Trends in private dental service provision in major city and other Australian locations.

OBJECTIVE: To investigate time trends in dental service provision by location.

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

SETTING: Australian private general dental 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: Annual services per dentist.

RESULTS: Decreases in the provision of restorative services, and increases in diagnostic and preventive services, occurred in major city locations but not in other locations. While decreases over time were observed in extraction rates in both major city and other locations, higher extraction rates persisted outside of major city locations. Denture and endodontic services fluctuated over time in both major city and other locations, with no difference by location observed in 2003-2004. No changes over time were observed for crown and bridge services, but crown and bridge services remained higher in major city compared with other locations in 2003-2004.

CONCLUSIONS: While the overall 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, a gap by location remains, with dentist workloads outside of major city locations marked by higher rates of tooth extraction and lower rates of preventive services.