Victorian Oral Health Alliance Blog

Budget fails public dentistry

2008-05-07T13:31:00.000+10:00

The Victorian State Budget does nothing to address some of the worst gaps in the Victorian health system, according to the Victorian Oral Health Alliance (VOHA).
VOHA Tony McBride spokesman said today that the Budget fails thousands of Victorians most in need of immediate dental care, “bordering on wilful neglect”.
He said the Budget offers less per person this year. Mr McBride said that the unchanged dental treatment targets are an effective decrease 3.45%.
To read VOHA's media release, click here.

State-wide general dental waiting list up slightly

2007-12-10T09:59:00.000+11:00

There were 112,337 Victorians waiting for general dental care at the end of last June, according to the 2007 DHSV Quality of Care Report, Reasons to Smile. The previous year there were 110,579 people waiting for general dental care – a 14% fall from 2004-05 (168,366). The agency's Annual Report outlines a number of achievements during 2006-07:

Providing treatment to 304,565 patients – a 1.4% increase on the previous year
Of these, DHSV treated 125,781 patients directly, with the remainder being treated by community dental agencies and private sector providers
The Royal Dental Hospital of Melbourne’s emergency department saw 17,951 patients – a 16.4% increase

NHMRC reaffirms support for fluoridation

2007-11-20T14:18:00.000+11:00

The National Health and Medical Research Council, Australia's peak health science research body, has recently issued a Public Statement on The Efficacy and Safety of Fluoridation 2007 reaffirming its support for this major disease prevention measure.

The updated NHMRC recommendation reads:

"Fluoridation of drinking water remains the most effective and socially equitable means of achieving community-wide exposure to the caries prevention effects of fluoride. It is recommended that water be fluoridated in the target range of 0.6 to 1.1 mg/L, depending on climate, to balance reduction of dental caries and occurrence of dental fluorosis."

Victorian dental waiting list data updated

2007-10-18T15:31:00.000+10:00

Waiting times for public dental care as at June 2007 were recently updated at the Your Hospitals website, published by the Department of Human Services.

The VOHA website has now collated all of the new data, and provided summaries and graphs which provide a much clearer picture of trends and the overall situation.

While there have been improvements at many clinics, the average waiting time across the State remains at just over 23 months, and patients in some areas still experience waiting times of 4 to 5 years.

Dental report card - Federal Election 2007

2007-10-12T14:51:00.000+10:00

A report card on the dental policies proposed by the major parties participating in the forthcoming Federal Election has been published by the ADA Inc.

The National Oral Health Alliance, representing a range of professional. community, welfare and consumer groups, issued a media release on 18 September which called for all parties to:

As a first step, ensure that all people on concession cards have a free basic course of dental care every 2 years;
Provide the funding for this initiative through the States and Territories on the condition that the States and Territories bring their own expenditure up to the new level of Commonwealth funding, extend water fluoridation to all communities, ensure that all children and eligible adults receive one course of general oral health care every two years, and ensure that no one waits longer than 24 hours to receive emergency dental care for swelling, infection and bleeding, or serious and persistent pain;
Conduct a full national review of the current oral health workforce.

Duelling dental programs

2007-09-20T17:48:00.000+10:00

The Federal Opposition has announced that a Labor Government would reinstate the Commonwealth dental program at a cost of $290 million over three years. The ALP suggests that this program would create up to one million additional dental sessions over this period.

Under the scheme, the money would be given to the States and Territories enabling them to supplement existing public dental services or buy private sector appointments for public patients. Currently about 650,000 people are on public dental waiting lists.

The Coalition’s dental program gives Medicare funding for dental care in the private system for people with chronic health conditions that affect their oral health and the elderly. It is costed at $385 million over four years - which is roughly the same annual allocation as is offered by the ALP scheme.

ADA’s Federal President, Dr John Matthews, said there were merits in both plans but questioned the capacity of Labor’s scheme to provide one million more visits.

The National Oral Health Alliance called on all parties to ensure that all concession cardholders had a free basic dental care every two years, extend water fluoridation to all communities, and conduct a national review of the oral health workforce.

Children's Television Advertising Standards Review

2007-09-17T10:33:00.000+10:00

The Australian Communications and Media Authority (ACMA) has published public submissions in response to their review of the Children’s Television Standards (CTS) at their website.

