The burden of oral disease among rural and remote Australians is compelling, and yet, achieving timely access to appropriate oral health care in these areas remains elusive. Vulnerable and socio-economically disadvantaged groups, such as Aboriginal and Torres Strait Islander people, who rely on government-subsidised oral health care, are disproportionately affected by poor access. 

This brief synthesises evidence regarding the extent of access challenges, and the possible factors impacting on access. It shows that maldistribution of public dental services, long-standing shortage of public dental workforce, and frequent turnover among public dental professionals primarily contribute to the problem of oral health care access in rural and remote areas.  Integrating oral health promotion, screening and non-invasive preventive care provision into primary healthcare is considered to be an effective and efficient strategy to improve access to oral health care, especially in resource constrained contexts. In some rural and remote Australian settings, where oral health care has been integrated into primary healthcare, improvements in oral health outcomes have been achieved. Despite, integrated oral healthcare models are not widely adopted.  

The barriers to integration of oral health into primary healthcare in Australia include: 

• Limited oral health knowledge and skills among primary healthcare professionals and legislative and regulatory boundaries hinder their ability to provide oral health care.  
• Dissociated dental and general healthcare systems results in siloed activities, including limited opportunities for interprofessional collaboration; and a lack of robust data infrastructure to facilitate data reporting, management and sharing between dental and primary healthcare systems. 
• Oral health care is not covered under Medicare, which is particularly important for vulnerable groups in rural and remote areas. Where there is limited access to care for children and adolescents, the existing fee-for-service funding structure does not allow for primary healthcare professionals to participate in oral health care provision. 

Key considerations at the healthcare system, organisational, professional and clinical service delivery levels are highlighted. Building oral health competency of primary healthcare professionals, expanding primary healthcare professionals’ scopes of practice to include oral health care, identifying oral health as a core component of primary healthcare, supporting the development and implementation of innovative integrated models that include oral health care, prioritising infrastructure development to support interoperability and data sharing, and enhancing access to oral health care under Medicare will enable wider adoption of integrated oral healthcare models.