1. Adult Dental Health Survey 2009 Barriers to Care Professor Gail Douglas University of Leeds

3. Overview Access to care Cost as a barrier to dental treatment Relationship with the dentist at last visit

4. Access to care Attempts to make an NHS appointment* Success in making an NHS appointment* not defined, no distinction between primary and secondary NHS dental services

5. Characteristics of those seeking an NHS dental appointment in the last 3 years

6. Characteristics of those seeking an NHS dental appointment in the last 3 years by sex

7. Characteristics of those seeking an NHS dental appointment in the last 3 years by socio-economic classification of household

8. Characteristics of those seeking an NHS dental appointment in the last 3 years by dental status

9. Percentage of adults by age who attempted to make an NHS dental appointment in the last 3 years

10. Characteristics of those seeking an NHS dental appointment in the last 3 years by self-reported dental health

11. Characteristics of those seeking an NHS dental appointment in the last 3 years by attendance pattern

12. Characteristics of those seeking an NHS dental appointment in the last 3 years by how often visits are made 6-12 12+

13. Characteristics of those seeking an NHS dental appointment in the last 3 years by time since last visit

14. Success (or not) in making an NHS appointment

15. Ease of having made an appointment

16. Percentage of adults by age who tried but failed to make an NHS dental appointment in the last 3 years by age

17. Those unable to make an appointment

18. Those unable to make an appointment by self- reported dental health and self-perceived need

19. Ease of making appointment by dental status

21. Who had an NHS dentist? By self reported dental health

22. Who had an NHS dentist? By self perceived treatment need

23. Who had an NHS dentist? By dental attendance pattern R OT

24. Who had an NHS dentist? By dental attendance frequency

25. Who had an NHS dentist? By time since last visit

26. Who found it less easy to make an NHS dental appointment? Those with poorer self-perceived dental health and those who attend dental check-ups less regularly. Majority however secured appointment at first attempt 9% attending less frequently than 12 monthly had to make 2 or more calls to get an NHS dentist compared to 2% who reported annual attendance

27. Cost as a barrier to dental treatment Had the cost of dental treatment influenced the type of treatment received? Had respondents ever delayed dental treatment because of its cost?

28. 26% said treatment option had been affected by cost 19% said they had delayed dental treatment because of cost 15% said they had both delayed treatment and that their treatment option was affected by cost

29. Effect of treatment cost by age

31. Effect of cost by sex

32. Effect of cost by location

33. Effect of cost by socio-economic classification of household

34. Effect of cost by dental status

36. Effect of cost by self-reported dental health

38. Effect of cost by clinical and self- perceived treatment need

40. Effect of cost by how often visits to the dentist are made (frequency) Frequency

41. Effect of cost by attendance pattern Attendance pattern

42. Effect of cost by time since last visit Time since last visit

43. Relationship with dentist at last visit Questions asked respondent to consider: – dentist listened carefully to what they had to say about their oral health – enough time to discuss their oral health – involved in decisions about their dental care – got answers they could understand – treated with dignity and respect – confidence and trust in dentist

45. Relationship with dentist at last visit 45

46. Who was less satisfied? Younger adults less satisfied than older ones No difference by sex or location Gradient by SE classification man/prof less negative about dentist than rout/manual – 17% vs 23% negative in at least one aspect – e.g. 7% vs 11% with regard to ‘listened carefully’

47. People with worse oral health were less satisfied Those with self-reported poor oral health less satisfied than those with good oral health – e.g 21% vs 5% ‘less confidence in dentist’ Those with clinically assessed decay more negative than those with no decay (28 and 18% respectively) Those with >12 v’s <12 restored teeth more negative (23 and 14% respectively)

48. Satisfaction by dental attendance Regular, routine and more frequent attenders were less negative about their relationship with the dentist: – 16% attended less than 1yr ago were negative vs 29% of those who had attended 1-5 yrs ago – 16% of those whose last visit was for a routine check up were negative vs 28% who had last attended for an emergency treatment – 15% of those attending 6-12m were negative vs 30% of those who attend less than yearly

49. Key Findings Access to NHS dentists – 58% of adults said they had tried to make an NHS appointment in the previous three years 92% successfully made and attended an appointment 1% made but didn’t keep their appointment 7% said they tried but were not able to make an appointment with an NHS dentist – Of those who successfully made an appointment 87% already had an NHS dentist 10% were able to get an appointment with the first new NHS dentist they approached

50. Key Findings Cost of treatment – 26% said the type of treatment opted for had been affected by the cost of this treatment – 19% said they had delayed dental treatment because of cost Relationship with dentist at last visit – 80% gave no negative feedback about their last visit to the dentist

51. Adult Dental Health Survey 2009 The NHS Information Centre commissioned the survey, with funding provided by the Department of Health in England, the Welsh Assembly Government and the Department for Social Services and Public Safety in Northern Ireland. The Office for National Statistics (ONS) was the lead contractor working in partnership with the National Centre for Social Research, the Northern Ireland Statistic & Research Agency, and a team of academics from the Universities of Birmingham, Cardiff, Dundee, Newcastle and University College London