Decline in usually visiting the dentist for a problem in Australia, 1994 to 2010: an age-period-cohort analysis

Abstract

Objectives: To determine the extent to which age, period and cohort factors have contributed to variation in problem-oriented dental visiting over time. Methods: Data were obtained from four National Dental Telephone Interview Surveys of Australian residents aged 5 years and over conducted in 1994, 1999, 2004 and 2010 (response rates 48–72%). The trend in the percentage of persons usually visiting the dentist for a problem was analysed by means of a standard cohort table and by a nested models framework for age–period–cohort analyses. Results : The percentage of persons usually visiting the dentist for a problem generally decreased over the periods examined (from 42.5% in 1994 to 31.5% in 2010). Problem visiting tended to be lower for children and adolescents compared with adult age groups at each point in time. Model fit tests revealed that the age–period–cohort model provided the best fit for the data (Hosmer–Lemeshow test statistic = 5.3; d.f. = 8; P-value = 0.72), indicating that both period and cohort factors were influential in problem visiting. Conclusion: This study found similar, consistent stories for both the age–period and age–cohort models, with usually visiting for a problem tending to be higher in older age groups and older cohorts. Problem visiting tended to decline over time for most age groups and most age cohorts. Understanding patterns of dental service use over time can be used to help inform service delivery policies that promote and facilitate appropriate use of dental services.