According to the ACMA, this review "aims to ensure that the CTS are operating effectively in the current environment and to identify the building blocks required to position the CTS for the future media environment".

A number of organisations associated with the Victorian Oral Health Alliance have made submissions to this review, with special emphasis on banning junk food advertising to children, and copies of these can be accessed at the ACMA website. Look for submissions by the Coalition on Food Advertising to Children, the Australian Dental Association, VicHealth, and Choice, amongst others.

Dentists too thinly spread in rural Australia

2007-08-31T09:26:00.000+10:00

The Australian Dental Association issued a media release yesterday calling on the Federal Government to do more to address the maldistribution of the current dental workforce, which is negatively impacting on the delivery of services in areas of need such as in rural, regional and remote parts of Australia.

Key recommendations in the release are as follows:

"The ADA calls on the Commonwealth Government to take the following steps to alleviate dental workforce shortages in regional, rural and remote parts of Australia:
• Fund an optional clinical placement year for graduating dentists (University and overseas trained dentists). This placement year, to be served mainly in the public dental sector (although some private rural placements should be considered in areas of special need) would increase access to dental care for public sector patients and significantly reduce waiting lists. The ADA believes in a clinical placement year but acknowledges this will require additional infrastructure and mentors.
• Create further scholarships for dental students from rural and remote parts of Australia to encourage graduates to practice in these areas.
• Extend the general practitioner and medical specialist relocation program to dentists. (This program offers financial grants for GPs and medical specialists to relocate to areas of medical doctor shortage.) Currently, “doctors can apply for grants of up to $30,000 to establish a new practice, or up to $20,000 to join an existing practice in an area of doctor shortage”.
• Create a moratorium or debt forgiveness on all dental graduates who in turn agree to provide their services in regional, rural and remote areas or in the public sector. The extent of the moratorium or debt forgiveness could reflect the period of time the dental graduate undertakes practice in these particular areas. The longer the period of guaranteed service in regional, rural or remote areas, the greater the moratorium or debt forgiveness.
• Provide accommodation assistance to enable under graduate students to attend rural clinics as is in place for medical students."

VicHealth chief calls for junk food ad ban

2007-08-20T15:19:00.000+10:00

Todd Harper, CEO of VicHealth, is reported in the Sunday Age yesterday calling on the government to legislate to ban junk food advertising in the interests of addressing the obesity and diabetes epidemics.

The same risk factors leading to increased rates of obesity and diabetes also contribute to dental decay, and three member bodies of the Victorian and National Oral Health Alliances, the Australian Dental Association, Australian Dental & Oral Health Therapists Association and Public Health Association of Australia, are also participants in the Coalition on Food Advertising to Children.

According to their website, "This coalition includes many key Australian health and consumer organisations, and is calling for a marked reduction in the commercial promotion of foods and beverages to children under 14 years old. The first step they advocate is to extend the statutory regulations to prohibit all television food and beverage advertising during programs where children make up a significant proportion of the viewing audience. This does not preclude the promotion of healthy eating messages to children through non-commercial social marketing".

The Pull the Plug on Food Advertising campaign is being run to help make the job of parents easier, and to give our kids a healthier future.

Register Online - Sign on to the Pull the Plug campaign

For more information visit http://www.chdf.org.au/foodadstokids/

Government extends EPC dental scheme

2007-08-14T14:10:00.000+10:00

Federal Health Minister Tony Abbott announced today that eligible patients receiving dental treatment under the Enhanced Primary Care (EPC) Scheme would now receive up to $4250 worth of Medicare funded care over two consecutive years.

This news was welcomed by ADA President Dr John Matthews, who said "the ADA had understood that the Enhanced Primary Care program would provide eligible patients with a rebate of $2000 per annum. The announcement of the rebate being $4000 over two years will enable a more comprehensive delivery of dental treatment to help those patients more effectively deal with the complications of chronic illness."

While the ADA welcomed the increase, it also expressed concern that funding has not been targetted to the financially disadvantaged and particularly those 650,000 on dental waiting lists. Similar concerns were also expressed by the Opposition.
These new Medicare EPC arrangements are due to commence from 1 November 2007, subject to the passage of legislation. The new dental service arrangements involve an estimated cost of about $380m over four years.

