Holes are appearing in our dental health system
Here is how to stop the decay.
Key Points
- Most dental treatment is not covered by Medicare.
- Cost is a barrier to older people seeking dental treatment.
- National Seniors calls for better-funded oral health for pensioners and those in aged care.
Two-thirds of Australian adults have not been to see their dentist in the past two years, and a quarter had not been in more than five years.
Of the 25,000 people surveyed by the Australian Dental Association at the end of 2021, one-third said they had postponed dental treatment since the pandemic.
Wait lists for public dental care can stretch for months.
The cost of dental treatment is a key reason. Most dental treatment is not covered by Medicare and bills at private clinics can quickly balloon into thousands of dollars.
Even for people with private health insurance, the rebates are often a small sliver of the overall cost of the treatment. With the rising cost of living, going to the dentist for preventative treatment can be one of the first things to be crossed off the expenses list.
Filling the Gap is a Sydney-based charity providing pro-bono dental treatment to people unable to access care through the usual channels.
The organisation links volunteer dentists with charities that assist refugees and asylum seekers, people experiencing homelessness, those going through drug and alcohol rehabilitation, and people who have experienced domestic violence.
It says our dental health system is not working and points to the waitlists of almost 100,000 people waiting for treatment in NSW alone.
For people needing dentures, the wait can often blow out to three years.
Senior Dentist Dr Sarah Raphael says because urgent and emergency treatment is prioritised, people needing preventative care fall down the list.
"It isn't a system that is working well enough for the people it should serve, and most of that boils down to funding." Medicare does pay for some essential dental services for some children and adults who are eligible.
A quarter of Australians over 75 have teeth affected by decay, while 20 per cent have complete tooth loss.
"Poor oral health is one of those chronic diseases that will show up later in life," Dr Raphael said.
"It's a slow burn. That is the problem. It takes a long time for it to impact you, and it might not cause too many acute problems right at the outset, but the fact that you have had had poor oral health all these years, it comes to a point where it might lead to diabetes, or cardiovascular disease, or other issues.”
Oral health was one of the issues raised in the Aged Care Royal Commission, which recommended the creation of a new Dental Benefits Scheme for seniors.
The scheme should minimise out-of-pocket payments for older Australians who live in residential care, receive the age pension, or qualify for the Commonwealth Seniors Health Card.
At last year's election, the Greens promised universal access to free dental care – a $77.6 billion pledge over ten years. But while Labor has committed to a long-term goal of expanding Medicare to cover dental health, there is no time frame.
In a 2019 report (also titled) Filling the Gap, the Grattan Institute called on the government to introduce a Medicare-style universal insurance scheme, which would cover primary dental care - for $5.6 billion a year. The Australian Dental Association is also calling for a senior dental benefits scheme to be introduced, in addition to the program that already exists, for children and teenagers under 18 whose families receive government benefits.
Poor oral health and the body
Untreated dental issues can have devastating effects on our overall health, including heart disease, diabetes, and even adverse pregnancy outcomes.
Gum disease – or periodontitis, where bacteria collects between the teeth and gums – has specifically been linked to heart disease.
It is important to look after your gums and teeth. The bacteria that infects the gums can lead to inflammation, and if left untreated, gum disease can eventually cause teeth to fall out.
People with periodontal disease are two to three times more at risk of experiencing a heart attack, stroke, or another cardiovascular issue, according to an article published by the Harvard Medical School. But according to the Australian Dental Association's survey, 66 per cent of respondents were unaware that poor oral health could impact medical conditions.
We have been advocating the government for years for such a system, providing basic dental care for pensioners, including those in aged care.
The dental care needs of people living in aged care have been neglected, as almost no access to dental care is provided.
We want a universal dental health care scheme for older Australians based on the Child Dental Benefits Scheme. This would provide pensioners access to an annual subsidy to help maintain their dental health and support the delivery of dental care to residents living in aged care.
Read more about our Fix Pension Poverty campaign and sign up on the National Seniors website.
For further reading: ABC, Filling the Gap, Probono Australia
