Pediatric Tooth Decay Vexes Australia as Government Debates Care



Pediatric tooth decay is a growing worldwide epidemic, as a University of Adelaide study reports that 40% of children ages 5 to 10 in Australia have decay in their primary teeth, and a quarter of these children have never gotten any treatment for it. Yet there is a debate in the nation over how best to provide care for these vulnerable populations.

“The prevalence of tooth decay was similar to other comparable countries, such as the United States and New Zealand,” said Associate Professor Loc Do. “But the prevalence of untreated decay was somewhat higher in Australia.”

The results come from the National Child Health Survey 2012-2014, which used data from more than 24,000 children ages 5 to 14 in each state and territory. The survey was a joint project of the Australian Research Centre for Population Oral Health at the university’s school of dentistry and state and territory dental services.

Furthermore, the survey found that these children have an average of 1.5 primary teeth with decay. Also, more than a third of children ages 9 to 14 had decay in their permanent teeth, and one in 7 in the age group hadn’t been treated previously for it. Overall results varied depending on the state and territory and on the socioeconomic status of the child’s family.

“Children from Queensland and from the Northern Territory had the highest prevalence and severity of tooth decay,” said Do. “Data in Queensland was collected at the start of the expansion of water fluoridation and the start of the survey (2010-12), so it was too early to see the positive impact of drinking water fluoridation.”

Generally, children from low socioeconomic backgrounds and indigenous children had significantly higher tooth decay rates, poor dental and general health habits, and unfavorable patterns of dental visits. While the National Oral Health Plan aims to have 100% of children see a dentist, one in 9 children has never had a visit.

“Significantly more children in the lowest-income households had unfavorable dental attendance. This income-related gap in dental visiting patterns has widened over time,” said Do. “We would like to see regular dental checkups as a matter of course to help children and their families to prevent tooth decay and treat oral health problems promptly.”

The results of the study come at a controversial time in Australian oral care. In January 2014, the federal Child Dental Benefits Schedule (CDBS) began allocating up to $1,000 during a 2-year period to families who receive Family Tax Benefit Part A, Parenting, or Double Orphan Pension payments to spend on preventive dental services.

The program has since provided more than 9.7 million services. Also, 80% of CDBS services have been in the private sector, with 97% bulk billed at no cost to families. Yet the government announced in March that only 30% of the nation’s 3.4 million eligible children had been accessing the program.

Now, the government is proposing replacing the CDBS with the Child and Adult Public Dental Scheme, promising a 5-year, $2.1 billion plan. The government will pay states and territories, which then will be responsible for administering care to improve waiting times and help more low-income concession card holders.

According to the government, coverage will expand to all children younger than the age of 18 as well as to 5 million low-income adults. It also will include an expanded range of Commonwealth-subsidized, clinically necessary treatment not covered by the CDBS.

“We are significantly increasing Commonwealth investment in frontline public dental health services, and we expect the result to be an extra 600,000 public dental patients treated every year as a direct result,” said Sussan Ley, minister for health.

The Australian Dental Association opposes these changes. The group attributes the CDBS’s low turnout to ineffective promotion and unrealistic initial targets. Also, it says the new plan represents a funding cut that will burden dental services and patients alike. It has since launched a campaign to save the CDBS.

“The state and territory public sector dental services are already overextended with waiting lists of between 9 months to 3 years, depending on which state you consider,” said association president Dr. Rick Olive. “What is happening is the government is promising delivery but it is doing it in such a way that the services will not, in fact, be accessible. It’s smoke and mirrors.”

The July 2 Federal Election in Australia will determine all 226 members of the 45th Parliament. Once the new government has been established, it will decide whether or not the CDBS will continue or if the Child and Adult Public Dental Scheme will be implemented.

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