ADA Inc calls for elderly not to be ignored

2007-08-10T16:59:00.000+10:00

The Australian Dental Association has urged the Government to address the oral health needs of Australia's elderly following the National Seniors Australia (NSA) launch of its election priorities in Parliament House.

In a media release issued today, ADA President Dr John Matthews noted that "for people aged over 65 years, the prevalence of tooth decay, gum disease, dry mouth and oral cancer, is higher than for the general population. Frequency of teeth extractions associated with gum disease also increases with age. Access to dental care can become more difficult as people get older, while oral diseases have the potential to impact negatively on older people's general health and social functioning."

Dr Matthews said; "It's time for Governments to take responsibility and implement the range of initiatives outlined in Australia's National Oral Health Plan, signed off by all government Health Ministers, to improve older people's oral health."

New research on access to dental care

2007-08-03T12:39:00.000+10:00

A new survey on access to dental care, released by Australia Fair, has revealed that:

90% of people think that regular visits to the dentist are important to maintain healthy teeth and mouths;
23% of people say they haven’t seen a dentist in over 2 years;
46% of people reported that it would be difficult for them to pay for basic preventative treatment ($300) today;
75% of people stated that the Federal Government must at least share the funding for dental care and only 5% think it is State Government responsibility alone;
46% of people stated that the cost of dental care influences their decision to see a dentist regularly.

The Australian Council of Social Service (ACOSS) is a participating body in Australia Fair, and ACOSS Executive Director Andrew Johnson said, "This research reinforces the fact that Australia has a crisis in access to dental care, particularly for low income and disadvantaged Australians."

Australia Fair has also released a broadcast-quality clip on You Tube, an online letter which Australians can e-mail to their Federal MPs asking for Federal Government support for dental care for people on low incomes, and a participation kit for local groups to find out more about oral health.

Physicians say "put the mouth back in the body"

2007-07-11T16:00:00.000+10:00

The Royal Australasian College of Physicians (RACP) recently issued a media release calling on state and Federal governments to "finally realise that the mouth can no longer be excluded from the body, and that oral health cannot be separated from health in general".

Professor Stephen Leeder, RACP spokesperson and co-director of the Menzies Centre for Health Policy said health policies, including health financing, needed to take account of this reality.

“There is increasing research and awareness of the connection between oral and general health,” he said.

“The failure to treat dental problems can lead to, or exacerbate, other illnesses elsewhere in the body. For example poor oral health has been linked to arthritis, coronary heart disease, diabetes and cardiovascular disease to varying degrees.

“And for children, dental caries is the single most common chronic childhood disease."

“There’s a contest at present between the States and the Commonwealth as to who should pay for public dentistry. We have yet to care for the hundreds of thousands of people waiting for treatment in public dental services. The oral health care scene in rural areas is especially troubling.”

“The RACP clearly perceives the unity of physical and dental health,” Professor Leeder said.

“The public dental workforce at present often faces the demoralising task of extracting rather than saving teeth, because by the time patients get to see them, it is too late for dental restoration.”

Professor Leeder’s comments were based on two dental health policy papers commissioned by the Menzies Centre in recent years from Professor John Spencer, Australia’s leading dental epidemiologist, in Adelaide.

“The various governments must also re-think how the dental workforce is trained and used and how problems can be fixed now and in the longer term.”

The RACP encourages COAG to confront the problems of oral health funding and workforce as a combined State/Commonwealth issue.

Sunday Age editorial supports Labor dental plan

2007-06-03T19:56:00.000+10:00

The Sunday Age today published an editorial supporting the ALP commitment to establish a national dental program which would directly address the treatment needs of an estimated 650,000 people on dental waiting lists around Australia.

The editorial accompanied a news story 'Smile - it's free dental care', in which Shadow Health Minister Nicola Roxon reportedly said that helping the states clear the 650,000 people currently on state government waiting lists had to be part of the solution to the dental crisis.

"Those waiting lists need to be cleared and we will provide assistance to the states to do that," she said. "We can't just set up a Commonwealth system to complement the state system without acknowledging that this is a crisis.

"They are all the same people to us — ordinary Australians who need dental care and we see it as our obligation to help them."

Costings for this Labor initiative are yet to be published.

