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Dental divide harming Australians as decay sets in

It is time medical and dental interests combined to combat a rise in tooth decay and oral disease in Australians, says the author of a Perspective published in the Medical Journal of Australia. Dr Lesley Russell, a Visiting Fellow at the Australian Primary Health Care Research Institute in Canberra, believes the time has come to end the “medical-dental divide”.

“Medicine and dentistry remain distinct practices that have never been treated the same way by the health care system, health insurance funds, public health professionals, policymakers and the public”, Dr Russell wrote.

And yet, she wrote, “oral diseases can ravage the rest of the body and physical illnesses and trauma affect oral health”.

A recent report from the Australian Institute of Health and Welfare (AIHW) found that Australians’ dental health has not improved in recent years, with a rise in the average number of children’s baby teeth affected by decay and an increase in the number of adults reporting adverse oral impacts.

Nearly half of all children aged 12 years had decay in their permanent teeth, the report found. Over one-third of adults had untreated decay, over 50% of people aged 65 years and over had gum disease and over 20% of this age group had complete tooth loss.

Ultimately, “untreated dental caries and oral disease cause eating and speaking difficulties and disrupt sleep and productivity”, Dr Russell wrote. “Poor oral health has been linked to infective carditis, coronary heart disease, stroke, adverse pregnancy outcomes and aspiration pneumonia. Destruction of the soft tissues in the mouth can cause lasting disability and even death.

“Impairment of appearance and speech by dental disease may inhibit opportunities for education, employment and social interaction.”

Financially, she reported, $7.857 billion was spent on dental treatment in 2010-11 and additional care costs exceeded $1 billion.

Dr Russell recommended five measures to end the medical-dental divide:

  • make dental and medical professionals partners in delivering health care including shared training, recognition of dental services as a part of primary care and the inclusion of dental information on patient records
  • health promotion activities related to eating well, smoking, substance misuse, breastfeeding and chronic diseases to include oral health information
  • special oral care for frail older people, people with mental illness and those on certain medication regimens
  • private health insurers to reconsider caps on dental care
  • investment in a “Dental Health Service Corps made up of dentists and dental staff, doctors, nurses, community and Aboriginal health workers and public health professionals to take oral health services and education where they are needed”

“It is time for governments, health professionals, policymakers and community groups to put their money where their mouths are and act together to improve the oral health of all Australians, so that in the future the only gap-toothed Australian smiles are those indicating a visit from the tooth fairy”, Dr Russell concluded.


?Closing the dental divide, Lesley M Russell BSc(Hons), BA, PhD Visiting Fellow, Medical Journal of Australia, doi: 10.5694/mja14.01407, published 15 December 2014.

Source: Australian Medical Association (AMA)