” A big focus of our effort is Aboriginal health. We are one of the early teams to work on addressing issues of rural and remote dental health care access for Aboriginal people.
A crazy (in today’s thinking) simple model of fly-in-fly-out support to locally owned and run Aboriginal Medical Service based dental clinics. The gold standard today.
Aboriginal Medical Services can have, run and look after fantastic dental services, it’s right. Proven over decades.
Just do it today! I want to see every 145 ACCHO in Australia with a dental service!
EVERY SINGLE ONE!
Professor Marc Tennant, UWA Orginally published in Croakey
NACCHO Recommendation 9
The incoming Federal Government fund Aboriginal and Torres Strait Islander Community Controlled Health Organisations deliver dental services.
- Establish a fund to support ACCHOs deliver culturally safe dental services to Aboriginal and Torres Strait Islander peoples.
- Allocate Indigenous dental health funding to cover costs associated with staffing and infrastructure requirements.
“A proportion of Aboriginal and Torres Strait Islander people have good oral health. On average, however, Aboriginal and Torres Strait Islander people experience poor oral health earlier in their lifespan and in greater severity and prevalence than the rest of the population. Aboriginal and Torres Strait Islander people are also less likely to receive treatment to prevent or address poor oral health, resulting in oral health care in the form of emergency treatment.”
Photo above : Gari Watson is a Goreng Goreng, Gangulu and Biri Gubba man who grew up in Brisbane, Queensland Gari was the third Indigenous dentist to graduate from James Cook University (JCU) in 2014. Gari was working at the Institute for Urban Indigenous health in his hometown of Brisbane. “Working in Indigenous health, with my people, is my passion in life,” said Gari. “Working on the frontline to improve oral health and contributing to closing the gap in Indigenous health equality is exactly where I want to be. I’m living the dream.”
I have spent three decades working in and around dental health/public health and innovation in Australia and other places.
We are a team of many, many people from all over earth – there is more than 100 people working on things with us; from Jeddah to Utah and everywhere in-between.
We have graduate students focused on addressing inequality and building systems to reform health care in Australia and across the world.
Poor dental health has become a condition of poverty and marginalisation over the last five decades.
Today the “average” (actually does NOT exist) Aussie kid has less than one decayed tooth. In fact, over half of kids have NO decay.
But, a small minority of kids have LOTS of decay and suffer a lot. These are more often than not those for poor areas or are at the edge of society.
Why has decay dropped to such a low prevalence in society? Not actually a simple, clean one-line answer. Brushing, eating better, fluoride, toothpaste…. the list goes on.
Amazing turnaround!!! In 1960’s, a 12-year-old had 12 holes in their teeth – today less than ONE! AMAZING.
This started in the late 1960’s so many adults today have low decay levels too. BUT, there are pockets of trouble too!
This trend is now in adults too – the poor suffer far more than the rich with dental disease.
Why? The risk factors are higher for the marginalised, it’s harder to access good preventive care and more risk-taking activity.
Australia has two dental systems – private dental care, that are small independent businesses on the whole and are free to charge as they like. This is more than 85 percent of dental care.
AND, a small public system for those on health care cards or similar. Also, here we have Aboriginal Medical Service based dental services too.
PS We also have dental care in some tertiary hospitals for tough problems, cleft lip and palate, oral cancer, jaw fractures and more.
The public dental system is small, often under-resourced, especially as dental disease is now a condition of poverty. It’s the wrong way round now (private: public ratio)
Remember, the public dental systems are run by STATE governments – the federal government does not really have a role in dental (although there are some growing bits of funding now).
Where do we need to go in dental health in Australia?
Everyone says dental should be part of Medicare. If I said the bill for that could be as large as the NDIS as a cost, you can see the problem.
And remember that most dental care is provided by small businesses where the government cannot control prices – there would be payment gaps!
Read more on Medicare Dental at https://croakey.org/a-new-publication-on-oral-health-catch-up-with-some-talkingteeth/ … It will explain in detail why that’s probably not achievable nor actually what would help Australians.
There are alternatives… We have seen some – targeted care for those in need subsidised by the government.
There are some efforts around to be targeted and maximising bang for buck. The most efficient models of providing good dental care are actually part of State government care systems.
State government dental care systems across Australia are run down, and the real opportunity now is to re-enforce them and grow them. Get some balance back into the nation
We now have dental workforce to do it!
In 2000, we were at a workforce crisis with a lack of dentists. Today, 20 years later, we have sufficient workforce coming though… In some places there are too many (Sydney and Melbourne) but as a nation we are now safe.
We need to get more dental workforce out of Nedlands, Double Bay and Toorak and into the rest of Australia – that’s the big effort for the next decade.
We need our dental focus to start with those in most need, the poor and marginalised (economically and geographically). This is where dental troubles are. They are not in Toorak or Double Bay.
And people in Toorak or Double Bay have access to care – some of the highest densities of dentists in the world are around those suburbs!!! True.
It is interesting that the Labor Party policy released last week has focused on the elderly. Demographic shift.
As I am explaining, dental disease is reducing in adults and those born from mid 1960’s forward are on the whole dental far better than their elders.
Focus on elder dental health is good! Australia is growing old and we still have dental troubles for people.
The maximisation of bang-for-buck from what I can see is for people to take their “voucher” (if Labor wins) and spend it in the public dental service. Help grow the safety net for others in need.
Obviously, where there is no public system, do use the local private practice but I just wish people would try their darndest to support their fellow Australians by helping grow the public system.
I should say, I am not employed either as a private or public dentist and take no money in sponsorship. I am an academic. (In addition, I do not have a share portfolio!)
And new things to think about. Telehealth is coming to dental. Yes, imagine screening teeth from images you take in your own bathroom.
Telehealth really going to be important in closing geographic gaps. Imagine screening kids to prioritise them for the dental team when they come to town.
There is a digital future in dentistry (I have seen experimental robots doing dental care! – it’s coming)’
An important initiative in dental will be big data and prediction. Well protected (privacy) coupled with good analysis is going to give us great tools to predict risk and predict where needs are.
We do need to see support going into the R&D of these big-data solutions in health. They will squeeze every bit of value from every dollar we spend on dental care. A digital future is coming to public health and dentistry.