Trends in Service Provision Among Australian Private General Dental Practitioners over a 20-year Period

Aim: To-investigate time trends in service provision.

Design: Five cross-sectional surveys across a 20-year period.

Setting: Australian private general practice

Participants: A random sample of dentists.

Methods: Mailed questionnaires were collected in 1983, 1988, 1993, 1998 and 2003 (response rates 71%-76%).

Main Outcome Measures: Services per visit, annual services per dentist; annual services per patient.

Results: Total services per visit increased over the study period from 1.78 to 2.37 (Poisson regression; P<0.05). However the annual number of services provided per dentist did not vary significantly, reflecting a trend among dentists to supply fewer patient visits per year. The annual number of services provided per patient increased from 3.47 to 5.50 (OLS regression; P<0.05), reflecting both increased service rates per visit and increased numbers of visits by patients. Dentists provided less restorative, prosthodontic and extraction services per year, but more diagnostic, preventive, endodontic and crown and bridge services. The annual care received per patient also included more diagnostic, preventive, endodontic and crown and bridge services but differed from the dentist pattern through increased rates of restorative services over the study period.

Conclusions: The content of dentist workloads has changed to include less emphasis on removal and replacement of teeth and more effort on diagnosis and prevention aimed at retention of natural dentitions.