Health system must better address Indigenous dental health

Australian Medical Association/AusMed

Indigenous Australians suffer an unacceptable rate of dental disease and tooth loss, and should receive more Government attention to address the problem.

The AMA has released its Indigenous Health Report Card 2019 and says the nation’s health system is failing Indigenous communities.

To seriously address the situation, more communities must have access to fluoridated water, funding for dental services must be boosted in remote areas, more Indigenous dentists are needed, oral health promotion must be enhanced, and a sugar tax on sweet drinks should be introduced.

In Darwin to release the Report Card, AMA President Dr Tony Bartone said it was unacceptable that a significant proportion of the Aboriginal and Torres Strait Islander population lives without access to affordable, culturally appropriate dental care.

“Good oral health is fundamental to overall health and wellbeing. It allows people to eat, speak, and socialise without pain, discomfort, or embarrassment,” Dr Bartone said.

“Aboriginal and Torres Strait Islander pre-school and primary school-aged children are more likely to be hospitalised for dental problems, and are less likely to receive preventive care, and adults and children from Indigenous backgrounds have much higher levels of untreated tooth decay.

“Poor oral health complicates and contributes to other illnesses, especially rheumatic heart disease and diabetes – illnesses that afflict Aboriginal and Torres Strait Islander Australians at a far greater rate than their non-Indigenous peers.”

Indigenous Australians, adults and children, have dental disease at two or three times the rate of their non-Indigenous counterparts in urban, rural, and remote communities, and are five times more likely to have missing teeth, the Report Card shows.

And there are fewer than 100 Aboriginal or Torres Strait Islander dental practitioners in Australia.

Dr Bartone said Australians living in rural and remote areas, need good-quality, affordable dental care, yet governments see oral health services for Aboriginal and Torres Strait Islander peoples as discretionary and short-term. Funding is piecemeal and arbitrary.

“Availability of dental services should be based on need. Funding should be transparent and every opportunity taken to build the community-controlled health sector with direct funding of vital prevention and dental treatment programs for the communities they serve,” he said.

“Water fluoridation, reducing sugar consumption, oral health promotion, and fluoride varnish programs from the eruption of the first tooth all help to prevent tooth decay.

“In 2017, only 98 Aboriginal and Torres Strait Islander people were registered as dental practitioners. We know that Indigenous people have better health outcomes when they receive culturally safe health care in a service where staff understand and respect them.”

Dr Bartone used the Report Card launch to call on all levels of Government to treble their investment in the Puggy Hunter Memorial Scholarship Scheme, and to set a goal of 780 Indigenous dental practitioners by 2040 to promote employment parity in the dental workforce.

“We urge all political leaders, at all levels of Government, to take note of this Report Card, and be motivated to work in partnership with Aboriginal peak bodies to find effective solutions and implement the recommendations,” he said.

Key recommendations from the Report Card include: Governments committing to a minimum standard of 90 per cent population access to fluoridated water; a strategic approach and additional investment to increase Aboriginal and Torres Strait Islander participation in the dental practitioner workforce; Federal Government investment in oral health promotion being reinstated and evidence-based initiatives implemented; and the Federal Government introducing a tax on sugar-sweetened beverages.

The AMA also calls for better availability of comprehensive oral health data for Aboriginal and Torres Strait Islanders, to enable effective monitoring and performance measurement.

And service models must be developed and implemented in collaboration with Aboriginal and Torres Strait Islander people, with funding arrangements reflecting the varying costs of providing services in regional and remote areas.

The AMA Indigenous Health Report Card 2019 is available at: https://ama.com.au/article/2019-ama-report-card-indigenous-health-no-more-decay-addressing-oral-health-needs-aboriginal

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