Oral health and dental care in Australia

This group has historically been identified as those on a low income and/or receiving some form of government income assistance, but now extends to include people experiencing other forms of disadvantage including refugees, homeless people, some people from culturally and linguistically diverse backgrounds, and people in institutions or correctional facilities (Department of Health, Disability and Ageing 2015). Poorer oral health results from infrequent dental care. Barriers include cost, appropriateness of service delivery and lower levels of health literacy, including oral health (Department of Health, Disability and Ageing 2015).

From the scientific literature

Immigrants experience oral health care inequity: findings from Australia’s National Study of Adult Oral Health (Jamieson et al, 2022)

The data used was collected from 15,727 participants using the Australia’s national Study of Oral Health (NSAOH) 2017-2018. The study aimed to assess the equity in access to services and patterns of use of oral health services among the Australian-born and overseas-born populations. The study also looked at whether there were any additional differences based on the main language spoken at home.

In 2017–18:

• A similar proportion of those people who mainly speak English at home visited a dental practitioner in the last 12 months as those who mainly spoke another language, 57% and 55% respectively.
• Around 1 in 10 (11%) people either born in Australia or born overseas had not visited a dental practitioner in the last 5 years.
• Most people (63%) usually visited a dental practitioner for a check-up rather than for a problem irrespective of main language spoken at home.

Explore the data using the priority population interactive 1 below.

In 2017–18:

• More people who were born in Australia who mainly spoke a language other than English at home had visited a dental practitioner in the last 12 months than those born in Australia who mainly spoke English at home, 69% and 56% respectively.
• 1 in 4 (24%) people born overseas who mainly spoke a language other than English at home visited a public dental service compared to 1 in 6 (16%) people born overseas who mainly spoke English at home.
• More people who were born in Australia who mainly spoke a language other than English at home usually visited a dental practitioner for a check-up (77%) than those born in Australia who mainly spoke English at home (63%).

Explore the data using the priority population interactive 2 below.

In 2017–18:

• A greater proportion of those people born overseas who mainly spoke a language other than English at home avoided or delayed visiting a dental practitioner due to cost (49%) than those born overseas who mainly spoke English at home (38%).
• Cost prevented recommended dental treatment for around 1 in 3 (32%) people born overseas who mainly spoke a language other than English at home compared to around 1 in 5 (21%) people born in Australian who mainly spoke English at home.

Explore the data using the priority population interactive 3 below.

The health of Australia’s prisoners 2022

People in contact with the criminal justice system often come from socioeconomically disadvantaged backgrounds (AIHW 2019). They are less likely to have accessed health-care services, and more likely to have a history of risk behaviours that can affect health and wellbeing (AIHW 2023).

People in prison have higher rates of tobacco smoking and high-risk alcohol consumption than the general population (AIHW 2024) which are behaviours that are known to increase the risk of oral disease (AIHW 2020).

The health of people in Australia's prisons 2022 report presents the results of the 6^th National Prisoner Health Data Collection (NPHDC) in Australia, which was conducted in 2022. The NPHDC is the main source of national data about the health of people in prison in Australia. Data for the NPHDC were collected in 2-week periods in all states and territories, except Victoria. There were 371 prison entrants who volunteered to participate in an Entrants survey when entering prison during the 2-week data collection period; 431 prison dischargees scheduled for release during or soon after also volunteered to participate in a Dischargees survey. People in custody during the collection period could participate in a Clinic survey if they visited a prison clinic.

Prison entrants

People entering prison are routinely given an initial health assessment. This health assessment provides clinicians with an indication of the health, and health needs, of the individual and whether referral for further assessment or treatment is required.

The NPHDC provided information from prison entrants on their health-seeking behaviours. Data were collected about visits to health professionals, both in the community and in prison (for those prison entrants who reported being in prison on a prior incarceration in the previous 12 months). 

During the 2-week data collection period:

• About 1 in 7 (15%) prison entrants reported consulting a dentist in the community in the 12 months prior to prison entry. Of the 153 prison entrants who had been in prison the previous 12 months, 11% reported consulting a dentist while in prison.
• About 1 in 6 (16%) prison entrants reported not consulting a dentist in the community in the previous 12 months despite needing to. Of the 153 prison entrants who had been in prison in the previous 12 months, only 4.6% reported not consulting a dentist despite needing to while in prison.

Explore the data in People in prison interactive 1.

Prison dischargees

The Dischargees form was completed for people in prison scheduled to be released during, or within 4 weeks of the data collection period. 

During the 2-week data collection period:

• Of the 177 prison dischargees who had been referred for further assessment of treatment following their initial health assessment on entry, around 1 in 6 (17%) reported being referred to a dentist/dental specialist.
• Of the 401 prison dischargees who visited the prison clinic, around 1 in 4 (26%) reported consulting a dentist/dental specialist.

Explore the data in People in prison interactive 2.

Prison dischargees were asked if they had ever been diagnosed with a health condition, and, if so, to specify its type. Dischargees were also asked if they had been diagnosed with a health condition for the first time in prison and, if so, the type of health condition.

During the 2-week data collection period:

• Around 2 in 5 (39%) prison dischargees reported they had been diagnosed with dental issues at some stage in their lives.
• Around 1 in 5 (22%) prison dischargees reported they were diagnosed with dental issues for the first time in prison. More prison dischargees reported being diagnosed for the first time with dental issues than any other health condition.

Explore the data in People in prison interactive 3.

Prison clinics

During the 2-week data collection period, various types of problems or conditions were managed at clinic visits including for medication/vaccination (13%), diabetes (11%) and dental conditions (3.3%).

Explore the data in People in prison interactive 4.

In prisons, nurses usually provide primary health care (or the first level of contact with the health-care system) whereas in the general community, general practitioners provide most of the primary health care.

The type of health professionals providing services at clinic visits during the 2-week data collection period were most often nurses (80%) followed by general practitioners (15%). A variety of other types of health professionals provided services during the 2-week data collection period including dentists/dental specialists (1.5%).

Explore the data in People in prison interactive 5.