Preventive services in Australia by patient and visit characteristics

Abstract

Growth in rates of preventive services has been linked to trends in retention of teeth and the emergence of minimal intervention approaches. In this study, we examined associations between patient-level characteristics and rates of the preventive services dental/prophylaxis and application of remineralisation agents. A random sample of dentists in Australia was posted a self-administered questionnaire in 2009-2010. A service log was used to collect data on preventive services and patient characteristics. Responses were obtained from 1,148 dentists (response rate = 67%). Preventive service rate models, adjusted according to the age and gender of patients, indicated that insured patients had higher rates of prophylaxis [rate ratio (RR) = 1.39; 95% confidence interval (95% CI): 1.21-1.59) and remineralisation services (RR = 1.85; 95% CI: 1.46-2.33), and that emergency visits had lower rates for prophylaxis (RR = 0.26; 95% CI: 0.20-0.35) and remineralisation services (RR = 0.23; 95% CI: 0.14-0.38). Those who had 20 teeth or more demonstrated higher rates of prophylaxis (RR = 1.41; 95% CI: 1.13-1.75) and remineralisation services (RR = 1.45; 95% CI: 1.02-2.08). Those with decayed teeth had lower rates of prophylaxis (RR = 0.54; 95% CI: 0.46-0.63) and remineralisation services (RR = 0.66; 95% CI: 0.53-0.82). Preventive services were associated with patient age, characteristics of visits and oral health. Patients who were worse off, in terms of attending an emergency visit for the relief of pain and having decayed teeth, had lower rates of preventive care. The findings indicate that patients most in need are missing out on the benefits of preventive dental services.