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Health card holders are a financially disadvantaged group and are the target population eligible for publicly-funded dental care. While their health status is generally worse compared with other Australians, there is also considerable variation among card holders. The aims of this study were to describe the oral health status of publicly-funded dental patients by type of care, geographic location and age, and to compare trends over time against other Australian studies. Patients were sampled randomly, based on date of birth, by State/Territory dental services in 1995-96. Dentists recorded oral health measures at the initial visit of a course of care using written instructions, but there was no formal calibration. The 6109 patients sampled were weighted in proportion to the numbers of publicly-funded dental patients for each State/Territory. Multiple linear regression analysis indicated that caries experience measured by the DMFT index increased across older age groups (p < 0.05). For rural compared with urban patients, mean numbers of decayed and filled teeth tended to be higher. For emergency compared with non-emergency care, mean numbers of decayed and missing teeth were higher, and filled teeth lower. The findings of this monitoring survey document high levels of previous disease and treatment and indicate variation between subgroups of users of publicly-funded dental care. This included an uneven geographic distribution of oral health and disease, and variation in unmet treatment needs by type of course of care. Temporal comparisons indicate publicly-funded patients have experienced the population trend towards lower levels of tooth loss over time but have higher levels of untreated decayed teeth compared with the general population.

Data on the dental health of Australian school children from 1977 to 1985 have previously been reported. Significant features included a secular decline in caries experience as defined by the number of decayed, missing and filled teeth in both the deciduous dentition (dmft index) and permanent dentition (DMFT index), and a change in the distribution of caries experience within the child population in Australia, indicated by increasingly smaller percentages of children accounting for greater proportions of total disease experience. The aim of the present paper was to extend the annual reporting on caries experience in Australia up to and including 1993, and to document the change in the distribution of caries within the child population since 1977. In addition, the data are compared with dental targets for children for the year 2000 in Australia and internationally. Caries data were obtained for the years 1977-1993 for children who were patients at School Dental Services in each State and Territory of Australia. Caries experience was recorded by uncalibrated dentists and dental therapists during routine dental examinations. From 1977-89 data were weighted by State and Territory estimated resident populations. From 1989, the data were stratified according to age, year, and State, and weighted to reflect proportions in the national estimated resident population for each State/age stratum. Between 1977 and 1993 there has been a decline in caries experience for 6 year old children from a dift++ of 3.13 to a dmft of 1.90, and an increase in the per cent with dmft = 0 from 33.1 per cent to 53.2 per cent with dmft = 0 in 1993. Over the same time period the DMFT for 12 year olds reduced from 4.79 to 1.10 and the per cent while DMFT = 0 increased from 10.5 per cent to 53.1 per cent. Projection of the decline in DMFT indicates the dental health target for 12 year old children of DMFT = 1.0 by the year 2000 should have been achieved by the end of 1995.

This report provides epidemiological data describing caries experience among the population of non-institutionalized older adults in Adelaide and Mt Gambier. Subjects were selected in a stratified random sample of persons aged 60+ who were listed on the South Australian Electoral Database. Oral examinations were conducted by four calibrated dentists among 853 dentate persons aged 60 years and over. There was an average of 14.7 missing teeth, 8.3 filled teeth and 0.3 decayed teeth, and a further 0.2 teeth were present as retained roots. The mean number of missing teeth was higher (p < 0.05) in older compared with younger age groups, and in Mt Gambier compared with Adelaide. The mean DFS of 22.1 was significantly higher (p < 0.05) among younger persons, females and in Adelaide. Root surface caries affected an average of 3.1 surfaces, and was greater (p < 0.05) among persons aged 70-79 years, males and Adelaide residents. However, when root caries was expressed as an attack rate per 100 exposed surfaces, differences were statistically significant only among age groups. Analysis of specific teeth revealed that no more than 40 per cent of molars were retained, and between 30 and 58 per cent of retained molars had coronal fillings.

This report describes the intra-oral distribution of caries and frequency of reported toothache using data from 9690 South Australian children aged 5-15 years. School dental therapists and dentists recorded dmfs and DMFS data and a questionnaire to parents sought information about toothache and its impact. There were higher levels of caries experience in deciduous teeth (mean 6-year-old dmfs = 2.61) compared with permanent teeth (mean 12-year-old DMFS = 1.15). In the deciduous dentition: between 11.4 per cent (9-year-olds) and 37.7 per cent (5-year-olds) of total dmfs was present as untreated decay; between 39.1 per cent (7-year-olds) and 42.8 per cent (10-year-olds) occurred on interproximal surfaces; and between 2.0 per cent (10-year-olds) and 27.8 per cent (5-year-olds) occurred in anterior teeth. In the permanent dentition, the majority of permanent caries experience occurred as fillings in pits and fissures of first molars and involved a single surface. Between 11.8 per cent (5-year-olds) and 31.8 per cent (12-year-olds) of children had a reported history of toothache, although the figure exceeded 50 per cent among children with all three forms of pit/fissure, interproximal and smooth-surface caries experience. The observed pattern of caries provides the basis for continued use of fissure sealants as a preventive measure among school children.

