Abstract Patterns of service provision are expected to change over time, reflecting the dynamics of factors such as oral health status and trends in population demographics. The aim of this study was to identify trends in service provision over time. Data were collected from a random sample of Australian dentists in 1983-84, 1988-89, and 1993-94. Changes observed between 1983-84 and 1993-94 included a trend towards increased proportions of patients in older age groups, decreases in the percentage of persons receiving restorative care (from 40.2 per cent to 37.7 per cent) and prostho- dontic care (9.3 per cent to 8.0 per cent), and increases in diagnostic (from 38.7 per cent to 46.0 per cent), preventive (20.9 per cent to 25.2 per cent), endodontic (5.3 per cent to 7.1 per cent), and crown and bridge services (3.1 per cent to 4.7 per cent) per visit. Other services such as orthodontic and general/miscellaneous services showed increases over the first half of the study period, but these did not continue between 1988-89 and 1993- 94. The total number of services per visit increased over the study period for adult patients. These findings indicate changing patterns of practice over time, consistent with an increasing orientation towards prevention of disease and maintenance of a natural dentition. Key words: Service provision, patient age, time trends, private general practice. (Received for publication February 1997. Accepted July 1998.) Introduction Historical trends in Australia have indicated improved oral health for children, with more than half the child population having no experience of clinical caries in the permanent dentition at the age of 12 years. 1 Among adults, decreased levels of tooth Australian Dental Journal 1998;43:(5):331-6 Service provision trends between 1983-84 and 1993-94 in Australian private general practice David Brennan* A. John Spencer* Fearnley Szuster* loss have occurred. The percentage of persons aged 65 years and over who had no natural teeth declined from 66 per cent in 1979 to 50 per cent in 1987-88 and 40 per cent in 1994. 2-4 These shifts in oral health status need to be considered along with changes in population demo- graphics for Australia. As the population grows, the numbers of children and young adults are only changing minimally, but there are substantial increases in the numbers of middle-aged and older adults. These changes will continue across the next several decades. 5 The pool of children and young adults at risk of oral diseases will be maintained, while the pool of middle-aged to older adults at risk of oral diseases, and hence in potential need of dental services, will increase. 6 Shifts in service provision can be expected to reflect these changes occurring in population demographics and oral health status. Data from the United States have shown that most dental treatment consisted of a narrow range of procedures, primarily of a reparative nature, 7 while Australian service-mix has been dominated by restorative, diagnostic and preventive services, with service patterns related to patient age. 8,9 In the United Kingdom, the changing pattern of treatment within the general dental service has included reductions in extractions and prosthodontics and increases in diagnostic, preventive and restorative care. 10 Australian data have indicated that while restorative services did not change in total between 1983-84 and 1988-89 there were changes in component services such as decreased provision of amalgams, but increases in glass ionomer restorations. 11 The aim of this analysis was to identify trends in service provision in Australian private general practice over time. This involved an examination of the distribution of patients by age group, the mix of services provided by main service areas, and the Australian Dental Journal 1998;43:5. 331 *Australian Institute of Health and Welfare Dental Statistics and Research Unit, Department of Dentistry, The University of Adelaide.