Dental Health

29 November 2016

Mister Speaker

My father was a dentist and a very good dentist and my brother, Andrew Freelander, is also a very good dentist and is highly respected in his community. So this speech is partly for them. I might have been a dentist too but I think I must have seen the film Marathon Man a few too many times.

This government continues to disappoint community expectations on dental care, particularly for the young and the very old. We are also failing ourselves with our levels of sugar consumption. Sugar consumption is at world record highs. So are obesity rates, which, according to the WHO, more than doubled in the last 25 years. Worldwide that is about 500 million people. The WHO also estimates that 42 million children worldwide under the age of five are obese. In Australia, obesity costs the taxpayer over $5.3 billion a year. One in four Australian adults is now classified as obese. That is compared to one in 10 about 30 years ago.

Exponentially increasing sugar consumption is a major cause of obesity and high persisting rates of dental decay. Our annual dental services bill is now $9 billion, even if you do not include hospitalisation costs, and over 60, 000 Australians a year already fall back on emergency departments across the country to access emergency dental care. It is not uncommon for me to see children with dental abscesses, sometimes requiring hospitalisation for intravenous antibiotics.

Until about the mid-17th century in the United Kingdom, one way you could tell the poor from the rich was by looking at their teeth. Poorer folk could not afford sugar, so they had better teeth than the rich, who could. In the last 200 years, the positions have been reversed with better dental care. Poor dental health affects everything from life expectancy to incidence of coronary artery disease, stroke, self-esteem and the ability to find work. The recent ABS patient experiences in Australia survey shows that those in more disadvantaged areas are much more likely to make forced visits to the dentist or the local hospital for emergency dental care. Preventative dentistry is less of an option if you are even moderately poor. Most Australians still do not quite see why dental care is not just a fully integrated part of Medicare. Private expenditure on dental services is running at about $6 billion a year.

For those who think we are doing okay, here are some facts to change your mind. One in five people who needed to see a dental professional in the last 12 months decided not to do so because of cost. Six out of 10 children have tooth decay by 15 years of age. People living in regional and remote areas are far more likely to avoid seeking dental treatment because of cost. The Australian Dental Association says the poor oral health of Indigenous children, children living in remote areas and children with disabilities demands urgent targeted action. There is only a very limited safety net for those needing dental care. Waiting lists in dental hospitals are now measured in years and, unbelievably, there is still no fluoridation in many small towns, leading to much, much higher rates of dental decay. Pensioners, I am told, are often particularly poorly treated.

So what is this government's response? Rationing. On 23 April this year, my birthday, the Minister for Health and Aged Care announced that she would abandon the National Partnership Agreement on Adult Public Dental Services and the Child Dental Benefits Schedule. The Turnbull government's intention is to go for wider coverage but with much less money being spent per head and with longer waiting lists. It is something the old Soviet Politburo could have dreamt up. People will be referred back to the public sector, where waiting lists are already in an unmanageable state. What a joke. Nationally, three million children will be forced onto longer and longer waiting lists. That will jeopardise the chances of improving dental health for life via early intervention. The whole scheme is as poorly explained as any we have seen in this portfolio—that alone is quite an achievement.

We are already struggling to cope with several generations of the dental disabled. This government appears not to understand the importance of dental care to those most disadvantaged. This is the 21st century and I believe this government has a very distorted priority if it cannot see the importance of providing adequate dental care. It is distressing to me to have to look into a child's mouth and be able to judge their parents' income. I know many children that I see have never seen a dentist and have terrible dental caries and dental abscesses which will affect their health and job prospects for the rest of their lives. This is one of the wealthiest countries in the world. Surely our priorities are wrong and it is time for change.