Federal Budget - reactions to dental measures

2007-05-09T09:11:00.000+10:00

The Federal Budget’s $378 million dental health scheme received mixed reaction.

The Australian Dental Association welcomed the measures, especially the recognition by the Federal Government to assume a greater role in dental care delivery to Australians. But the Association said that too many Australians with dental problems have been ignored and are the losers as the measures don't go far enough.

ADA President Dr John Matthews said: “Australia has a maldistribution of dentists in rural and remote sections of the country and the Charles Sturt University proposal (to build a dental school), if successful, will go some considerable way to redress this maldistribution.” However nothing has been done to remedy the shortfall in the numbers of dentists in the public sector.

Carol Nader, of The Age wrote: “In Victoria, more than 140,000 people are on waiting lists for dental treatment. A bipartisan committee of federal MPs last year recommended that Canberra help the states pay for public dental services. While the federal and state governments play the blame game, in parts of Victoria patients wait years for dental treatment. In Moe, the wait is more than five years.

“The Federal Government has committed $378 million to help people see a private dentist — but only if they have a chronic health condition that is affected by their dental problems. The Government will allow patients to get up to $2125 a year in Medicare rebates for dental treatment, up from the current $77.95 for three dental sessions. The extra money is essentially an admission by the Government that the current scheme has failed. But while it says the new scheme will help treat 200,000 people over four years, it still won't help hundreds of thousands of people on dental waiting lists who do not have chronic health conditions.”

The President of the Australian Council of Social Services, Lin Hatfield Dodds, said: “ … while the Government has put some money into dental care and that’s good move, but none of that money is going to make a difference to the 650,000 Australians who are still on dental waiting lists tonight for an average of over two years”.

The Opposition’s health spokeswoman, Nicola Roxon, promised that a Labor Government would reintroduce a Commonwealth dental program. She said that the package was an admission that the dental care of Australian’s was the government’s responsibility but it was insufficient.

Federal Budget 2007 - dental highlights

2007-05-08T21:52:00.000+10:00

Key initiatives affecting dental services and the future availability of sufficient dental care providers, especially in rural areas, are outlined in extracts from the Federal Budget Papers below.

"Dental school — Charles Sturt University
The Government will provide $65.1 million over four years for the establishment of a new regional dental school at the Charles Sturt University, including the construction of residential accommodation for students.
The funding will provide for 60 additional dentistry places: 30 in a five-year dentistry course and 30 in a three‑year paradental course. Rural training encourages graduates to pursue careers in rural areas. "

"Dental training — expanding rural placements
The Government will provide $12.5 million over four years to improve rural access to dental services by expanding dental training in regional settings. This measure will provide clinical placements in rural training settings for up to 30 metropolitan dentistry students annually.
In addition, three scholarships per year will be established under the Puggy Hunter Memorial Scholarship Scheme to encourage Indigenous Australians to train in dentistry or in the allied health professions such as oral hygiene."

"Dental treatment — enhanced Medicare items for patients with chronic and complex conditions
The Government will provide $377.6 million over four years to improve access to dental items available on the Medicare Benefits Schedule (MBS) from 1 November 2007 for patients with chronic and complex conditions.
The expanded MBS items will provide for an initial dental assessment and subsequent dental treatments. Each patient will receive a $125 benefit for an initial dental assessment (up from $77.95) and benefits for subsequent dental treatments up to the value of $2,000 per year. The new items will be available to patients being treated under a general practitioner management plan and team care arrangements, or under a multidisciplinary care plan in an aged care facility. The items will be available where the person’s oral health is impacting on, or is likely to impact on, their chronic medical condition.
This measure includes $53,000 in capital funding in 2007-08 for Medicare Australia system enhancements."

VOHA Comments

While these measures are welcome, they will regrettably have negligible impact on public dental waiting lists which see hundreds of thousands of Australians waiting up to five years for access to basic dental care.

Dental waiting times in many Victorian areas are increasing again after significant improvements reported in the lead up to the recent State election.

If the Coalition was hoping these budget measures would take the dental crisis off the front page, they are likely to be disappointed.

Federal budget preview - dental care for chronically ill

2007-05-07T08:53:00.000+10:00

In a front page story in The Age today (Fifth-term fight ensures federal budget has bite) Michelle Grattan predicts that tomorrow's Federal Budget "will pour about $375 million over four years into fixing the teeth of those with chronic illnesses. This will help 200,000 people and take some pressure off state waiting lists for acute dental care".

