Pattern and factors associated with utilization of dental services among older adults in rural Victoria.

BACKGROUND: In Australia, rural and regional areas have an increased proportion of older people who are ageing more rapidly than their metropolitan counterparts. This increase in the ageing population and its uneven geographic distribution is likely to pose an oral health challenge in the near future. METHODS: A cross-sectional study conducted in a sample of 226 community-dwelling adults aged 55 years and older, living in the City of Greater Bendigo who completed a questionnaire and received an oral examination. RESULTS: Overall, 51.2% of participants reported having been to the dentist in the previous 12 months. Reported barriers to dental care were: cost of services (32.7%), fear of dentists (25.8%), length of waiting lists (18.1%) and availability of oral health care services (11.1%). Living alone, gender, low income, lack of education, low self-perceived oral health needs, self-perceived barriers, edentulism, and presence of mobility problems were statistically significant variables associated with less use of dental services (p < 0.0001). CONCLUSIONS: Access to dental care is affected by financial and structural barriers as well as other predisposing and enabling factors among older adults. Thus, increase in user services will require efforts to reduce financial barriers and make dental care culturally and linguistically competent.

The presenting complaints of low income adults for emergency dental care: an analysis of 35,000 episodes in Victoria, Australia.

OBJECTIVE: This study examined the mix of presenting problems faced by a large diverse dental service treating low-income Australian adults and provides a basis for communities to understand and manage demand for dental services. DESIGN: A retrospective analysis in a state-wide multi-centre dental health service. Data for all patients (in all public adult dental clinics in the state of Victoria during May-Aug 2005) who used the emergency services in a 12 week period were recorded and analysed. A triage question tree was developed and embedded into a neural network based computer triage tool. RESULTS: Approximately 52% of low income adults presenting for emergency treatment required treatment on the day of triage. The main problem was with natural teeth (89.6%). Of those with natural teeth problems, 41.3% had pain disturbing their sleep patterns and 14.7% had experienced a swelling. Metropolitan patients accessed the services 2.3 times more than rural patients. CONCLUSION: These data clearly highlight that there is significant opportunity to reduce nearly 48% of on-day demand for emergency dental care through the application of appropriately clinical based triage.