Practice activity trends among oral and maxillofacial surgeons in Australia

© 2004 Brennan et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.BACKGROUND: The aim of this study was to describe practice activity trends among oral and maxillofacial surgeons in Australia over time. METHODS: All registered oral and maxillofacial surgeons in Australia were surveyed in 1990 and 2000 using mailed self-complete questionnaires. RESULTS: Data were available from 79 surgeons from 1990 (response rate = 73.8%) and 116 surgeons from 2000 (response rate = 65.1%). The rate of provision of services per visit changed over time with increased rates observed overall (from 1.43 ± 0.05 services per visit in 1990 to 1.66 ± 0.06 services per visit in 2000), reflecting increases in pathology and reconstructive surgery. No change over time was observed in the provision of services per year (4,521 ± 286 services per year in 1990 and 4,503 ± 367 services per year in 2000). Time devoted to work showed no significant change over time (1,682 ± 75 hours per year in 1990 and 1,681 ± 94 hours per year in 2000), while the number of visits per week declined (70 ± 4 visits per week in 1990 to 58 ± 4 visits per week in 2000). CONCLUSIONS: The apparent stability in the volume of services provided per year reflected a counterbalancing of increased services provided per visit and a decrease in the number of visits supplied.David S Brennan, A John Spencer, Kiran A Singh, Dana N Teusner and Alastair N Gos

The dental labour force in Australia: the position and policy directions

The practice of dentistry in Australia is changing. One substantial change is a decrease in visits per year supplied by dentists. At present dental graduate numbers, there will be a widening gap between the capacity of the dental labour force and the population?s demand for dental visits and services. This publication presents an overview of the aggregate shortage of the dental labour force and considers the policy directions to close the supply-demand gap. While both short-term and long-term directions are presented, the focus is on longer term directions for Australia to develop a sustainable self-sufficiency in its dental labour force.John Spencer, Dana Teusner, Knute Carter and David Brenna

Self-rated dental health and dental insurance: modification by household income

BACKGROUND: Previous studies have reported that socioeconomically disadvantaged Australians have poorer self-rated dental health (SRDH), are less likely to be insured for dental services and are less likely to have regular dental visits than their more advantaged counterparts. However, less is known about the associations between dental insurance and SRDH. The aim of this study was to examine the associations between SRDH and dental insurance status and to test if the relationship was modified by household income. METHODS: A random sample of 3,000 adults aged 30-61 years was drawn from the Australian Electoral Roll and mailed a self-complete questionnaire. Analysis included dentate participants. Bivariate associations were assessed between SRDH and insurance stratified by household income group. A multiple variable model adjusting for covariates estimated prevalence ratios (PR) of having good to excellent SRDH and included an interaction term for insurance and household income group. RESULTS: The response rate was 39.1% (n = 1,093). More than half (53.9%) of the participants were insured and 72.5% had good to excellent SRDH. SRDH was associated with age group, brushing frequency, insurance status and income group. Amongst participants in the $40,000- <$80,000 income group, the insured had a higher proportion reporting good to excellent SRDH (80.8%) than the uninsured (66.5%); however, there was little difference in SRDH by insurance status for those in the $120,000+ income group. After adjusting for covariates, there was a significant interaction (p < 0.05) between having insurance and income; there was an association between insurance and SRDH for adults in the$40,000- < $80,000 income group, but not for adults in higher income groups. CONCLUSIONS: For lower socio-economic groups being insured was associated with better SRDH, but there was no association for those in the highest income group. Insurance coverage may have the potential to improve dental health for low income groups.Dana N Teusner, Olga Anikeeva and David S Brenna

Job satisfaction of registered dental practitioners

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.Background: This study was designed to measure job satisfaction among registered clinical dentists so as to identify issues which may influence recruitment and retention of dentists in active clinical practice. Methods: A questionnaire measuring dimensions of job satisfaction was mailed to a stratified random sample of 80 private and 80 public sector dentists selected from the 1999 Victorian Dental Register. Results: An adjusted response rate of 60 per cent was achieved (n=87). Analyses showed significant differences (ANOVA; p<0.05) in levels of satisfaction for various dimensions of job satisfaction by gender, age group and practice type. Differences in job satisfaction between male and female dentists related to the personal time dimension. Differences in satisfaction between dentists of different age groups were attributable to six dimensions: relationships with colleagues, relationships with patients, relationships with staff, personal time, community and administrative responsibilities. Differences between levels of satisfaction among private and public dentists related to the autonomy, relationships with patients, pay and resources dimensions. Conclusion: There are various dimensions of job satisfaction that may be pertinent to issues influencing recruitment and retention of dentists. Differences that exist between levels of job satisfaction among private and public sector dentists, between male and female dentists and dentists of different age groups need to be addressed in order to improve recruitment and retention rates of dentists in active clinical practice in different sectors of the dental care system.L. Luzzi, A.J. Spencer, K. Jones and D. Teusne

Longitudinal comparison of factors influencing choice of dental treatment by private general practitioners

