Kids' teeth improve, uninsured's teeth don't

Australians are significantly more likely to visit a dentist, particularly for checkups and preventative care services, if they have dental insurance, according to a new report by the Australian Institute of Health and Welfare (AIHW).

The report, Insurance and use of dental services: National Dental Telephone Intervierw Survey 2010, shows a higher proportion of Australian adults with dental insurance had made a dental visit in the last 12 months (70.9%) than those who did not have insurance (48.3%).

The use of preventive care services was also more common among people with dental insurance.

‘A greater proportion of adults who had dental insurance visited for a checkup than those who did not have insurance,’ says AIHW spokesman Associate Professor David Brennan.

‘And a higher proportion of adults with insurance had scale and clean services in the previous 12 months than those without insurance.’

While people with insurance tended to seek services oriented to prevention of problems and retention of natural teeth, people without insurance required treatment for dental problems.

A higher proportion of adults without insurance (43.9%) had fillings than those with insurance (37.2%) and extractions were more common among those without insurance (19% compared to 10.4%). A lower proportion of those with insurance received dentures (3.2%) than those without insurance (6.3%).

Adults who visited the dentist in the last 12 months made 2.3 dental visits on average, and this did not vary between people with and without insurance.

‘This suggests that while insurance reduces costs of dental care, it does not lead to unreasonable use of dental services,’ David says.

Among people with dental insurance, dental visit and treatment patterns were similar for those who were Australian Government concession cardholders and non-cardholders.

Among cardholders, dental visit and treatment patterns varied depending on whether the cardholder was also insured.

‘Cardholders are entitled to free or subsidised dental care provided by state and territory governments,’ David says.

‘But even with this entitlement, cardholders without insurance were far less likely to visit the dentist for a checkup than cardholders without insurance.’

What about kids?

Another recent AIHW report showed that the oral health of children has improved markedly over the last 30 years.

The report, Child Dental Health Survey Australia 2007: 30-year trends in child oral health, describes the oral health status of Australian children examined by school dental service staff in 2007. The report also examines long term trends to 2007.

‘The good news is that between 1977 and the mid-1990s, the average number of deciduous (baby) teeth affected by caries halved in children aged 6,’ says Professor Kaye Roberts-Thomson of the AIHW’s Dental Statistics and Research Unit.

Caries in the permanent teeth of children aged 12 declined even more dramatically: in 1993, children aged 12 had less than a quarter of the number of teeth affected by caries than in 1977.

‘However, in both age groups, the average number of caries has increased slightly since the mid-1990s,’ Kaye says.

In 2007, just under half (46%) of children aged 6 attending school dental services had a history of decay in their baby teeth – that is, at least one decayed, missing or filled tooth, and on average, children aged 6 had about 2 decayed, missing or filled teeth.

In contrast, one-tenth of children aged 6 with the most extensive history of tooth decay had almost 10 baby teeth affected – over 5 times the national average.

‘Among older children, 39% and 60% of children aged 12 and 15 respectively had some history of decay in their permanent teeth. The average number of teeth affected was one for 12-year-olds and 2 for those aged 15,’ Kaye says.

‘Again, the one-tenth of 12-15 year-olds with the most extensive history of tooth decay had much higher numbers of teeth affected, with between 5.2 and 8.6 permanent teeth affected.

‘This was more than 4 times the national average for those age groups.’