, Australia: Detailed Expenditure Items, 2003–04 (Reissue). Cat. no. 6535.0.55.001. Canberra: ABS. Viewed 7 January 2019.
• ABS (Australian Bureau of Statistics) 2011. Household expenditure survey, Australia: summary of results, 2009–10. Cat. no. 6530.0. Canberra: ABS. Viewed 7 January 2019.
• ABS (Australian Bureau of Statistics) 2017. Household expenditure survey, Australia: summary of results, 2015-16. Cat. no. 6530.0. Canberra: ABS. Viewed 7 January 2019. 
• AIHW (Australian Institute of Health and Welfare): Chrisopoulis S, Harford JE & Ellershaw A 2016. Oral health and dental care in Australia: key facts and figures 2015. Cat. No. DEN 229. Canberra: AIHW.
• COAG (Council of Australian Governments) Health Council 2015. Healthy Mouths, Healthy Lives: Australia’s National Oral Health Plan 2015–2024. Adelaide: South Australian Dental Service.