Conundrums in merging public policy into private dentistry: experiences from Australia’s recent past

Abstract

Oral disease continues to be a major problem in Australia impacting quality of life, the economy and broader health system. Although the understanding of caries and periodontal disease has improved along with increased government support, oral diseases continue to be the most prevalent among all health conditions. This is despite unprecedented levels of funding in the Chronic Disease Dental Scheme and the Teen Dental Plan. Access to primary care dentistry in the private sector, where the majority of dental services are provided, remains a critical issue. Under the current system of dentistry, it cannot be assumed that the practice of dentistry represents a prioritised approach to combat disease patterns based on scientific evidence in primary health and prevention. Drawing on data in relation to these two programs, the present study highlights issues impacting dental service provision. This includes issues such as access and affordability to dental care, sustainability of policy and its unintended consequences, private practice pressures and the impact of remuneration on treatment. This paper argues that without structural reform there will continue to be barriers in implementing policies capable of improving oral health. What is known about the topic? The burden of oral diseases remains high and there continue to be problems in accessing and affording dental treatment. What does this paper add? This paper highlights factors impacting dental service provision and offers potential solutions to improve access to primary care dentistry. What are the implications for practitioners? A consideration of these factors may assist policy makers and governments in formulating effective policies.