Description of comprehensive dental services supported by the Medicare Chronic Disease Dental Scheme in the first 23 months of operation

Abstract

Australia's Medicare universal insurance system has supported comprehensive dental service through the Chronic Disease Dental Scheme (CDDS) since November 2007. Public debate opposing CDDS includes claims of over-servicing, calls for expansion to universal eligibility, and government threat of closure. Here we examine CDDS services over the first 23 months of operation. CDDS statistics on patient age, gender and item numbers claimed from November 2007 to December 2009 from Medicare were subjected to analysis. The distribution of 404,768 total CDDS patients varied across Australia from 3.6% of the population in NSW to 0.07% in NT, while uptake increased over time. The average patient had 7.58 dental treatments, and the most common were: direct restorations (2.27), preventive and periodontal services (1.46), diagnostic services (1.43), extractions (0.77), and new dentures (0.53). Crown and bridgework appeared over-represented (0.48). Although data do suggest over-servicing in crown and bridgework, there also appears to be significant community need for the CDDS. Clear guidelines for dental clinical diagnosis and treatment planning, as well as a pre-approval process for crown and bridgework is suggested to improve the CDDS, and this could form the basis for expansion to universal eligibility for dental Medicare.