This publication explores the relationship between dental attendance patterns and oral health status. The findings are sourced from the 2004–2006 National Survey of Adult Oral Health (NSAOH). In this survey a random sample of Australian adults was interviewed by telephone to collect information on dental attendance patterns and self-reported oral health. An oral examination was then undertaken to collect information on tooth decay and gum disease.
In this report the dental attendance patterns of Australian adults have been categorised into three groups which represent contrasting attendance behaviour. These groups were formed through the concept of a ‘favourable’ to ‘unfavourable’ pattern of dental attendance where these descriptors reflect how closely the pattern of attendance reflects that recommended by the dental profession. The ‘favourable’ dental attendance group, which includes approximately 40% of Australian adults, have a usual dental care provider that they visit at least once a year for the purpose of a check-up. The ‘unfavourable’ dental attendance group, which includes nearly 30% of Australian adults, visit the dentist infrequently and usually for a dental problem. The remaining group, labelled ‘intermediate’, have a mixed pattern of dental attendance that cannot be categorised as either favourable or unfavourable.
Adults with an unfavourable pattern of dental attendance had significantly poorer oral health outcomes than those with favourable attendance. In particular, they were more likely to:
- rate their own oral health as either fair or poor
- have experienced toothache, sensitive teeth and bleeding gums in the previous year
- report being uncomfortable with their dental appearance
- report that they had avoided certain foods due to dental problems.
The type of dental treatment received varied significantly by pattern of dental attendance. Adults with an unfavourable pattern of dental attendance were 3.7 times more likely to have had a tooth extracted in the previous year and half as likely to have received a professional scale and clean treatment, than adults in the favourable attendance group.
Adults with an unfavourable pattern of dental attendance were also more likely to report barriers to accessing dental care than those with favourable attendance. In particular, they were 3 times more likely to report:
- delaying or avoiding dental care due to cost
- difficulty paying a $100 dental bill
- being very afraid or distressed when making a dental visit.
The pattern of dental attendance that people displayed did not lead to variations in the average number of teeth with dental decay, although the nature of this decay experience and the way it was managed varied significantly. On average, adults with unfavourable attendance had more than 3 times the level of untreated decay and 1.6 times more teeth missing due to dental disease than those with favourable attendance. Conversely, those with favourable attendance had more restored teeth. These findings reflect the type of dental care received to treat dental disease. Those seeking regular dental check-ups were more likely to have dental disease treated promptly, which led to less untreated decay, fewer extractions and more teeth restored.
Gum disease was also more frequent among adults with an unfavourable pattern of dental attendance. Those with unfavourable attendance were 1.6 times more likely to have gingivitis, and 1.5 times more likely to have periodontitis, than those with favourable attendance.
The findings in this report clearly demonstrate the gap in oral health status between adults with favourable and unfavourable patterns of dental attendance. As the number of adults with unfavourable attendance is a sizeable proportion of the adult population, a significant challenge remains for the dental health system in Australia to close this gap.
Professor of Social and Preventive Dentistry
AIHW Cat. No. DEN 208