NACCHO- the National Authority for comprehensive Aboriginal Primary Health wants fluoride added to the water supplies of all Aboriginal communities.
Download the NACCHO submission
In its submission NACCHO called on the federal government to provide money to Aboriginal-controlled health organisations so they could provide dental services.
Aboriginal people were more likely than non-indigenous Australians to have lost all their teeth, it said.
The organisation urged state and territory government to fluoridate all town, city and Aboriginal community water supplies.
As well more work was needed to attract dental workers to remote Aboriginal communities.
“There are concerns among dental health professionals that positions in Aboriginal communities are not seen as part of the usual career ladder,” NACCHO said.
Exposure to Aboriginal controlled health organisations during training would help attract more young dentists.
Proper funding would allow organisations to offer competitive remuneration packages that would encourage dentists to remote and rural areas
RECOMMENDATIONS
NACCHO recommends that the NPA for adult public dental services:
1. Provide culturally appropriate oral health services to all Aboriginal and Torres Strait Islander people;
2. Increase the oral health workforce available to improve the oral health of Aboriginal and Torres Strait Islander people;
3. Increase oral health promotion activity with the aim of improving health outcomes for Aboriginal and Torres Strait Islander people;
4. Improve the collection, quality and dissemination of oral health information about Aboriginal and Torres Strait Islander people; and
5. Foster the integration of oral health within health systems and services, particularly with respect to primary health care and Aboriginal and Torres Strait Islander people.
In addition, NACCHO asserts that:
1) Oral Health is a priority health issue for Aboriginal peoples.
2) Oral health is a core part of the holistic health that Aboriginal Community Controlled Health Services aim to provide.
3) Aboriginal Community Controlled Health Services should provide primary oral health care services including emergency and preventative oral health care and oral health promotion.
4) Australia’s National Partnership Agreement to come into effect June 2014 should be fully funded and implemented, in particular in relation to measures for Aboriginal and Torres Strait Islander Peoples in particular.
5) The Patient-assisted Transport Scheme (PATS) must be extended to dental patients.
6) Dental services should be subsidised to all needy Aboriginal and Torres Strait Islander patients to reduce or eliminate cost as a barrier to accessing services..
7) Aboriginal and Torres Strait Islanders in correctional facilities should have access to culturally appropriate oral health programs.
8) All oral health workers must receive cultural awareness training either as part of their initial training or through on-going professional development. This will increase the level of culturally accessible oral health services.
9) There should be support for more Aboriginal and Torres Strait Islander individuals to be trained in all the oral health profession: dentists, dental hygienists, dental therapists, etc.
10) The Australian Dental Council (ADC) should include performance indicators for training schools for recruitment and retention of Aboriginal and Torres Strait Islander trainees and have a target of 2.4% of each profession being Aboriginal and/or Torres Strait Islander individuals.
11) Oral health should be included in the core training of all health workers including Aboriginal Health Workers.
12) Fluoridation of drinking water supplies is an effective strategy to reduce oral health problems.
13) Culturally appropriate Oral Health promotion materials need to be developed, tested for impact, and widely disseminated if effective.
14) Improved and regular collection of data on Aboriginal oral health status and use of services is needed to allow monitoring of the impact of interventions and assessment of achievement of oral health goals and targets.
NACCHO will:
15) Work with all Australian governments to develop oral health service provision at all its member health services.
16) Work with stakeholders to develop cultural awareness training for all oral health workers.
17) Campaign in support of fluoridation of city, town and community water supplies.
18) Improve the level of useful Aboriginal oral health data initially by influencing the capacity for the sector to collect national data collection in those Aboriginal Community Controlled Services with an existing oral health service – e.g periodontal and dental caries status, oral hygiene knowledge and periodontal disease links with Diabetes etc.
19) Support research to collect information on the areas of individual oral health behaviours, knowledge and barriers in regards to oral health including the availability and affordability of oral hygiene items.
NACCHO calls upon the Federal Government, in collaboration with state and territory governments and NACCHO, to:
20) Fully fund and implement the 2014 National Partnership Agreement
21) Set and monitor goals and time specific targets in relation to meeting a range of oral health outcomes such as caries rates, periodontal disease rates and tooth extraction rates.
22) Formally recognise oral health as a key part of Aboriginal holistic health care to be provided by ACCHSs.
23) Allocate resources specifically for oral health services for Aboriginal peoples.
24) Increase oral health promotion activities in ACCHSs. This would require both increased financing for the development and testing of suitable materials, service provision and training of the AHW workforce.
25) Provide subsidised tooth brushes, tooth paste and floss to all remote communities in the first place and extend this as necessary to other communities where data collection indicates there is an access issue for these items.
NACCHO calls upon state and territory governments to:
26) Fluoridate all town, city and Aboriginal community water supplies that do not naturally contain a level of fluoride sufficient to prevent dental caries and immediately fluoridisation where this has ceased.
We welcome feedback on this recommendations
Extra money but no extra teeth for Indigenous Australians
While the Australian Dental Association Inc. (ADA) welcomes the additional $777 million announced by the Australian Government for the renewed National Partnership Agreement (Agreement) to “Closing the Gap” in Indigenous disadvantage, it laments the fact that dental health is forgotten.
The additional funding by the Australian Government will be for a further three years to 30 June 2016. The Australian Government is asking the States and Territories to continue their investment to renew the Agreement.
President of the ADA, Dr Karin Alexander, said: “The Australian Government’s announcement creates more funding but this funding will be put into Indigenous Australians’ mouths that will continue to have decayed teeth and diseased gums at rates higher than other Australians.
“The additional commitment to Closing the Gap in Indigenous disadvantage is welcome. However, while this Agreement has laudable goals such as closing the life expectancy gap, and halving the gap in mortality rates for Indigenous children under five within a decade; it is time that it specifically focuses attention and resources to improving Indigenous Australians’ dental health.
“The continuation of this NPA is one way to start to address the Indigenous dental health gap that has opened from the cessation of the previous Chronic Disease Dental Scheme.
“The research shows an association between poor oral health and chronic disease. Provisions to address Indigenous Australians’ dental health will therefore have a real bearing on their life expectations and quality of life. Considering that Indigenous Australians have higher rates of periodontal disease (90% compared to 25% of non-Indigenous Australians) and greater prevalence of dental disease (five times that of non-Indigenous Australians), this is a gap that will receive little attention by this Agreement as it stands.
“In particular, the Agreement should require that comprehensive treatment be made available to those Indigenous Australians receiving assistance from Agreement programmes. For example, the Northern Territory Stronger Futures part of the Agreement involves the use of preventive fluoride varnish and fissure sealants. While these preventive measures are a good supplement, they must not be considered a substitute for complete dental care.”
Dr Alexander concluded, “Furthermore, the Agreement must fund fully equipped, skilled, trained and experienced mobile dental teams to ensure access to comprehensive dental treatment for Aboriginal and Torres Strait Islander communities. The pilot programmes that are in place under the NPA should be made permanent”.
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Congrats NACCHO for this submission. At last some action. Remote Aboriginal communities have been missing out for far too long and it is ten years since when questioned the Menzies School of Health Research responded to a similar call by saying they were still carrying out “:trials”. As if 40 years experience in mainstream was not enough. If I live long enough I might now see the day where pharmacists are employed at ACCHOs to dispense medicines as has occurred in mainstream since the inception of the Pharmaceutical Benefits Scheme.
By Rollo Manning