Australian Child Dental Policy Improves Treatment, Not Prevention

The Child Dental Benefits Schedule (CDBS) was introduced in Australia to improve access to dental care for socioeconomically disadvantaged children. However, whether its use is associated with better oral health remains unclear.

To examine CDBS uptake among eligible Queensland children and compare oral health outcomes between CDBS users, eligible non-users, and non-eligible children.

We analysed cross-sectional data from the Queensland Child Oral Health Study 2022-24, a representative school-based survey of 7,718 children aged 5-14 years. Associations between CDBS utilisation and dental caries outcomes were examined, including effect measure modification by dental attendance frequency, adjusting for sociodemographic characteristics.

One-third (33.6%) of children were CDBS-eligible, of whom 66.7% had used the scheme. Lack of awareness was the most common reason for non-use. Eligible children had a higher prevalence of dental caries than non-eligible children. Among eligible children, non-users were more likely to report infrequent dental attendance (adjusted PR=1.96; 95% CI: 1.59-2.41). Compared with users, non-users had lower primary dentition caries experience (adjusted PR=0.80; 95% CI: 0.69-0.93) and fewer filled and missing surfaces, but tended to have more untreated decayed surfaces. Dental attendance frequency did not modify associations with overall caries experience.

Among eligible children, CDBS utilisation was associated with more frequent dental attendance and a pattern consistent with greater treatment of existing disease, but not with less caries experience. Greater emphasis on prevention, broader service coverage, and integration with population-based initiatives may strengthen its contribution to improving child oral health and reducing socioeconomic inequalities.

CDBS use was associated with more frequent dental attendance and greater treatment experience, while eligible non-users tended to have more untreated decayed surfaces. This pattern may reflect treatment of existing disease rather than prevention of caries. Greater emphasis on preventive care and early intervention within subsidised dental services is needed to reduce untreated disease and prevent caries progression.