Over the last decades, clinical practice in oral health, home care and fluoridation has lead to significant improvements in oral health.43 This is a positive outcome which reflects long–term progress in dental care and prevention. Despite these improvements, the majority of the population visit a dental practitioner less frequently than may be clinically appropriate. The major causes of this are the lack of affordable access to private services for people on below average incomes and the lack of timely care for concession card holders in the public sector due to inadequate funding. Additionally, some areas of Australia still do not have fluoridated water, thereby increasing the risk of poor oral health.
43 Peterson, P.E. and Lennon, M. (2004), ‘Effective use of fluorides for the prevention of dental caries in the 21st century: the WHO approach’, Community Dental Oral Epidemiology, Vol 32, pp.319–21 and McDonagh, M.S., Whiting, P.F., Wilson, P.M., Sutton, A.J., Chestnut, I., Cooper, J. et al. (2000), ‘Systematic review of water fluoridation’. Bridge Medical Journal, Vol 321. pp.855–9.
Adult visiting patterns highlight two distinct groups in the community. The first is the 39 per cent of people with favourable visiting patterns who access services focused on prevention and the early treatment of problems. This group predominately uses the private sector – an arrangement that works well. However, for the majority of the population unable to access the private sector, or with long waiting times in the public sector, current arrangements are inadequate. For this group visits are less frequent and fall outside accepted clinical recommendations, leading to greater risk of poor oral health.
This separation is evident across adults and children and can lead to very different oral health outcomes. While children’s visiting patterns are high across the population, recent increases in caries in children highlights the need to refocus efforts to reduce the prevalence of dental decay, particularly in the minority of children who suffer the greatest burden of disease.
Poor oral health has an impact on individuals in terms of overall health, pain and social exclusion. Poor oral health also has broader economic impacts in terms of economic loss and the impact on Commonwealth and State and Territory government expenditure − with funds allocated to the treatment of complex problems in hospitals and visits to GPs and pharmacists for treatment of pain and infection.