Dental health of children

In WA the dental health of older children has markedly improved over the last two decades.

Among 12 year olds (an international indicator age), the average number of decayed, missing due to decay and filled permanent teeth was 0.99 in 1996 compared with 2.43 in 1985.

Despite these improvements in permanent tooth dental health, the prevalence of dental decay in deciduous teeth of young children remains unacceptably high and is a cause for concern. About 36 per cent of five year old children in WA had teeth affected by decay in 1996. Unpublished WA data indicates that most of the decay experienced in children below pre–school age consists of untreated cavities rather than fillings, possibly because this age group does not receive organised dental care and few attend private dentists.

School Dental Service

The School Dental Service (SDS) provides free preventive dental care across WA for all enrolled five to 16 year old school children and for 17 year olds in remote areas. In 1996, more than 245,000 children were enrolled in the SDS. Approximately 90 per cent of pre–primary and primary school children were enrolled. Although over 81 per cent of secondary school children were enrolled in the SDS, only 55 per cent were actually receiving care. These findings suggest that while dental services are available and accessible, they are not widely utilised by young adults. The Dental Health Education Unit of Dental Services has recently conducted a survey of Year 11 students to ascertain attitudes to dental attendance and the dental expectations of students. A campaign is proposed to raise awareness among high school students and their parents about the services provided by the SDS.

Adult care

The dental health status of the adult population contrasts widely with that of children. Tooth decay experience is still widespread in adults and gum disease is particularly prevalent in older adults. The WA sector of the 1987/88 National Oral Health Survey is the only survey, to date, to provide oral health data about the general population. People from financially disadvantaged backgrounds are more likely to have poorer oral health than the general population and more likely to attend for emergency rather than for basic dental care. Furthermore, people who attend for an emergency are more likely to receive extractions rather than restorative care. Access to affordable dental care is therefore, a particularly important issue for low income people.

Rockingham Dental Clinic expanded from four to eight chairs.

In WA, dental services to financially and geographically disadvantaged people are provided through the Perth Dental Hospital, six metropolitan dental clinics and 11 country clinics, supplemented by mobile and itinerant services. The clinic at Rockingham has been expanded this year from four to eight chairs and a new eight chair clinic is being built in Midland and is due for completion in September 1997. In addition, a Country Patients’ Dental Subsidy Scheme exists for eligible people in country areas where a government clinic is not available. Dental treatment, subsidised with Health Department funds, is provided by local private dentists. About 300,000 people aged 18 years and over are eligible for publicly funded dental care in WA. However, less than a quarter of those eligible for care access publicly funded dental clinics, possibly due to long waiting lists.

The Commonwealth Dental Health Program (CDHP), which commenced in WA in July 1995, was set up to improve access to dental care for financially disadvantaged people. It is estimated that the CDHP made dental care available to an additional 40,000 people each year. Although the CDHP ceased to operate from 1 January 1997, it has raised expectations among people who previously received care under the Commonwealth program but must now rely on the existing State program.

The Adult Dental Programs Survey was established in WA as part of the evaluation process of the CDHP. The survey, originally implemented by the CDHP, is now being used to collect oral health data about a sample of people attending publicly funded dental clinics and is ongoing. The termination of the CDHP has adversely affected the availability of dental care for financially disadvantaged people by restricting access to timely and appropriate services. To meet the expectations of financially disadvantaged people in WA, and to provide for two to five year old children who currently get little care, the existing State dental care delivery system will need to be expanded.

Scheme for country patients

In WA, dental services to financially and geographically disadvantaged people are provided through public dental clinics. In addition, a Country Patients’ Dental Subsidy Scheme exists for eligible people in country areas where a Government clinic is not available.

Dental treatment, subsidised with Health Department funds, is provided by local private dentists.

About 300,000 people aged 18 years and over are eligible for publicly funded dental care in WA.

However, less than a quarter of those eligible for care access publicly funded dental clinics, possibly due to long waiting lists.

The Commonwealth Dental Health Program (CDHP), which started in Western Australia in July 1995, was set up to improve access to dental care for financially disadvantaged people.

It is estimated that the CDHP made dental care available to an additional 40,000 people each year.

Although the CDHP ceased to operate from January 1, 1997, it has raised expectations among people who previously received care under the Commonwealth program but must now rely on the existing State program.

The Adult Dental Programs Survey was established in WA as part of the evaluation process of the CDHP. The survey is now being used to collect oral health data about a sample of people attending publicly funded dental clinics and is ongoing.

The termination of the CDHP has adversely affected the availability of dental care for financially disadvantaged people by restricting access to timely and appropriate services.

To meet the expectations of financially disadvantaged people in WA, and to provide for 2 to 5–year–old children who currently get little care, the existing State dental care delivery system will need to be expanded.