Dentistry: a neglected part of Australian healthcare?

Emergency department doctors face all manner of patients with a wide spectrum of medical, mental and dental problems. They deal with the results of road traffic accidents, drug and alcohol abuse, acute medical conditions and increasingly they get faced with a large number of dental patients suffering from infections and dental pain.  Sadly many of these patients are children. Why is this an increasingly common situation in hospital emergency departments?

Devastating news on children’s healthcare…

The Australian National Oral Health Survey results released by the University of Adelaide show that dental decay affects a significant proportion of Australian children. Over 40% of children between the ages of 5 years and 10 years have decay in their primary (baby) teeth and one quarter of children in that age group have not received dental care for their decay.  Sadly this sets a trend for those children who continue to experience decay in their adult teeth.

More than 30% of children between the age of 9 years and 14 years already have dental decay of their adult teeth. The data of over 24,000 children show that those living in the Northern Territory and Queensland have the worst dental health in Australia.

The problems of reaching Australian patients…

There are many reasons why patients suffer extensive dental disease.

One problem many Australians face living in rural and remote locations, is the frequent inaccessibility of preventive dental education and dental care. Many people live in remote areas with vast distances between them and dentists, oral health therapists and dental hygienists. This means they are unlikely to receive preventive dental advice or be able to access routine dental examinations and dental care locally.  Instead they are forced to travel vast distances. This means they tend to travel for dental care only when they have a problem and often it is too late to save teeth.

The inequality of dental care between the cities and rural locations is also magnified because the vast majority of the dental health workforce is concentrated in the Metropolitan areas of our country. Why is this the case? Sadly there isn’t adequate availability of State dental care due to inadequate investment in government sponsored dental health programmes to cover the Australian population living outside the cities in such a large country.

Another very important factor that presents a hurdle for children to access dental care is the poor uptake of the Commonwealth Child Dental Benefits Schedule (CDBS) administered through Medicare. This system has been set up to ensure that children in families who have low income can access dental care with the financial assistance of the Federal government. It allows families to receive up to $1000 over two calendar years to help with the costs of dental treatment. Sadly there is only around 37% uptake and in many cases this is because parents remain unaware that they are entitled to access this financial assistance. It is important that the government mount a public awareness campaign to raise the awareness of this group of parents.

The CDBS system caters for treatment in the dental practice setting and not under general anaesthetic in a day surgery or hospital setting. However, the Australian Dental Association is lobbying the government to change this and allow for dental treatment under general anaesthetic as many young children cannot be treated in a general dental practice due to their anxiety and their inability to co-operate, particularly very young children.

The State dental healthcare resources are stretched and they cover vast areas. Most dentistry in Australia is provided privately either under the extra’s cover of the private health insurers (PHIs) or entirely funded by the patient for those who are uninsured. The PHI’s charge increasing premiums and at the same time the rebates increase by smaller margins so that patients now pay a greater proportion of their dental invoices than they did in the past. This too acts as a disincentive for patients to obtain regular dental examinations, cleans and dental care and many choose to drop out of PHI cover.

What causes this dental disease explosion?

The most important contributing factor to dental disease is sugar in all its forms!

Sugar is in almost everything you buy in a tin, a packet or pre-prepared meals. Sugar is used by the food industry as both a preservative and to achieve the “bliss factor” in terms of taste to make you come back for more. With so much sugar included in the diet, dental health education is critically important and much more needs to be done in Australia if we really want our children to have healthy teeth into adulthood. Dental health education must be prioritised by our government.

Lack of dental awareness

There are still large numbers of Australians of all ages who are not aware of the underlying causes of dental decay and gum disease. There are also large numbers of people who are aware, but have not received adequate preventive advice to cause them to change the things they do that contribute to dental decay or gum disease.

Preventive dental health education of children, teenagers and particularly young parents is extremely important. Adults need to hear the preventive messages about avoiding dental disease regularly to help them minimise their own dental disease and that of their children.

Dental disease has been clearly shown in epidemiological studies to be linked with a number of medical conditions. Poor oral health is clearly linked with coronary artery disease, hypertension, stroke, renal disease, premature birth and low birth-weight babies. Other links have been proposed to exist with conditions including Alzheimer’s disease.

Sad but true

Dental extractions are one of the most common reasons for the admission of children to hospitals for a general anaesthetic. This is a sad reflection of the dental health of our nation.  Far more needs to be done to educate people, especially young people, for the future. It’s more important now than ever with the large amounts of sugar that are included in the average diet.

Dental disease prevention and health education…

Dental disease prevention and dental health education has become a largely neglected area of government health funding and yet, it is the most important dental investment the government could make to reduce the future demand for dental treatment with a positive flow-on effect on other medical conditions. In the long run it would save money for the health budget!

Dental health awareness appears to be an all time low…

This is despite the best efforts of the Australian Dental Association dental health awareness week that dentists use to promote oral health in the community. But this is one week in the whole year. It would be helpful if the media could focus on dental disease prevention and the government could increase the priority of oral and dental health as part of overall health awareness throughout the year.

We all need to start putting pressure on State Health Departments, to up their game and start putting their money where their mouth is literally by funding their dental health services adequately and on the media, to focus on dental health in the community.

Support the dentists, oral health therapists and dental hygienists and their support teams. They don’t want to be taking teeth out of young children; they don’t want to even have to fill kids teeth.

Put teeth first…

• The time has come to lobby both Federal and State government to put teeth first and accept dental health is an important part of overall general healthcare.
• Fund preventive dental health education, encourage involvement of the media and support State dental services with adequate State funding.
• Fund dentistry through Medicare and improve the future dental health of our nation.

Dental disease is preventable! So let’s prevent it!

Contact the friendly team at NQ Surgical Dentistry today on (07) 4725 1656 or call in to see us at 183 Kings Rd, Pimlico QLD 4812