Dental checkup

Image source: Dental Council of NSW

A new report from the Australian Institute of Health and Welfare (AIHW) presents a snapshot of the oral health and dental behaviour of Australian adults in 2010. The National Dental Interview Survey was conducted on a random sample of over 10,000 Australian adults during the period July 2010 to February 2011. The survey found that a majority of adults reported they had good dental health, with two thirds having visited a dentist in the previous 12 months. But a significant proportion of those surveyed reported difficulties in accessing affordable dental care. Over 31% reported they avoided or delayed a dental visit due to cost. Those on lower incomes were more likely to report avoiding or delaying a visit due to cost.

 

More people (31%) from low income households reported either poor or fair dental health, compared to those from high income households (12%). Overall some 18.7% rated their dental health as either poor or fair—lower than reported in 2007. While the proportion of adults visiting a dentist had increased since 1999 when the first survey was conducted, the proportion of those reporting cost as a barrier to dental care has risen steadily since then.

Broad geographic differences between those in rural areas and those in metropolitan areas were not significant when it came to self-rated dental health status, but those in rural areas visited a dentist less often than those in urban areas. This difference largely reflects the ongoing maldistribution of the dental workforce, which is largely located in metropolitan areas. Regional variations in dental health status may be due to the extent of water fluoridation.

The AIHW report found that dental conditions accounted for an estimated 60,251 hospital admissions in 2009–10. Most of these admissions could have been avoided. Both dental decay and gum disease (the main causes of dental problems) can be prevented; good dental hygiene, such as regular brushing with fluoride toothpaste and avoidance of sugary and acidic foods and beverages, is important. Other preventative measures include water fluoridation, regular dental check-ups (every one to two years) and the professional removal of plaque build-up through regular scaling and cleaning.

In addition to the avoidable cost and trauma of hospitalisation, dental problems impact directly on the economy. In 2010, according to the report, an estimated 3 million hours of work was lost due to absence attributed to dental problems. The cost to the economy for such absences was estimated to be in the vicinity of $103 million.

Most dental care in Australia is provided by private dentists on a fee for service model, and is not subsidised through Medicare. Australians spent $4.5 billion out of pocket on privately provided dental care, according to this other AIHW report (Table 3.9). Publicly funded dental care is available through state and territory clinics, mainly to children or adults with a valid concessional card. But the waiting time for adult public dental care can be long. In 2010–11, according to the COAG Reform Council (Table NHA.13.1), some 345,000 people were on public dental waiting lists, with a significant proportion (26.8%) waiting six months or longer for care.

It will be interesting to see if access to affordable and timely dental care improves as the Dental Reform Package announced by the former Labor Government is rolled out. This package allocated additional funding of $344 million to the states and territories from July 2014, to improve their public dental services under a National Partnership Agreement (NPA). From January 2014 it also provides a means-tested Medicare benefit, capped at $1,000 over two years, to children aged up to 17 for basic dental treatment. Both these initiatives look set to continue, at least in the short term. In its health policy election document, the Coalition indicated it would honour the NPA, but at its expiry (December 2015) it would move adult dental services under Medicare arrangements. Child dental benefits also appear to be supported in this document.