Concession card holders
Children in the concession card holder group are those whose primary carer holds a PCC or an Commonwealth Government HCC and those children who hold a HCC themselves.80 The child concession card holder group includes children from low income families, homeless families and those children whose parents are unemployed or disabled.
80 See Appendix G for a list of Centrelink concession cards.
Generally, child card holders are more likely to have unfavourable oral health habits than non–card holders and are therefore at higher risk of developing oral disease. With regard to frequency of visits, non–card holder children are more likely to visit a dental practitioner annually than card holder children.
In the National Dental Telephone Interview Surveys from 1994 to 2005, non–card holders were 18.8 per cent more likely to visit a dental practitioner yearly than card holders. Non–card holder children were also more likely to visit a dental practitioner for a check–up rather than to treat a problem. Card holders were generally reported as having a higher prevalence of extractions and fillings. For the younger cohort, the prevalence of preventive treatment (scale and clean) declined over time among card holders but remained fairly consistent among non–card holders.81
81 Ellershaw, A.C. and Spencer, A.J. (2009), Trends in access to dental care among Australian children, AIHW Dental Statistics and Research Series, No.51, pp.30–45.
Rural and regional residents
Children living in rural and remote locations also face barriers to dental services. These include availability of oral health services mainly from the maldistribution of the dental workforce. Children from rural areas have often been found to have poorer health outcomes than their urban counterparts. Data sourced from the National Dental Telephone Interview Surveys showed that children in rural and remote areas were just as likely as children in urban areas to visit a dental practitioner at least once a year and visit the dental practitioner for a check–up. However, slight differences were found in the course of treatment received by children and when such treatment was provided. In general, children in rural and remote areas were more likely to receive their course of treatment in the public sector. Additionally, adolescents in rural and remote areas were more likely to receive extractions82 and fillings than children in urban areas.83
82 “In all survey years except 2005 the percentage of adolescents receiving an extraction was higher in rural and remote regions, but differences were not statistically significant”: Ellershaw, A.C. and Spencer, A.J. (2009), Trends in access to dental care among Australian children, AIHW Dental Statistics and Research Series, No.51, p.39.
83 ibid, pp.39 and 41.
Indigenous Australians have consistently been found to have poorer oral health than other Australians. Indigenous Australians are more likely to experience tooth loss, gum disease and receive less treatment for caries.84 In general, Indigenous Australians also have poorer oral health visiting patterns, accessing dental care less frequently than their non–Indigenous counterparts.85
84 Australian Health Ministers’ Advisory Council (2010), Aboriginal and Torres Strait Islander Health Performance Framework, AHMAC, p.32.
85 Jamieson, L.M., Roberts–Thomson, K., and Sayers, S.M. (2010), ‘Risk Indicators for Severe Impaired Oral Health Among Indigenous Australian Young Adults’, BioMed Central Oral Health, Vol 10, No. 1, p.10.
The poor oral health of Indigenous children was confirmed through the Child Health Check Initiative (CHCI) under the Northern Territory Emergency Response, which found that 43 per cent of children had an oral health problem. The most prevalent problem reported was untreated caries (40 per cent of all children), followed by gum disease (5 per cent of all children). 86
86 AIHW (2011), Dental Health of Indigenous Children in the Northern Territory – Findings from the Closing the Gap Program, p.1.
Children of low income earners
Children of low income families (in households earning less than $924 per week87) may be ineligible for public dental services, depending on jurisdiction and age, and are likely to be non–holders of private health insurance. Financial barriers, particularly the costs associated with purchasing private health insurance and receiving dental services without insurance benefits, place this group at risk for unfavourable visiting patterns and poor oral health.
87 Australian Healthcare and Hospitals Association (2011), Policy Paper on Oral Health, p.5.
In general, children that have private health insurance or are covered by their parents’ private health insurance package are more likely to have favourable visiting patterns and are hence at lower risk of experiencing oral disease. In general, children with insurance are more likely than uninsured children to visit a dental practitioner at least once a year,88 and are more likely to visit the dental practitioner for the purpose of receiving a check–up rather than treating a problem.89 Uninsured children are generally more likely than insured children to receive extractions and fillings.90
88 Ellershaw, A.C. and Spencer, A.J. (2009), ‘Trends in access to dental care among Australian children’, AIHW Dental Statistics and Research Series, No.51, pp.28 and 30.
89 ibid, pp.32–34.
90 ibid, pp.37–44.