Current Issues in Health Care

Lecture 2 – Australia’s National Oral Health Plan

 2015-2024

Development of Plan
 Prepared by the Oral Health Monitoring Group
 Subcommittee of the Community Care and Population
Health Principal Committee
 Reports through the Australian Health Ministers’ Advisory
Council to the COAG Health Council
 This is the second plan and is based on the profile of the
oral health of the population, and findings from several
studies which indicate improvements over the last 20‐30
years, but still evidence of poor oral health among Australians.
 More than 90% of adults and 40% of young children have experienced tooth decay
at some stage in their life.
 Three out of ten adults have untreated tooth decay.
 Only four out of every ten Australian adults (39%) have a favourable visiting pattern,
i.e. seeing a dentist once a year for a check‐up, rather than waiting to treat poor oral
health.
 Aboriginal and Torres Strait Islander people and adults who are socially
disadvantaged or on low incomes have more than double the rate of poor oral
health than their counterparts.
 People with additional or specialised health care needs or those living in regional
and remote areas find it more difficult to access oral health care.
 Even though we have made progress, there are still challenges to address, which is
the purpose of the plan

Why a national oral health plan?

 If you don’t have a plan, it doesn’t matter what you do because you can go
anywhere. You will get somewhere, and by chance it may be where you want to go,
but mostly likely it wont be

Why a national oral health plan?

 Aim to improve health and wellbeing across the Australian population by improving
oral health status and reducing the burden of oral disease.
 Achieve this by helping all Australians to:
o retain as many of their teeth as possible throughout their lives;
o have good oral health as part of their general good health; because it is
related to general health and quality of life and
o have access to affordable and quality oral health services.
 Promote oral health and prevent disease
 Provide equitable access to oral health care.
 Deliver effective and efficient use of resources.

Themes: Four broad themes under pin the Plan:

  Recognition that oral health is an integral part of general health
 A population health approach, with a strong focus on promoting health and the
prevention and early identification of oral disease
 access to appropriate and affordable services – health promotion, prevention, early
intervention and treatment – for all Australians
 education to achieve a sufficient and appropriately skilled workforce, and
communities that effectively support and promote oral health

 Originally in the first but is also in the second oral health plan
 Reinforcement that oral health is an important part of health and cannot be
separated from health
 Concerns about mouth, teeth and dentures are related to quality of life, thus oral
health has an influence on how people perceive their quality of life – important
because it is telling us that oral health has to be improved to achieve good quality of
life

Emphasis on prevention
 Recognition of the importance of reducing oral health disparities and inequities in
access to oral health care
 In all areas, the Plan seeks to make the best possible use of resources, both human
and financial by:
o Basing actions on the best available evidence
o making effective use of the full oral health team (general and specialist
dentists, dental therapists, dental hygienists, oral health therapists,
prosthetists and dental assistants)
o building strong cooperation and partnerships across the health and
community services sectors and beyond, to address the socio‐economic
factors that determine general and oral health

Reduction of inequalities
 ‘Reduce the prevalence, severity and impact of poor oral health AND inequalities in
access to Oral health treatment’
 Aim of the health plan is to work to reduce those inequalities

This was the last plan ->

  It was focused on the below flow chart

Progress on Action Items in the 2004-2013 plan

 49 action items
 4 with strong progress
 5 with considerable progress
 7 with reasonable progress
 15 with some progress
 17 with little or no progress

Progress since the last plan

 
 I
n
c
r
e
a
s
e
d

number of dental practioners

 o Went from 6 to 10 dental schools in Australia (other schools
also train allied professionals)
 Increase in population covered by water fluoridation
 Development of a consistent oral health message
 Significant increase in cooperation between oral health and other
health professionals
 Development of dental assessment of ages care

The new plan

 The cover has much more racial inclusion

Structure of oral health plan

 Based on guiding principles, foundation
areas and priority populations

Guiding Principles
 Universalism – more heavily covers
people who are disadvantaged
o Not just that they have access, but the outcome of that access
Foundation areas


Summary of strategies
Priority populations
 slightly different from the previous one
 Groups that have inequalities with their oral health due to social disadvantage
What is the state of Australia’s oral health
 Oral health of Australian children using public dental services improved significantly
from mid‐ 1970s to the mid‐1990s.
 During this time substantial reduction in tooth decay.
 Decline stabilised in the 90’s, and there has even been an increase in DMFT since
then
 Most likely the result of:
o improved access to fluoridated drinking water
o Use of fluoride toothpastes
o Provision of preventive oral health services
o Adoption of good oral hygiene practices

What is the state of Australia’s oral health

 Since the mid‐1990s tooth decay among children has increased in some states and
territories
 Factors implicated in this increase include:
o Increased consumption of non‐fluoridated bottled water
o increased consumption of sugary food and drinks
 According to the Child Dental Health Survey 2009
o 51% of six‐year old children
o 454% of 12‐year old experience tooth decay
 Aboriginal children have high rates of tooth decay, also children living in low social-
economic areas
 As you increase remoteness, you increase untreated tooth decay, but it is also
dependent on income
What is the state of Australia’s oral health
 Approximately 23% of Australian adults have moderate to severe periodontal
disease
 Prevalence of periodontal disease increases with age and there are higher rates in
people with low income
 Periodontal disease is the reason for tooth extraction in 16.5% of people aged 45 –
64 and 20% of people over the age of 65.
 Once again concession cardholders are more likely to report that their tooth
extraction was due to periodontal disease.
 Incidence of oral cancer depends on age, gender and ethnicity – some groups have
high incidence because they are exposed to a risk factor particularly alcohol and
tobacco

4 fundamental determinants of oral health

 Flouride is not the only thing
UN Sustainable Development Goals (SDGs)
 Launched in 2016
 Evaluate the MDGs

Millennium Development Goals (MDGs)

 In 2010 the UN established the MDGs.
 8 international development goals to improve the health and QoL of people
 All UN member states committed to achieving by 2015.

 Without good oral health, students may not attend school

 Mother’s oral health plays a role in the child’s oral health – better education for the
mother there is better oral health outcome for the child

 Oral health is a missing opportunity – to use the MGD’s to improve oral health
UN Sustainable Development Goals (SDGs): A time to act.
Rodrigo Mariño, Rajdeep Singh Banga doi: 10.17126/joralres.2016.002
 We have an opportunity to make oral health part of the new goals

Sustainable Development Goals (SDGs)

 17 interrelated and interdependent goals to:
o end poverty
o fight inequality and injustice; and
o tackle climate change,
 whilst maintaining sustainable development and prosperity.
 The 17 goals are associated with 169 targets and hundreds of indicators.
 The SDGs became official on the 1st of January 2016 and the deadline set for
achievement by 2030.
 Here are the 17 goals – number 3 is good health and well-being
o How can we make oral health part of the achievement of each of these
goals? Because there is a role for it

This is SDG for health

 Unimelb is part of a consortium
of universities working towards
good oral health