This outcome is a tribute to the National Oral Health Alliance campaign in which ACOSS and the ADA led a very broad coalition of organisations from the welfare, community and dental professional sectors to obtain increased resources to address waiting lists of up to five years for access to public dental care.

Ms Grattan's story also notes that:

"The dental money is a response to strong Coalition backbench pressure to do something on dental health and Labor's promise of a dental scheme.
At present, people whose chronic illness includes dental problems can only get three visits a year covered by Medicare. This is often inadequate to give them proper care.
However, the states will still be left with a big dental problem because the change will not cover people who have trouble with their teeth but not a chronic illness."

More detailed analysis and response awaits the formal presentation of the budget tomorrow.

Vic Budget's dental increase quietly welcomed

2007-05-03T20:16:00.000+10:00

The State Government's Budget announced on 1 May provides $138 million of dental services - an increase of $8 million.

The Victorian Oral Health Alliance (VOHA) welcomed:

$1.5 million to fund fluoridation of water in rural Victoria;
$1.5 million to establish a dental school at Bendigo; and,
additional funds for dentures for older Victorians living in supported residential facilities.

However VOHA members felt that a lot more could be done to help Victorians, especially 100,000-plus people on the public dental waiting lists.

The alliance now awaits the Federal Budget to see if the Commonwealth Government can further help improve the oral health of disadvantaged Victorians.

Acute dental problems put people in hospital - report

2007-04-20T13:55:00.000+10:00

Dental conditions are one of the major contributors to hospitalisation for acute conditions, according to a report released today.

The report says that dental conditions account for 7.9% of the avoidable admissions, involving almost 44,000 people.

Dental conditions were the third highest cause of avoidable hospital admissions for children aged 0-10 years, with only asthma and ear, nose and throat infections experiencing higher rates.

Released by the Australian Institute of Health Welfare, the report - Atlas of avoidable hospitalisations in Australia: ambulatory care sensitive conditions - looks at the level and extent of regional variation in a sub-set of avoidable hospitalisations: ambulatory care-sensitive (ACS) conditions. ACS are certain conditions for which hospitalisation is considered avoidable through preventive care and early disease management.

In 2001-02 admissions for ACS conditions accounted for 8.7% of all hospital admissions. This equates to more than 552,000 admissions, all of which are potentially avoidable. One of the key findings is that people in the most disadvantaged areas had 61% more hospitalisations for an ACS condition than those in the least disadvantaged areas.

ACOSS wants $160 million for dental checks

2007-04-18T16:47:00.000+10:00

The Australian Council of Social Service (ACOSS) today called on the Federal Government to spend $160 million on dental checks for low-income adults every two years. In its budget submission, ACOSS wants almost $3 billion for child care, indigenous health and other welfare initiatives.

Choice says evidence supports fluoridation

2007-03-22T12:35:00.000+11:00

Consumer magazine Choice is supporting fluoridated drinking water. After examining the present evidence relating to fluoride, the March edition concludes that "at present the evidence is very strong that it's a safe and effective public health measure".

The three-page report says:
* There's solid scientific evidence that fluoride added to drinking water helps to protect teeth from decay
* The claims of those who oppose fluoridation are often based on outdated information, questionable research, and selectively picking studies that support their case
* There's no convincing evidence for harmful effects from fluoride at the levels used in our water supply.

Choice also looked at fluoride toothpaste. The magazine says that clinical trials have shown that while fluoride toothpaste definitely helps prevent tooth decay, it isn't as effective a public health measure as fluoridated drinking water.

National Oral Health Alliance lobbies Parliament

2007-03-22T09:49:00.000+11:00

The largest and most representative oral health deputation ever seen in Australia descended on Canberra last Tuesday urging the Commonwealth Government to play a coordinating role and ensure that more resources are dedicated to public dental services and preventive programs.

The National Oral Health Alliance deputation of 85 people included representatives from 35 welfare, community and professional organisations.

Briefing sessions and presentations were delivered to the deputation by Health Minister Tony Abbott, Shadow Health Minister Nicola Roxon, and Senators Lyn Allison and Bob Brown from the Democrats and the Greens respectively. Members of the deputation then formed into teams to speak with many MPs from across the political spectrum.