This study aimed to assess oral health status and the social impact of oral conditions among dental patients with HIV infection in comparison with general dental patients receiving public-funded care in Adelaide, South Australia. DMFT and CPITN indices were recorded by one dentist at a clinic for HIV dental patients. The data were compared with information from an existing survey of general dental patients. Social impact was assessed using the Oral Health Impact Profile questionnaire and responses from HIV dental patients were compared with responses from a telephone interview survey of Adelaide residents. HIV patients were aged 21 to 49 years (median = 34), 90.7 percent were male and 29.6 percent had stage 4 HIV infection. Oral candida was present among 32.0 percent, hairy leukoplakia among 24.1 percent, HIV gingivitis among 18.5 percent, and HIV periodontitis among 33.3 percent. The DMFT index and its components did not differ significantly between HIV and general dental patients, while CPITN scores were lower among HIV patients (p = 0.01). However social impact among HIV patients was frequent: 64.6 percent reported toothache, 43.7 percent avoided foods, and 16.7 percent avoided going out because of dental problems. HIV patients reported significantly greater levels of social impact than the Adelaide sample (p < 0.01). Patients to this clinic frequently presented with severe and disabling oral conditions which were not adequately captured using standard clinical indices.

Despite the reported benefits of computer-assisted telephone interview (CATI) methods, experiences from their use in Australian oral health surveys have not been described. This report aimed to present methodological aspects of a CATI survey conducted in the five mainland states. A response rate of 66 per cent was obtained, yielding 4050 completed interviews. Analysis revealed generally small levels of non-response bias: persons who avoided or delayed dental treatment because of cost and non-health card holders were harder to contact, while non-English speakers and persons aged 20-29 years were less likely to participate. A total of 1770 person hours of interview time was spent on the survey: 64.5 per cent of that time was spent on the telephone with an average of 10 minutes 17 seconds per call (13 minutes 37 seconds per completed call). Only seven questions had missing data for more than 1 per cent of respondents. Comprehension of questions and cooperation with the interview was rated by interviewers as 'good' or 'very good' for more than 90 per cent of respondents. The CATI method was highly efficient and yielded good quality data for the survey.

Oral symptoms and their effects on well-being provide an indication of the social impact of oral disease and can be used to document the burden of illness within populations. This report presents findings about the social impact of oral disease among a random sample of 1217 non-institutionalized persons aged 60 years and over living in Adelaide and Mt Gambier. They completed a questionnaire containing 49 questions about the effect of oral conditions on dysfunction, discomfort and disability. Over 5 per cent of dentate persons and over 10 per cent of edentulous persons reported impacts such as difficulty in chewing, discomfort during eating and avoidance of foods 'fairly often' or 'very often' during the previous 12 months. Impacts on social roles and interpersonal relationships were reported by up to 5 per cent of persons. Edentulous persons reported social impact more frequently, particularly in areas related to chewing and eating. Older age was associated with significantly greater amounts of impact among dentate persons, while edentulous males reported significantly more impact than edentulous females. There were larger variations among dentate persons according to their dental utilization patterns, with the highest levels of impact reported by individuals who usually attended for dental problems and who had attended the previous year. The high frequency of social impact reported in this study no doubt reflects extensive levels of disease experience, including high rates of missing teeth and edentulism, among older adults.

There has been a growing recognition of the need to obtain information about the oral health of older Australians. The aim of this report is to provide descriptive epidemiological information about the oral health and treatment needs of non-institutionalized older adults in Adelaide. Data from interviews with 178 persons aged 60+ were obtained from a pilot study. Clinical data were available for 106 persons who participated in oral examinations. Among the 52.9 per cent of dentate persons, the prevalence of root decay (27.1 per cent) was slightly higher than coronal decay (23.6 per cent). Some 28.1 per cent of dentate persons had a serious periodontal condition, defined as the presence of four or more teeth with at least 5 mm or more of periodontal attachment loss and periodontal pocketing of 4 mm or more at one or more of those teeth. The majority of persons (83.8 per cent) wore one or two dentures. Disorders associated with dentures were frequent, affecting 77.4 per cent of upper denture wearers and 72.5 per cent of lower denture wearers. Persons who were older, who had lower educational attainment or lower household incomes were disadvantaged in aspects of oral health status and dental caries. However, there were no consistent associations between chronic medical conditions and oral disorders. Despite the high prevalence of oral impairment, reflecting extensive disease activity in the past, high levels of untreated disease were relatively uncommon. Instead, a high prevalence of oral disorders created a substantial need for basic forms of dental treatment in this group.