The health and wellbeing of people living in rural and remote Australia is adversely affected if they are suffering from a toothache, sore gums or ill-fitting dentures. As a dentist who owns a practice in Central Queensland, I see many patients who have been avoiding dental care due to fear, accessibility issues or cost.
The COVID-19 pandemic made people’s oral health status even worse as dental practices were closed during outbreaks, some dental staff have not returned, and waiting lists for treatment have grown longer in both the private and public sectors. In some areas of Australia right now, waiting periods for public dental services are over three years.
Dental practitioners are not evenly spread across Australia – private dental practitioners are concentrated in more affluent suburbs in capital cities. Dentists and dental specialists comprise 80 per cent of the dental practitioner workforce, while dental prosthetists, oral health therapists, dental therapists and dental hygienists make up the remaining 20 per cent. Non-registered dental workers in the industry include dental assistants, practice managers and dental technicians.
Attracting and retaining these health workers to rural and remote areas of Australia is a challenge.
In rural and remote Australia, publicly funded dental services may be provided by state and territory governments (albeit with long waiting lists), the Royal Flying Doctor Service (RFDS) or Aboriginal Community Controlled Health Organisations (ACCHOs). Sadly, these services are also not evenly spread across the country.
Apart from geographical access issues for people living in rural and remote Australia, the cost of dental treatment is also an access barrier, as 80 per cent of dental services are offered in the private sector. For adults, dental care is not part of Medicare (apart from Veterans’ Affairs clients), aged care, home care or the National Disability Insurance Scheme (NDIS). For people with mental ill health, access to timely and affordable dental care is exceedingly difficult. If anyone misses a health check-up, it is always dental care.
Oral health care and mental health are interconnected. People with poor oral health or appearance suffer from huge self-confidence issues – avoiding social interactions, education and job opportunities – and have poor eating habits. Misalignment or discoloration of teeth, loss of tooth structure, tooth decay, loose teeth and gum issues lead to functional and aesthetic challenges for a person. For people living with mental illness, poor oral health can make their lives more challenging.
With an increase in living costs, lack of oral care education and poor eating habits, dental decay and gum problems are on the rise, and dental practitioners and companies are exploring innovative and technological ways of providing oral health care. These include mobile dental services (RFDS), teledentistry services (Pacific Smiles Dental) and oral-health screening via smartphones using artificial intelligence (Smilo.ai).
Instead of waiting for patients to attend dental appointments, dental practitioners are also engaging with community members via blogs, social media, SMS text messages and in person at various events and exhibitions around the country.
In a post-COVID-19 environment, we need to find other ways to raise awareness, expand educational efforts and increase people’s access to dental care.