The Australian Greens, as part of its agreement with the Government, have initiated a proposal for a national dental health program, called Denticare which will include dental treatment in Medicare and make it part of the public health program.

WHAT WILL DENTICARE DELIVER TO AUSTRALIANS?

  • Dental treatment covered by Medicare. Phasing in over five years, Medicare will cover preventative and restorative dental treatment so that everybody can afford to go to the dentist.
  • Assistance to those most needing it. Low income earners, kids and teens, pensioners and those with chronic disease will be among the first to access dental treatment under Medicare.
  • Investment in the public dental system. Injecting much‐needed funds into the public system to decrease waiting lists and to revamp school dental programs.
  • More dentists and dental nurses. To ensure that Australia has enough dental health professionals in the places they need to be, we propose increasing investment in dental training and placement.

Poor dental health is a major health problem for Australians, particularly the less well off, and for Australian in general. Poor dental health causes, not only significant pain and suffering for many Australians, but also causes a range of more general health problems, as well a large cost in lost working days, school absenteeism and related social issues. Key problems are:

  • More than half of all Australians have poor dental/oral health
  • Many Australians are unable to afford to visit the dentist. A third of people say they can’t afford to go to the dentist, or delay going to the dentist because of the cost.
  • An estimated 500,000 people are on waiting lists for public dental care, with average wait times of 27 months and in some cases more than 5 years.
  • Poor dental health creates a range of other illnesses. 7‐10% of GP visits are due to poor dental health.
  • More than 60,000 hospital visits a year are caused by dental problems.
  • Low income earners, people in rural and regional areas, and Aborigines have worse dental health. For example, between the ages of 16 and 20, Aborigines have 8 times the non‐indigenous rate of decay.
  • Complications from untreated dental disease already cost Medicare $350m a year and the hospital system at least $100m more. It is estimated that up to $2 billion in lost productivity is attributed to dental problems.

POOR DENTAL HEALTH IS NOT JUST ABOUT BAD TEETH

Untreated dental disease results in an unnecessary burden on the health system: Up to 10% of GP visits are due to poor dental health.

Australia could avoid more than 60,000 hospital visits a year which are caused  by dental issues4. This costs the country approximately $500m in direct costs and up to $2 billion in lost productivity every year.

Among the diseases and problems that are known or thought to be exacerbated by poor dental health are heart attack, low birth weight in babies, diabetes, and cerebrovascular disease (CVD) or stroke.

For example a study by the University of Columbia  and AETNA found found a relationship between periodontal (gum) treatment and the overall cost of care for several chronic diseases. The results of the study, which included approximately 145,000 Aetna members with continuous dental and medical coverage, indicate that periodontal care appears to have a positive effect on the cost of medical care, with earlier treatment resulting in lower medical costs for members with diabetes, coronary artery disease (CAD), and cerebrovascular disease (CVD) or stroke.

It stated: "The results of this study are encouraging because they show the connection between good oral health and overall well-being, as well as illustrating that the early treatment of periodontal disease can help reduce medical costs for these conditions," said Pat Farrell, head of Aetna Specialty Products. "We believe that in addition to lowering medical costs, we are also helping to improve members’ quality of life. We will continue to work with Columbia to demonstrate ways that dental care can improve the overall health of our members."

Poor dental care can have a major impact on children's health and well-being.

The British Dental Journal stated (http://www.nature.com/bdj/journal/v201/n10/full/4814259a.html):

"The effect of a relatively common chronic disease, severe dental caries, affects young childrens' growth and well-being. Treating dental caries in pre-school children would increase growth rates and the quality of life of millions of children."

Among the the issues discussed were that:

  • Following treatment of affected decayed teeth there is more rapid weight gain and growth velocity in the treated children.
  • Children with untreated early childhood caries (ECC) have significantly poorer oral health-related quality of life than children without ECC.
  • Comprehensive treatment in pre-school children makes a very significant difference to the psychological and social aspects of the child's life.

The impacts on children are widely reported. As an example the World Health organisation noted: (http://www.who.int/bulletin/volumes/83/9/editorial30905html/en/index.html)

"Ninety per cent of pre-adolescents reported an impact related to oral health (6). Prevalence of dental pain was found to be about 33% among Brazilian teenagers, of whom 9% reported distressing, excruciating pain (7). Toothache leads to school absence, which is a ready indicator of children’s health. In the USA, where caries is lower than elsewhere, visits or dental problems accounted for 117 000 hours of school lost per 100 000 children (8). Because most school dental services work mainly during school hours, loss of schooling among the poor, who have higher caries rates, is high."

HEART DISEASE

The evidence linking poor oral health with heart disease has been growing over the past 15 years. A study released in April this year, found that a person with fewer than 10 of their own teeth is seven times more likely to die of coronary disease than someone with more than 25 of their own teeth.

Scientists are investigating the role that dental bacteria might play in heart disease. Studies show that people with greater exposure to the bacteria that cause periodontal (gum) disease are at increased risk of heart disease.

Professor Hanny Calache, Director of Clinical Leadership, Education and Research at Dental Health Services Victoria (DHSV), said there is also a known link between poor diet and heart disease.

“People who don’t have enough teeth to chew well, will avoid eating raw fruits and vegetables which reduces their intake of fibre and Vitamin C. Studies show that this increases the risk of cardiovascular disease,” said Hanny.

The good news is that eating a healthy and balanced diet of fresh fruit and vegetables, lean meat, fish and wholegrains, drinking plenty of tap water, and avoiding sugary foods is good for both your oral and heart health. (http://www.dhsv.org.au/news-stories/2010/04/30/evidence-links-heart-disease-and-oral-health/)

For more information:

www.greensmps.org.au/denticare

Senator Richard Di Natale, Ph: 03 96202966