Ending the medical-dental divide in Australia 171



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Our teeth are one of our most crucial parts of our body – and one of the most expensive to fix. With dental care not a bulk billed health service, it can hurt our pockets more than surgeries and even cancer treatments.

Dr Lesley Russell from the Australian Primary Health Care Research Institute believes it is time that medical and dental practitioners combined forces to begin a decline in tooth decay and oral disease in Australia once and for all. It is a critical area of concern yet it feels like it has been years since the government has taken notice.

She said that “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”, and how true this is. As most of us know, if you have a dental issue, it can be difficult or even impossible to have surgery on another part of your body. This means there can be dire consequences for those of us who are struggling to make ends meet as it is and cannot afford expensive dental care.

Oral disease can ravage the rest of the body as it is connected to the rest of the body, leading to physical illness and trauma – a fact that many medical practitioners and even the government ignores.

According to a recent report from the Australian Institute of Health and Welfare (AIHW), our dental health has not improved in recent years. In fact, children’s baby teeth are affected by decay more than ever, as are the total adults experiencing oral problems. Over one third of adults have untreated decay and over 50 per cent of people 65 years old and older have had gum disease, with a further 20 per cent having lost one or more teeth.

Dr Russell wrote in her article in the Medical Journal of Australia that untreated dental caries and oral disease cause eating and speaking difficulties and disrupt sleep and productivity. “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”, she said.

Oral problems go further than affecting our overall health – they can even impair our appearance and speech so much that we may lose confidence and inhibit our ability to seek employment or interact socially.

As a nation, we spent $7.857 billion on dental treatment in 2010 and 2011, with care costs exceeding $1 billion. So how can we end the medical-dental divide?

Dr Russell recommends five measures:

  • 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”.


What do you think? Should dentistry and medicine be considered one of the same? Do we have a national issue in your eyes? How have your dental issues affected your life? Tell us below.

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  1. Yes totally agree, i havent bwen to a dentist for years, out of my budget, the doctors who do not bulk bill, you need to pay first , so i just miss out until i save enough money, heaven forbid i get really sick, $80 for up front fee, i know we get $37 dollars, but who carries this amount cash around these days, dentist and doctors should all be on bulk bill medicare, we dont mind paying a small up front fee but who else earns $80 per 10 minutes work

    9 REPLY
    • Tradies earn nearly as much as a doctor. They certainly earn more than a pharmacist (who also does a lot of study & also has care for people’s health)

    • Doctors appointments are 10 min (if you are lucky) x 6 per hour can only discuss one problem a visit, i have gone without blood pressure tablets because i couldn’t afford a visits to the doctors for scripts, i can walk so i can post pone getting the car fixed. We all have money issues but health is something that everyone should be able to access at a small cost, i am not talking about free ride just income tested

    • This doesn’t allow for overheads, room rental, rates, staff, utilities, medical equipment……

    • Doctors have years of learning, long hours, major responsibility for life and death decisions. I am not a doctor but if you feel that your doctor is not value for money ask around and try another one.

    • Working as a practice manager for a group of GPs the one thing everyone forgets is our overheads. All our equipment is extremely expensive, we don’t charge for dressings when we use dressings on patients, an autoclave to sterilize our equipment can cost $5500, a defibrillator $2500 and don’t forget the insurance doctors have to pay, I can go on. The Medicare rebate, if we are lucky, increases by half the CPI each year but there has been a hold on the rebate increase since Labor came in and now the Liberals have told us their will be no increase until 2018! Doctors cannot afford to bulk bill any more. My GPs do NOT do 10 minute appointments. Our patients are NOT pushed out the door but are given the time needed for what they have come for which on sees our doctors running behind on a regular basis. My doctors on a daily average spend at least an extra two hours worth of unpaid paperwork for their patients. My daughter wants to do medicine but at this rate what incentive does she have. I remember a comment made by Julia Gillard when she was health minister: doctors earn plenty of money, who is she kidding with her parliamentary super etc ! Australia needs to wake up and realise healthcare cannot be free any more.

    • Healthcare is not free. It is paid for with our taxes & everyone who spends money in Australia pays tax.

  2. Good article. I agree – was talking about this issue yesterday. Being single I cant afford dental. Is either my teeth or travel. FYI your site keeps crashing

  3. Defiantly agree
    Something has to be done
    A trip to the dentist used to put fear in us as kids
    Now as adults the fear is not the pain it’s the cost
    Dental treatment is vital to good health
    So many links of oral neglect are linked to many medical conditions and as such cost the government in the long run
    Wake up Australia !!
    Tell the politicians WHAT WE NEED…

    2 REPLY
  4. I’ve never understood why our mouths are treated differently to the rest of our bodies. Dental care should be treated under medical care, anything necessary for health and wellbeing should be covered, anything cosmetic at the individual’s own expense. Simple!

  5. Yes I agree, I have to have dental work done and being on a disability pension getting the money together is near impossible so I joined an extras health fund and pay fortnightly so I can get some work done, either way dentistry is very expensive

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