Improving access to dental services

The ACRN submission for the inquiry into the provision of and access to dental services in Australia was accepted for publication.

Special thanks to Leonie Short for her significant efforts and expertise with this paper. In it she outlines the state of dental care in Australia, the significant challenges with long waiting lists for services, particularly in regional and rural areas, and the continued neglect of oral health in aged care facilities.

The paper calls for the funding and implementation of the 5 specific oral health recommendations from the Royal Commission into Aged Care Quality and Safety (2021):

  • Recommendation 19: Urgent review of the Aged Care Quality Standards, in particular best-practice oral care, with sufficient detail on what these requirements involve and how they are to be achieved.
  • Recommendation 38: Residential aged care to employ or retain allied health professionals, including oral health practitioners.
  • Recommendation 60: Establish a Senior Dental Benefits Scheme for people who live in residential aged care or in the community.
  • Recommendation 79: Review Certificate III and IV courses to consider including oral health as a core competency.
  • Recommendation 114: Immediate funding for education and training to improve the quality of care, including oral health.

The paper includes some considerations of how to implement changes stating that if the Senior Dental Benefits Scheme is funded and implemented, there is no guarantee that older Australians will avail themselves of the program. We already see that the Child Dental Benefits Scheme has only a 30-40% uptake rate after years of implementation.

Approximately 50% of older Australians do not attend for regular dental check-ups, they mainly make a dental appointment with toothache or pain (extraction rather than a filling, root treatment or treatment for periodontal diseases), and they have low oral health literacy going back decades. What older Australians have thought about oral health care or dental treatment has changed a great deal since the 1940s. They may also have a fear of ‘dentists’ and dentistry which is passed on to their adult children and grandchildren. We need to address dental trauma, fears, and anxiety so that they are dental patients that dental practitioners will want to treat. Dental practitioners will not participate in the Senior Dental Benefits Scheme if it is more trouble than it is worth.

So, to ensure a good uptake of the Senior Dental Benefits Scheme, a national consumer-led communication program to inform older Australians about the link between general health and oral health, and the importance of twice-daily oral health care and regular dental check-ups is required.

The paper also shares examples we can learn from. The UK provides a more progressive model for oral health care in care homes, which could offer valuable insights for Australia. Training and upskilling health workers, carers, and disability support workers in oral health care are crucial to improving overall oral health outcomes.

This submission was spearheaded by Leonie Short. Leonie is a register dental practitioner – dental therapist – who is committed to improving access to oral health care and dental services in Australia. She lobbies and advocates to give a voice, and a mouth, to persons living in an aged care home, receiving care at home, or participants in the NDIS. Instead of retiring after she left CQUniversity in 2021, she established her own company – https://seniorsdentalcareaustralia.com.au/ – to provide oral health care training to carers, disability support workers and health workers. As a social enterprise company, they speak with, and write educational articles for, a variety of local consumer-led community groups (Parkinson’s Qld, Probus) and organisations (COTA) in Australia. Since March 2023, and in partnership with Dr Padma Gadiyar (CEO of Smilo.ai), they have been able to offer oral health coaching services as part of the NDIS.

You can download the submission to read in full below and see all Aged Care Reform Now parliamentary papers on our submissions page.

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