Smiles all round for kids’ travelling dentist scheme

by Matt Cowgill

Published by The Age, Tuesday 11 June

Kids with bad teeth grow up to be adults with worse teeth. This causes them pain and can cost a lot of money to fix. That’s why the Victorian government’s budget plan to bring back dental vans – the Smile Squad – makes a lot of sense.

Poor dental health is a big problem in Australia. Nearly half of Australian children have at least a moderate amount of plaque on their teeth. About a fifth have gingivitis, which can develop into periodontitis, a serious condition if left untreated. The figures are worse for Indigenous children, for children in poorer households, and for children who live outside the major cities.

A lot of Australians have problems with their teeth. About a fifth of adults have moderate or severe periodontal disease, and a quarter have untreated tooth decay. These problems are not only painful, they can make it hard to eat a nutritious diet and hard to get and keep a good job. And bad dental health can contribute to other serious health problems, including diabetes and heart disease.

The best way to deal with dental problems is to prevent them from developing in the first place. Stopping the spread of tooth decay in kids and teaching them about how to take proper care of their teeth, is much cheaper than taking more drastic action down the track.

Spending money today to improve the oral health of children could make it more affordable to introduce a universal dental care scheme in future. A universal dental scheme – the big missing piece at the heart of Medicare – is clearly needed, as we show in our recent Grattan Institute report Filling the Gap.

Australia already has a Commonwealth scheme to subsidise dental care for children in low- and middle-income families. But not enough families use it – only about a third of eligible children get care under the scheme, perhaps because some parents are unaware of it, or their local dentist doesn’t provide services under the scheme, or because it’s hard to fit dental care into busy schedules.

The Smile Squad plan means that all children in Victorian public schools will, if their parents consent, get a free check-up each year. If they need follow-up treatment, they’ll get it in a dental van or a public dental service, again without charge. The state government promises to hire about 500 extra dentists and other oral health professionals to run the Smile Squad vans.

Last week’s budget set aside $322 million over the next four years for the Smile Squad. Some of the bill – on top of that $322 million – will be sent to the Commonwealth, because the vans will be able to provide services to eligible kids under the existing federal scheme. So it will cost a lot of money. But a dollar spent now improving children’s dental health is likely to save much more than a dollar down the road.

The dental van scheme should also help to improve the shocking situation for adults who need public dental care. At the moment, most dental services for adults are done in the private system. If you can’t afford to pay for care, and many can’t, your only option is to get on the waiting list for public care. The waiting list is very, very long. The typical person on the waiting list in Victoria has to wait for about 18 months before they get treated, and some people can wait up to three years. During that time, of course, their oral health only gets worse, and more expensive to treat.

Adults on the waiting list for public dental care have to queue alongside kids who need care. The Smile Squad scheme will take children out of the queue, which should mean shorter waits for adults.

The Smile Squad scheme could be a model for other states to follow. The government should work with researchers to carefully monitor the scheme’s impact on kids’ oral health. Once the scheme has been up and running for a few years there should be an evaluation of its benefits, which can be weighed against its costs.

We think it’s likely that the Smile Squad will prove good value for Victorians’ money. Improving our kids’ teeth is worth it. This is a scheme that should make Victorians smile.