The Alliance recommended these key 'solutions' to the oral health crisis affecting half of Australia's population:
1. The Commonwealth Government should ensure that all people on concession cards have a free basic course of dental care every two years. This preventive health measure would help improve the poor oral health of people on low incomes and lessen the number of tooth extractions and more expensive treatments needed.
2. The Commonwealth Government should provide funding for this initiative through the States and Territories, on the condition that the States and Territories:

bring their own expenditure up to the new level of Commonwealth funding
extend water fluoridation to all communities
ensure that all children and eligible adults receive one course of general oral health care every two years, and ensure that no-one waits longer than 24 hours to receive emergency dental care for swelling, infection, bleeding or serious and persistent pain

3. The Commonwealth should conduct a full national review of the current oral health workforce.

Very favourable responses were provided by MPs representing Labor, the Democrats and the Greens. Mr Abbott was supportive of the third recommendation but declined to involve the Commonwealth Government in a new partnership with the States to address the urgent need for improved oral health measures.

VOHA will publish details of any further developments arising.

National Survey of Adult Oral Health highlights need for national action

2007-03-19T12:42:00.000+11:00

An extensive survey by the Australian Institute of Health and Welfare has found that often disadvantaged people were three times more likely to have dental problems.

The report comments that the “pervasive nature of disadvantage is such that it calls for a range of interventions including efforts to tackle the root causes of disadvantage itself”.

The release of the survey – on Saturday at the Australian Dental Association’s (ADA) conference in Sydney – was timely, as representatives of a National Oral Health Alliance, which includes the Australian Council of Social Services and the ADA, will meet with the Federal Health Minister, Mr Abbott and other Parliamentarians, in Canberra tomorrow to discuss ways for disadvantaged people to see a dentist at least every two years.

The survey found that:

One-in-four Australians have untreated tooth decay
Dental care has remained “chronically under-funded” for the past decade
About 50% of adults have only “irregular” visits to the dentist
About The Federal Government spends almost as much on health insurance subsidies for private dental care ($438 million a year) as States spend in total on public dental services (about $500 million)
Using 2002 figures on public dental care spending, there would only have been enough money to provide every eligible person with one session of basic preventative care every five years
The introduction of fluoridated water and toothpaste had not “immunised” people born between 1967 and 1983 against decay.
20% said that cost had prevented them from having recommended dental treatment

The 2004-06 National Survey of Adult Oral Health was compiled after interviewing 14123 people aged 15 – 97 with 5505 people being dentally examined. The previous survey was conducted in 1987-88.

Today’s Sydney Morning Herald article 'Dental care is failing the needy', summarises the report.

Koori children face more decay

2007-03-02T15:17:00.000+11:00

A five year study reported in the March 2007 edition of the Journal of Paediatrics and Child Health shows that almost four out of every five Aboriginal children have decayed teeth or other oral health issues.

It showed that 78% of indigenous children under the age of 10 years have dental disease compared with only about 50% of other children.

Socio-economic disadvantage is considered the key factor in poor indigenous oral health.

VOHA has advocated the use of outreach services for Aboriginal communities, which are often located in regional areas. Our 2007 budget submission to the Victorian Government includes a specific proposal on this area of special need.

Waiting times - some better, some worse

2007-03-02T14:29:00.000+11:00

The VOHA website has now updated all of the Victorian public dental waiting times in the light of new information published by the Department of Human Services in the last week.

The bad news for 11 out of the Unlucky 13 rural areas is that their waiting times have deteriorated over a period of nine months (September 2006 versus December 2005).

Patients on the lists at Moe and Churchill clinics have 66 months to wait for treatment, those at Sale will wait 63 months and those in Warrnambool 58 months.

Two rural clinics in the Unlucky 13 have improved. Ballarat patients now only have to wait 47 months (down 6 months) while Portland patients have halved their wait time from 66 months to 33 months.

The bad news for metropolitan areas is that waiting times for dentures deteriorated at seven of the Unliucky 13 Metropolitan clinics. Patients waiting at eight of those 13 clinics will not receive their new dentures for three years or more.

The Minister for Health, Bronwyn Pike, issued a media release about the new waiting times yesterday.