Does Provision of Dental Services Vary in Different Counties?

Provision of dental services to the priority groups, dental manpower situation, and reports on dental services from the Norwegian Board of Health in the counties

Short summary of Report from the Norwegian Board of Health 8/2005

According to the Dental Health Services Act, there are five priority groups that the county authorities have a statutory duty to provide dental services for. These are:

• Group A: children and young people aged 0-18
• Group B: mentally handicapped adults
• Group C: elderly people, people with long-standing illness and people with a disability pension who are either living in an institution or receiving home nursing care
• Group D: young people aged 19 20
• Group E: other groups that the county authorities have decided to give priority to.

The county authorities can also provide dental services for adults, who pay for their treatment, if the needs of people in the priority groups have been met.

This report presents a description of provision of public dental services to the priority groups and the dental manpower situation in the counties. It is the third in a series of reports on dental services published by the Norwegian Board of Health. The two previous reports (Reports 5/2004 and 14/2004) showed that there were great differences between the counties in provision of dental services. This raised concern that people in the priority groups in several counties were not receiving the dental services that they have a statutory right to receive. The latest public statistics on dental services (source: Statistics Norway), presented in this report, show that there are still great differences between the counties. For example:

• The proportion of people in group c who are under supervision of the public dental services is 55 per cent in the county of Aust-Agder and 99 per cent in the county of Oppland
• A public dental officer or dental hygienist in the county of Vest-Agder has, on average, 1 400 patients under supervision. A public dental officer or dental hygienist in the county of Finnmark has, on average, 550 patients under supervision.
• The dental manpower situation in the counties of Nord-Trøndelag, Oppland and Akershus is very similar. The proportion of adults under supervision of the public dental services is 14.6 per cent in Nord-Trøndelag, 6.5 per cent in Oppland and 0.3 per cent in Akershus.
• There were no vacancies for public dental officers in Oslo in 2004. The number of people in the priority groups per man-year for public dental officers was 2 200. There were 25 vacancies for public dental officers in Nordland in 2004. The number of people in the priority groups per man-year was 900.
• The population density in the counties of Oppland and Troms is the same. Net operational expenses per person under supervision of the public dental services is approximately NOK 1 000 in Oppland and NOK 2 000 in Troms.

Do the statistics give a misleading picture of the situation, as a result of statistical errors or different interpretation of concepts?

Can differences in service provision be explained by geographical, administrative, economic, health, social or cultural differences between the counties?

Do the county authorities fulfill their statutory duty to all people in the priority groups, or does service provision vary according to where one lives?

These are issues that the Norwegian Board of Health is concerned about, and that are discussed in this report.