The True Prevalence of Unscheduled Dental Visits in the Australian Defence Force

Background: An essential element for determining suitable risk management strategies for dental emergencies in the Australian Defence Force (ADF) is an accurate measurement of that outcome which best reflects those dental visits collectively termed 'unplanned presentations'. Purpose: The aim of the study was to determine the true prevalence of Unscheduled Dental Visits (UDVs) in the ADF. Method: A cross-sectional study was conducted on 878 deployable ADF personnel. Measurement of UDVs was determined by a dental chart audit of participants and a questionnaire to participants on any presentations to non-ADF dental centres and other health professionals for reasons relating to their oral health. Additionally, the reason for these presentations to both the ADF dental centres and non-ADF dental centres were recorded so as to exclude those visits of a trivial or non-dental nature. Results: The study found that the documented prevalence of UDVs was in line with previous studies (16.2%) but when visits to non-ADF dental centres were considered, there was a significant underreporting of UDVs (20.2%). A comparison with the Australian population showed a similar prevalence of UDVs for those who received an annual dental examination (ADE) and who had private health insurance. But for Australians who forego ADEs and have no private health insurance, the prevalence of UDVs increases by a factor of 2.5. A breakdown of the reasons for UDVs showed no significant difference between total UDVs and the documented UDVs, with fractured and broken teeth and fillings (33.9%) being the most common reason for a UDV. Conclusion: The results indicate that UDVs are underreported in the ADF. The significance of the underreporting is that it results in incomplete dental records for forensic and treatment planning purposes, loss of quality control; and an inability to accurately predict UDVs on deployments and provide proportionate dental support. Finally, it should be noted that low UDV prevalence is conditional on continual ADEs and universal access to dental care.