Oral health and dental care in Australia

Many Australians face financial barriers in accessing dental services (Department of Health, Disability and Ageing 2015). Overall, individuals directly fund a significant proportion of total expenditure on dental services, 61% in 2022–23 (AIHW 2024).

Expenditure

Dental services expenditure data presented in this section are derived from the AIHW Health Expenditure Database. It is important to note that the COVID-19 pandemic affected every aspect of the health system in 2019–20 and in the years following.

• Recurrent expenditure on dental services in Australia is estimated to be $12.5 billion for 2022–23, up from $9.8 billion in 2012–13.
• Between 2012–13 and 2022–23 total expenditure on dental services increased at an average annual growth rate of 2.5%.
• Total expenditure on dental services increased from $11.3 billion in 2021–22 to $12.5 billion in 2022–23.

• Per capita expenditure on dental services fluctuated over the decade, from $399 in 2019–20 to $476 in 2022–23. 

Government expenditure

• Australian Government expenditure on dental services fluctuated over the decade to 2022-23, from a high of $1.7 billion in 2012–13 to a low of $1.2 billion in 2013-14 with expenditure remaining relatively stable between 2014–15 and 2022-23 at around $1.3 billion. Across the period, Australian government expenditure declined at an average annual rate of 2.0%.
• Overall, state and territory government expenditure on dental services grew at an average annual rate of 3.0%. Expenditure fluctuated over the decade; expenditure was lowest in 2012–13 ($742 million) and highest in 2022–23 ($995 million).
• Between 2012–13 and 2022–23, Australian Government per capita expenditure on dental services fluctuated between $51 in 2019-2020 and $73 in 2012-2013, declining overall during the decade at an average annual rate of 3.4%.
• State/territory and local government per capita expenditure fluctuated during the period 2012–13 to 2022–23, ranging from $32 in 2012–13 to $38 in multiple years.

Non-government expenditure

• Non-government expenditure on dental services (including health insurance funds, individuals and others) increased steadily overall, from $7.3 billion in 2012–13 to $10.2 billion in 2022–23. This represents an average annual growth rate of 3.3%.
• Total non-government expenditure on dental services increased by over $1 billion from $9.0 billion in 2021–22 to $10.2 billion in 2022–23. 
• Expenditure on dental services by individuals accounted for the majority of non-government expenditure, increasing from $5.7 billion in 2012–13 to $7.6 billion in 2022–23 at an average annual growth rate of 2.9%.
• Expenditure by health insurance funds on dental services increased at an average annual growth rate of 4.6%, from $1.6 billion in 2012–13 to $2.5 billion in 2022–23.
• Per capita expenditure on dental services by the non-government sector increased from $320 in 2012–13 to $386 in 2022–23. Across the period, per capita expenditure grew at an average annual rate of 1.9%.

Explore the data using Costs interactives 1 and 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, Australians spent an average of $7.62 per week on dental fees, compared to $5.74 in 2003–04 and $7.23 in 2009–10.
• Residents of 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 residents 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

Financial barriers may reduce the likelihood of dental attendance and adversely influence the timeliness and comprehensiveness of care that is sought and provided (Chrisopoulos et al. 2016). Financial burden reflects direct and indirect costs of dental services to the individual, the disposable income of a household and the number of people dependent on that income (Chrisopoulos et al. 2016).

Children aged 5-17 years

The following data were sourced from the National Dental Telephone Interview Survey 2021 conducted by the Australian Research Centre for Population Oral Health, The University of Adelaide (Chrisopoulos et al. 2023). The nominated child’s parent or guardian was asked a range of questions relating to financial barriers including whether costs had led to the child’s dental visit being avoided or delayed, prevented them from receiving the recommended treatment and whether dental visiting during the previous year had caused a large financial burden to the family.

