Longitudinal Trajectories of Dental Attendance in Australian Adults

Understanding how dental attendance evolves throughout life can inform targeted preventive health care policies by identifying key moments when people are more or less likely to seek dental care. Trajectory modeling of age and time trajectories takes a life course approach to understanding dental attendance, offering insights into both developmental perspectives (e.g., life stages) and structural perspectives (e.g., social position and health care systems) throughout the life course. This study used group-based trajectory modeling to identify (1) the age trajectories of dental attendance among Australian adults from young adulthood to retirement age and (2) the distinct time trajectories of dental attendance among Australian working-age adults. Data from the Household, Income and Labour Dynamics in Australia (HILDA) study was used to fit 2 trajectory models (age and time based). Age trajectories were fitted for individuals aged 15 to 64 y using dental attendance data from 3 time points: 2009, 2013, and 2017. Time trajectories were fitted for working-age adults (24-54 y) using data from 2009 to 2017 and descriptively analyzed by social characteristics. Dental attendance was classified as frequent (less than 2 y since the last visit) or infrequent (2 y or longer). Two distinct age trajectories emerged among participants (N = 11,189): the mostly frequent (75.1%) and declining-infrequent group (24.9%). A sharp decline in the probability of being frequent attendees was observed between 15 and 20 y in a quarter of the population with no subsequent change. Four time trajectories were identified (n = 7,033): consistently frequent (37.8%), consistently infrequent (8.9%), increasing attendance (22.2%), and declining attendance (31%). Descriptive analysis showed that age and social inequalities were evident in the trajectories. The findings emphasize the need for preventive health care policies that account for life-stage dynamics and their impact on attendance behaviors, in addition to improving structural factors.