The Travels of the Techno-Freedom-Fighter

I just got back from having my usual late-night beer with my father. He was a little bit upset about his recent visit to the public health dentist (whom he refers to as Dr Mengele). It took him almost four weeks to be seen, and in the meantime he has had a shocking toothache which has not made him the most pleasant person to be around. Basically the aforementioned dentist, was only able to to an emergency repair job on his tooth. My old man like many post war immigrants to Australia didn’t really have the best dental care what he was growing up. This means that he has absolutely shocking set of teeth at the moment. Because he is on a pension, he really doesn’t have the money to go and get the whole job done privately. The funny thing is that everytime I go to one of these political forums you see this question come up all the time from people. Why did you have to cut the dental health budget?

Poor oral health causes pain and difficulty eating, which can mean dependence on medication, nutritional deficiencies and associated health conditions such as diabetes and heart disease. Visible tooth loss can affect self esteem, restrict social and employment opportunities. There are 650,000 people on waiting lists for public dental care with an average waiting time of 27 months. A study of public dental health patients from 1995/6 to 2001/2 showed a decline in oral health with increases in the number of decayed, missing and filled teeth, particularly for 25 – 44 year olds.

Whilst each state and territory provides public dental services, per capita spending varies markedly from state to state, services are confined to concession card holders prepared to endure long waiting times and school students. Each state requires some form of patient co-payment, the introduction of which has led to a decrease in use. Oral dental health is the least subsidised area of state health care at $369m/year. Many adults receive only ‘emergency’ dental care, teeth are extracted at 122% higher rates than in private dentistry and little is invested in improving adult oral health.

‘Strengthening Medicare’ provides dental treatment for people with chronic illness but this is limited by GP and dentist willingness to participate, a three-visit cap, a restricted list of treatment items and a upper limit fee of $275. Information on use of these items suggests that there has been a low level of referral by GPs.

It is absolutely clear that we need to establish a national public dental health program that is free for concession card holders and special needs groups, and which includes a full dental check-up and basic dental treatment every two years. This program should be funded at per capita levels that will meet the goals of the national oral health plan and delivered in a timely manner, as determined by national benchmarks – with costs to be shared equally between the Commonwealth and the States. As well as dental health assessment and follow-up by dental hygienists in residential aged care and a long range dental health workforce planning and more university places for dentists and dental hygienists.