In 2021:

• around 1 in 11 (8.9%) children aged 5–17 years avoided or delayed dental visits due to cost
• cost prevented recommended dental treatment for around 1 in 20 (5.2%) children aged 5–17 years
• dental visits in the previous 12 months were a large financial burden for about 1 in 11 (8.9%) children aged 5–17 years
• for children aged 5–17 years, more females (22%) experienced at least one financial barrier or hardship associated with dental care compared to males (18%)
• around 1 in 4 (24%) children aged 11–17 years experienced at least one financial barrier or hardship associated with dental care compared to around 1 in 7 (15%) aged 5–10 years
• children aged 5–17 years who held an Australian Government concession card (23%) were more likely to have experienced at least one financial barrier or hardship associated with dental care than those who did not hold a concession card (18%)
• children aged 5–17 years without dental insurance (15%) were more likely to have avoided or delayed visiting the dentist due to cost than those with dental insurance (5.7%)
• around 1 in 4 (25%) children aged 5–17 years eligible for Child Dental Benefits Schedule experienced at least one financial barrier or hardship associated with dental care compared to around 1 in 6 (17%) children not eligible for Child Dental Benefits Schedule.

Explore the data further in Costs interactive 4.

• The proportion of children aged 5–17 years who reported that cost prevented recommended dental treatment remained relatively stable between 1994 and 2021, ranging from 8.5% in 1996 to 4.6% in 2002.

Explore the data further in Costs interactive 5.

Adults aged 18 years and over

The following data were sourced from the National Dental Telephone Interview Survey 2021 conducted by the Australian Research Centre for Population Oral Health, The University of Adelaide (Luzzi et al. 2023). Respondents were asked a range of questions relating to financial barriers including whether they had avoided or delayed visiting a dentist due to costs, whether cost had prevented them from receiving the recommended treatment and whether dental visiting in the previous year had caused a large financial burden.

Adults who avoided or delayed dental care due to cost

Among adults aged 18 years and over:

• around 4 in 10 (38%) adults eligible for public dental care avoided or delayed dental care due to cost compared to around 3 in 10 (30%) adults ineligible for public dental care
• those with dental insurance were less likely to avoid or delay dental care due to cost than those without dental insurance, 19% and 47% respectively
• those who usually visit the dentist for a problem (56%) were almost three times as likely than those who usually visit for a check-up (21%) to avoid or delay dental care due to cost.

Adults who reported that cost prevented recommended dental treatment

Among adults aged 18 years and over:

• more females (20%) reported that cost prevented recommended dental treatment than males (16%)
• adults aged 35-54 years (21%) and 55-74 (20%) were more likely than those aged 18-34 (16%) to report that cost prevented recommended treatment
• people without dental insurance (24%) were more likely to report that cost prevented recommended treatment than those with dental insurance (15%)
• people who usually visit the dentist for a problem (41%) were more than twice as likely to report that cost prevented recommended treatment than those who usually visited for a checkup (13%).

Adults who stated they would have great difficulty paying for a basic, preventive dental visit

Among adults aged 18 years and over:

• females (16%) were more likely than males (10%) to report they would have difficulty paying a $200 dental bill
• a greater proportion of Indigenous people (33%) reported they would have difficulty paying a $200 dental bill than non-Indigenous people (13%)
• around twice as many adults without a qualification or with a qualification other than a degree (15%) reported they would have difficulty paying a $200 dental bill than those adults with a degree or higher qualification (7.1%)
• adults without dental insurance (21%) were more likely to report that they would have difficulty paying a $200 dental bill than those with dental insurance (6.7%)
• around 3 times as many adults eligible for public dental care (26%) reported they would have difficulty paying a $200 dental bill than those ineligible for public dental care (9%).

Among adults aged 18 years and over:

• adults without dental insurance (14%) were more likely to report that dental visits were a large financial burden than those with dental insurance (5.9%)
• adults that usually visit the dentist for a problem (24%) were more likely to report that dental visits were a large financial burden that those who usually visit the dentist for a check-up (5.4%).

Explore the data further in Costs interactive 6.

The trend data for all three measures of financial barriers showed a marked decrease in 2021, possibly due to reduced access to dental care as the result of the COVID-19 pandemic.

• The proportion of adults reporting that cost prevented recommended treatment increased from 18% in 1994 to 25% in 2017, before decreasing to 18% in 2021.
• The proportion of adults reporting a large financial burden associated with dental care remained reasonably stable between 1994 and 2021, ranging from 8.8% in 2021 to 14% in 1999.

Explore the data further in Costs interactive 7.