Dental care requires federally funded universal system, health experts say

Jalal Khan has seen a lot of desperate patients during his time as a dentist.

Key points:

  • Patients on the public dental scheme often wait more than 12 months for treatment
  • 80 per cent of eligible patients miss out on treatment each year
  • There were 70,000 avoidable hospitalisations due to acute dental conditions in 2015-16

“I’ve had patients that have had teeth held together with paper clips,” he said.

“I’ve had patients that have been wearing dentures for so many years that the dentures are broken, fractured, they’ve got fungus on them.

“I’ve removed teeth for a gentleman that’s tried to remove them with pliers, and he was in absolute agony.”

Dr Khan has his own Sydney practice, but has made it his mission to improve dental health across the country.

Once a month he takes his mobile clinic to remote communities to treat dental problems and give access to preventive care.

“It’s confronting what we see sometimes, but it really makes us further motivated to expand the service and reach as many people as we can,” he said.

Sydney dentist Dr Jalal Khan stands in front of his truck in an outback Queensland town

PHOTO: Dr Khan takes his mobile dental surgery out to the remote areas once a month. (ABC News: Nicole Bond)

Dr Khan said it was time oral health was covered by a public Medicare-style scheme.

“There is definitely a need for there to be a universal dental scheme that is delivered by [the] federal government,” he said.

“For too long, dentistry and the mouth has been cordoned aside as a separate part of the body when it comes to health policy.

“But the reality is that it is impacting the general health of Australians and it’s also costing the government money.

“[In] 2015-2016 there were 70,000 hospitalisations due to acute dental conditions that could have been prevented.

“Each separation in an emergency department costs lots of money, all of this avoidable.”

‘I didn’t go for check-ups — I knew it cost quite a bit’

Graham Williams. Interviewed by 7.30, June 2019

PHOTO: Graham Williams has been waiting for more than a year to see a public dentist. (ABC News)

Graham Williams has been waiting for more than a year to see a dentist through the public system.

“When I smile you can see a few [teeth] missing,” he said.

“There’s a few that need to be removed — they’ve broken off down to the gum.”

Mr Williams cannot afford to pay to see a private dentist and he qualifies for the public system.

He admits his teeth have not been a priority for him over the years.

“I didn’t go for normal check-ups and routine work because I knew it would cost quite a bit,” he said.

But he never expected he would have to wait so long for treatment in the public system.

The dental divide – and the decay of public dental services

“Whenever I ask them about the wait or the reason for the wait they don’t seem to know,” he said.

“I rang them again three months ago to make sure I was still on the list and they gave me a waiting time of 12 to 15 months.”

During his most recent call, he was told that he was 101st on the waiting list and “would possibly be in the next round”.

“I think it’s a long time to wait for dental, especially in a country like Australia,” he said.

“You think it would be better, especially because poor dental health can also lead to other health issues and that’s more of a strain on the health system in general.”

Mr Williams has far more serious health concerns than his teeth.

He is receiving treatment for melanoma, which has now spread to his brain.

“If I was to get my teeth fixed up I think it would be one less stress to worry about while I’m going for my treatment, and [I could] worry about the melanoma instead,” he said.

Dental care policy and programs ‘a dogs breakfast’

Dr Martin Dooland. Interviewed by 7.30, June 2019

PHOTO: Dr Martin Dooland has been at the forefront of calls for improved dental coverage for decades. (ABC News)

Public dental services, which are run by the states and territories and are means-tested, are so over-stretched that each year 80 per cent of people eligible for help miss out on treatment.

Mr Williams is worried about the consequences of delayed care.

“If my teeth are getting worse in the longer time that I am waiting, it’s definitely going to cause more work for them to have to fix up and possibly other severe problems,” he said.

Poor dental health can also affect far more serious medical problems, such as heart disease and stroke.

Calls mount for Medicare-funded dental care

Calls mount for Medicare-funded dental care

Dr Martin Dooland has been at the frontline of dental health policy for more than 30 years.

He says dental care is one of the biggest gaps in Australia’s health system.

“The gap between the wealthy and low-income earners is very broad and, in fact, in Australia the oral health of adults affected by that gap is amongst the worst in the OECD,” he told 7.30.

“Oral health policy and programs in Australia have been a simple dog’s breakfast.”

In 2015-2016, Australia’s dental bill was $9.9 billion and individuals contributed 58 per cent of that in out-of-pocket costs.

It is estimated that each year, 2 million Australian adults do not get dental care when they need it because of the cost.

‘An anti health promotion model’

Oral health is the third-highest cause of acute preventable hospital admissions in Australia.

Dr Dooland said delays in public treatment were contributing to that.

“People realise waiting times are long and they give up,” he said.

“They end up waiting until there is a problem, the problem becomes severe and debilitating by the time they seek care; it becomes emergency care.

“And that pattern of dental care is the most destructive to dental health of all the patterns that people can adopt.

“It’s an anti-health promotion model.”

Access to regular check-ups and treatment would provide better outcomes, he said.

“What is needed is for patients to be able to seek a check-up every year or two, have treatment and prevention in a timely fashion,” he said.

“Then these low-income adults would not arrive at the door of public dental services in a state that costs a great deal to fix and, of course, in pain and discomfort and embarrassment.”

A coordinated federal approach to the problem would not only cut waiting times, it would also save money, according to Dr Dooland.

“Most of the dental care provided to low-income adults — pensioners, unemployed and such — is funded by the states,” he said.

“The Commonwealth in the last few years has been topping that money up, but the Commonwealth and the state money put together is only enough to treat one fifth of the eligible group.

“I’m sure politicians and health bureaucrats have lots of people telling them that story — that if you put resources into oral health you will save funding expenses in the acute hospital system — but it is a fact.

“It is a mystery to me why decision makers can’t look at their own data and see what is happening.”

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