Dental Health Services Victoria

Completed research projects are detailed below.

• The dental cost study
• The capacity of dental therapists to provide direct restorative care to adults
• Traumatic orodental injuries and the development of an orodental injury surveillance system

Why people on public dental care waiting lists do or do not use services

Aims:

• Investigate the factors influencing people on people on public dental waiting lists to attend or not attend dental clinics, including their health literacy.
• Explore peoples' perceptions of their oral and general health status and associated behaviors while waiting for public dental care.

The dental cost study

Aims:

• Investigate the costs to the health system associated with a public dental care when dental treatment is delayed for two years.
• Investigate the health and social impacts on consumers of delayed dental treatment.
• Identify potential measures to monitor the effective use of public dental health care.
• Identify areas of data required for further improvement of public dental health services.

Key findings:

Major findings of the study related to the distribution of costs for proposed treatment types.

• 8% of all proposed treatment costs were allocated to preventive care.
• The smallest proportion of costs (2%) was for the proposed management of periodontal disease, even though 22% of the study sample showed evidence of advanced periodontal disease and 61% showed evidence of calculus, indicating a need for scaling and cleaning.
• Almost 38% of the proposed costs were for fillings or restorative treatment.
• Approximately 25% of proposed costs were for dentures.

Differences in the proposed costs between the two groups were apparent in all types of treatment apart from preventive care. The average cost for the proposed treatment among the longer-waiting Group A was higher for diagnostic services and periodontal, endodontic and restorative treatments, and for dentures. Costs for oral surgery and other services-mainly interpreter services-were higher for the shorter waiting Group B.

The capacity of dental therapists to provide direct restorative care to adults

Aims:

• Investigate the success rate of restorations placed by dental therapists 6 months post placement in adults older than 25 years of age under the prescription of a dentist.
• Assess adult patient satisfaction with the restorative services provided by the dental therapist.
• Assess dental therapists’ satisfaction with the provision of restorative services to adult patients older than 25 years of age.
• Determine the effect of patient’s age on suitability for direct restorative treatment by dental therapists.
• Inform the development of new models of oral health service delivery within the public sector.

Key findings:

Dental therapists demonstrated the capacity to provide direct dental restorative care under the prescription of a dentist to adults older than 25 years at a standard similar to that expected of newly graduated dentists.

Outcomes:

The findings from this project have resulted in a changed scope of practice for dental therapists. The Dental Practice Board of Victoria has approved for DHSV to run a pilot educational program to assist with the extension of the role of the Dental Therapist.

Traumatic orodental injuries and the development of an orodental injury surveillance system: a pilot study in Victoria, Australia

Aims:

• Measure the frequency, causes and patterns of traumatic orodental injuries in patients of all ages treated at the Royal Dental Hospital of Melbourne in Victoria, Australia, over a 12-month period.
• Investigate the feasibility of establishing an orodental injury surveillance system.

Key findings:

Of the 304 patient records extracted and analysed, approximately 75% of all cases were aged less that 24 years and 67% were male. The most frequent causes of orodental injury were falls from less than 1m or being struck by or colliding with a person or object. Injuries were most often associated with leisure and sports activities.

Orodental injuries sustained in one traumatic incident were often multiple and serious. Many severe orodental trauma injury cases present at this public dental hospital are expensive to treat, require long-term management and may be preventable.

Outcomes:

The findings from this study have led to the development and planned implementation of an enhanced electronic orodental injury structured history form that incorporates the collection of key injury surveillance data.

Prospective data is to be combined with injury surveillance data that are routinely collected by all Victorian public hospital emergency departments in order to improve understanding of the nature of orodental injuries impacting Victorian communities and assist with appropriate service planning and the design of orodental injury prevention interventions.