People with additional and/or specialised health care needs

This group includes people living with mental illness, people with physical, intellectual and developmental disabilities, people with complex medical needs and frail older people. These people can be vulnerable to oral disease; for example, some medications for chronic diseases can cause a dry mouth, which increases the risk of tooth decay (Queensland Health 2008). A number of factors make accessing dental care more difficult for this group, including:

  • a shortage of dental health professionals with skills in special-needs dentistry
  • difficulties in physically accessing appropriate dental treatment facilities
  • the cost of treatment. People with additional and/or specialised health care needs often have their earning capacity eroded by ill health (COAG 2015).

People with disability in Australia

Around 1 in 6 (18%) people in Australia—or about 4.4 million—have disability (AIHW 2020). Some people with disability experience difficulties accessing and using health services. Barriers can include longer than desired waiting times, the cost of services, the accessibility of buildings and direct or indirect discrimination by health professionals. Some people with disability may also experience issues caused by a lack of communication between the health professionals treating them (AIHW 2020).

The People with disability in Australia 2020 report presents data sourced from the Australian Bureau of Statistics’ 2018 Survey of Disability, Ageing and Carers (ABS 2019). Data from this survey found that people with disability aged under 65 had difficulties accessing health services in the previous 12 months:

  • 1 in 8 (13%) who need to see a dental professional are placed on a public dental waiting list
  • 7 in 10 (70%) who have been on a public dental waiting list wait 1 month to more than 1 year before receiving dental care
  • 3 in 10 (28%) who need to see a dental professional delay or do not go because of cost.

Older Australians

Older people make up a considerable proportion of Australia’s population—at 30 June 2020, over 1 in 6 people were aged 65 and over. The Older Australians report explores aspects of health and wellbeing of older people, including their oral health and their use of dental services.

There are many programs and services available to support the health of older Australians. Older people’s access to these services may vary according to where they live, their access to transport, their health and cultural background, as well as socioeconomic factors.

Oral health generally deteriorates over a person’s lifetime, and oral disease can impact on people’s health and wellbeing more broadly.

In 2017–18, older Australians aged 65 and over had an average of 13.7 missing teeth. Most (59%) suffered periodontitis and around one-quarter (27%) avoided eating some foods due to problems with their teeth, mouth or dentures.

According to the 2017–18 National Survey of Adult and Oral Health, almost 3 in 5 older people saw a dentist in the last 12 months.

The cost of dental services is often reported as a barrier to accessing services. In 2017–18, of people aged 75 and over:

  • 22% avoided or delayed dental care due to cost.
  • 18% reported they would have difficulty paying a $200 dental bill.
  • 9.8% reported cost prevented dental treatment.