Kiwi study finds obvious inequalities in dental care provision

Dental Tribune International

一. 27 六月 2016

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DUNEDIN, New Zealand: Investigating the provision of dental care at the Faculty of Dentistry at the University of Otago, New Zealand’s only dental school, Kiwi researchers have found clear differences in the provision of dental extractions, endodontic treatment, crowns, and preventive care for Maori and Pacific Islanders, as well as patients of low socio-economic status (SES).

The findings suggest that Maori, Pacific Islanders and people with a low income were less likely to receive preventive care—which is free or at low cost—and extraction alternatives such as endodontic treatment or crowns. Consequently, Maori had 1.8 greater odds of having had a tooth extracted than European New Zealander patients, while Pacific Islanders had 2.1 times the odds. Moreover, patients of low SES had 2.4 times greater odds of having had a tooth extracted than did high SES patients.

In addition to highlighting inequalities in dental care provision, the results confirm previous findings that costs remain a primary barrier to receiving appropriate dental care. “We have a service that is dedicated for children and adolescence, but once a person reaches adulthood, they’re on their own,” lead researcher Dr Jonathan Broadbent told ONE News.

In New Zealand, residents are entitled to free basic oral health services until their 18^th birthday. The university’s clinics provide dental care at prices that are generally lower than those provided in private dental practice. Hence, the observed treatment inequalities are likely to be an underestimate of those occurring in private dental practice in the country, the researchers stressed.

Considering that the university’s dentistry school is the country’s only institution for the education and training of dentists, the results give insights into how New Zealand dental students may treat patients once they have completed their training, the researchers said. In the dental setting, practitioners and students may make assumptions based on ethnicity or SES about whether a patient is likely to conform to a preventive care regimen, or they might make judgements about a patient’s ability to pay for alternatives to dental extraction, they wrote.

Policies addressing the reduction of inequalities should therefore include enhanced cultural training for dentists and promote greater ethnic diversity among dental professionals. “Right now the proportion of Maori and Pacific in the dental workforce is very low and does not mirror the proportion of Maori and Pacific that are in the wider population,” Broadbent said.

The researchers collected data from 23,799 patients treated in the clinics between 2006 and 2011. In the study group, 5.4 per cent were Maori, 2.0 per cent Paciﬁc Islander, 4.8 per cent Asian, and the remainder European New Zealander. Regarding SES, 17.0 per cent were classified as being of low SES, and 11.3 per cent were beneficiaries or unemployed during the study period.

The study, titled “Ethnic and socioeconomic inequalities in dental treatment at a school of dentistry”, was published in the June issue of the New Zealand Dental Journal.