The document attached has been archived with permission from the Australian Dental Association. An external link to the publisher’s copy is included.Background: Service rate variations and appropriateness of care issues have focused attention on factors that influence treatment decisions. The aims of this study were to examine what factors dentists consider in choosing alternative treatments, the stability of these factors over time and whether stability of treatment choice was related to age of dentist. Methods: Baseline data were collected by mailed self-complete questionnaires from a random sample of Australian dentists (response rate=60.3 per cent, n=345 private general practitioners provided service data from a typical day) in 1997–1998 and followup data were collected in 2004 (response rate=76.8 per cent, n=177 matched longitudinal cases). Results: The most frequent factors considered important across six alternative treatment pair choice scenarios were caries rate for ‘exam v. x-ray’, age of patient for ‘preventive v. restorative intervention’, cost of treatment for ‘crown v. buildup’, ‘root canal v. extraction’ and ‘bridge v. denture’, and calculus for ‘prophylaxis v. scaling’. The only differences over time were (t-test, P<0.05): higher proportions of responses in the mouth status group at follow-up for ‘exam v. x-ray’; higher proportions of responses in the visit history group at follow-up for ‘preventive v. restorative intervention’; a lower proportion of responses in the caries group at follow-up for ‘crown v. build-up’; and a higher proportion of responses in the treatment constraints group at follow-up for ‘prophylaxis v. scaling’. Conclusions: While a wide range of responses were offered as factors influencing the choice of alternative treatments, cost of treatment was a major consideration in situations where significantly cheaper alternatives existed, while patient preference was commonly included as a secondary consideration across a wide range of treatment choice scenarios. The treatment choice responses showed a high degree of stability over time across all age groups of dentists, suggesting that if routines are developed these are established before or soon after graduation as a dentist.DS Brennan, AJ Spence

Household income modifies the association of insurance and dental visiting

BACKGROUND Dental insurance and income are positively associated with regular dental visiting. Higher income earners face fewer financial barriers to dental care, while dental insurance provides partial reimbursement. The aim was to explore whether household income has an effect on the relationship between insurance and visiting. METHODS A random sample of adults aged 30–61 years living in Australia was drawn from the Electoral Roll. Data were collected by mailed survey in 2009–10, including age, sex, dental insurance status and household income. RESULTS Responses were collected from n = 1,096 persons (response rate = 39.1%). Dental insurance was positively associated with regular visiting (adjusted prevalence ratio (PR) = 1.18; 95% CI: 1.01-1.36). Individuals in the lowest income tertile had a lower prevalence of regular visiting than those in the highest income group (PR = 0.78; 95% CI: 0.65-0.93). Visiting for a check-up was less prevalent among lower income earners (PR = 0.65; 95% CI: 0.50-0.83). Significant interaction terms indicated that the associations between insurance and visiting varied across income tertiles showing that income modified the effect. CONCLUSIONS Household income modified the relationships between insurance and regular visiting and visiting for a check-up, with dental insurance having a greater impact on visiting among lower income groups.Olga Anikeeva, David S Brennan and Dana N Teusne

Geographic distribution of the dentist labour force

There are projected shortages in the supply of dentists in Australia, and these shortages are likely to be more evident in areas outside of capital cities.1,2 This report explores the geographic distribution of dentists and the differences in supply of dental services to regions defined by remoteness. Remoteness may be thought as the travel time to obtaining goods and services. Australian Statistics Geographical Codes (ASGC) Remoteness Areas describe the relative remoteness of an area by using road distance as a proxy for remoteness and population size of a service centre as a proxy for the availability of services.Dana N Teusne

Dental labour force, Australia 2000

Dental statistics and research series no. 2

Oral health impacts on self-rated general and oral health in a cross-sectional study of working age adults

OBJECTIVES: The aims were to assess the joint effects of oral health and general health functional problems on self-ratings of general and oral health among adults. METHODS: Data were collected from adults aged 30-61 years in Australia by mailed survey in 2009-2010. Self-rated health of 'very good/excellent' was analysed by oral health impact (OHIP-14) and number of health problems (EQ-5D) controlling for socio-demographics. RESULTS: Responses were collected from n = 1093 persons (response rate = 39.1%). General health self-ratings were higher in the high-income group (prevalence ratio [PR] = 1.06, 1.00-1.12) but lower for those with a higher number of health problems (PR = 0.84, 0.76-0.93). The interaction of health problems with oral health impact indicated that self-rated general health was worst when both the number of health problems and OHIP score were higher. Oral health self-ratings were lower for males (PR = 0.92, 0.87-0.98), those aged 50-61 years (PR = 0.92, 0.85-0.99), for those with more health problems (PR = 0.82, 0.71-0.95) and higher oral health impact scores (PR = 0.54, 0.46-0.64). CONCLUSIONS: For working age adults, oral health impact was associated with general health for those with more health problems indicating those in worse health suffer more impact from oral health problems.David S. Brennan and Dana N. Teusne

Comparing UK, USA and Australian values for EQ-5D as a health utility measure of oral health

Accepted: 7 January 2015Objectives: Using generic measures to examine outcomes of oral disorders can add additional information relating to health utility. However, different algorithms are available to generate health states. The aim was to assess UK-, US- and Australian-based algorithms for the EuroQol (EQ-5D) in relation to their discriminative and convergent validity. Methods: Data were collected from adults in Australia aged 30-61 years by mailed survey in 2009-10, including the EQ-5D and a range of self-reported oral health variables, and self-rated oral and general health. Results: Responses were collected from n=1,093 persons (response rate 39.1%). UK-based EQ-5D estimates were lower (0.85) than the USA and Australian estimates (0.91). EQ-5D was associated (p<0.01) with all seven oral health variables, with differences in utility scores ranging from 0.03 to 0.06 for the UK, from 0.04 to 0.07 for the USA, and from 0.05 to 0.08 for the Australian-based estimates. The effect sizes (ESs) of the associations with all seven oral health variables were similar for the UK (ES=0.26 to 0.49), USA (ES=0.31 to 0.48) and Australian-based (ES=0.31 to 0.46) estimates. EQ-5D was correlated with global dental health for the UK (rho=0.29), USA (rho=0.30) and Australian-based estimates (rho=0.30), and correlations with global general health were the same (rho=0.42) for the UK, USA and Australian-based estimates. Conclusions: EQ-5D exhibited equivalent discriminative validity and convergent validity in relation to oral health variables for the UK, USA and Australian-based estimates.D.S. Brennan and D.N. Teusne