Restorative service patterns in Australia: amalgam, composite resin and glass ionomer restorations

Abstract

Aim: To examine the provision of amalgam, composite resin and glass ionomer restorations, and to assess whether these main restorative services varied by patient, visit and oral health characteristics. Design: A cross-sectional survey incorporating a log of service items provided on a typical day. Setting: Australian private general practice. Methods: Data on services and patients were collected by a mailed survey from a random sample of dentists from each State/Territory in Australia in 1998-99 with a response rate of 71%. Main Outcome Measures: Rates per visit of amalgam, composite resin and glass ionomer restorations among dentate adults who had received a restoration. Results: Analysis showed older patients had lower amalgam rates but higher glass ionomer rates, composite resin rates were lower at emergency visits, capital city patients had higher amalgam rates but lower composite resin rates, patients with decayed teeth had higher amalgam and composite resin rates, and use of restorative materials varied by clinical problem. Conclusions: Despite widespread use of alternative materials, amalgam rates remained high in circumstances such as replacement restorations and restorations involving more than one surface. Other restorative materials also had specific applications. Both amalgam and composite resins were provided at higher rates to patients with active caries but composite resins were also used at higher rates for aesthetic problems. Glass ionomer restorations were used at higher rates for initial and one-surface restorations, and for conditions such as root caries and dentinal sensitivity.