When Australians need to see a GP, Medicare picks up all or most of the bill. When they need to see a dentist, Australians are on their own. There’s no compelling medical, economic, or legal reason to treat the mouth so differently from the rest of the body. Australia should move towards a universal primary dental care scheme, funded by the Commonwealth Government.
Most spending on dental care comes straight out of patients’ pockets. As a result, people who can’t afford to pay don’t get dental care, unless they go on long (often multi-year) waiting lists for public care. About 2 million people who needed dental care in the past year either didn’t get it, or delayed getting it, because of the cost. Low-income people are most likely to miss out on care.
The consequence of this is widespread poor oral health. About a quarter of Australian adults say they avoid some foods because of the condition of their teeth; for low-income people, it’s about a third. Low-income people are more likely to have periodontal disease, untreated tooth decay, or missing teeth.
Bad oral health has painful and costly consequences. Evidence suggests oral health conditions can contribute to other health problems, including diabetes and heart disease. Most oral health conditions are preventable and get worse if untreated – people often end up going to a GP or hospital emergency department to be treated for conditions that could have been arrested with earlier care.
Existing public dental schemes are inadequate, uncoordinated, and inequitable across states. Most states have waiting lists of well over a year for public dental care – and if people need to wait a year for care, their conditions are only going to get worse.
The Commonwealth should take responsibility for funding primary dental care – just as it takes responsibility for primary medical care. Under a universal dental scheme, Australians could get the care they need, when they need it, without financial barriers.
It would be impractical to move to a universal scheme overnight. The cost would be large – around $5.6 billion in extra spending per year – and the oral health workforce would need to be expanded. So, the Commonwealth should announce a roadmap to a universal scheme, including plans to expand the workforce, followed by incremental steps towards a universal scheme.
The first step is for the Commonwealth to take over funding of existing public dental schemes, fund them properly to the tune of an extra $1.1 billion per year, and enable private-sector providers to deliver publicly-funded care. Coverage should then be expanded – first to people on Centrelink payments, then all children. After that, the Commonwealth should take the final step to a universal scheme, ideally within a decade.
Removing financial barriers to dental care would improve Australians’ oral health. This report shows how to fill the dental gap in our health system.