DT Asia Pacific No. 6, 2019
Rise of non-premium dental implants in Asia Pacific region
/ Coca-Cola criticised by NZDA for culturally appropriating Maori language.
/ FDI World Dental Congress 2020—China is shaping future of oral health
/ Improved instrumentation to reduce endodontic complications
/ Australian agency has launched investigations into clear aligner providers
/ Recent proposal revamps Australian oral healthcare system
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DENTALTRIBUNE
The World’s Dental Newspaper · Asia Pacific Edition
Published in Hong Kong
www.dental-tribune.asia
MAORI ON COCA-COLA
New marketing ploy by Coca-Cola
by labelling its products with Maori
language has been criticized by the
New Zealand Dental Association.
” Page 04
Vol. 18, No. 06
FDI WORLD DENTAL
CONGRESS
CLEAR ALIGNER
The Australian Health Practitioner
Regulation Agency has launched
investigations into four providers
of clear aligner therapy due to
breaching of advertising laws.
FDI will be putting special focus
on China when its World Dental
Congress is held in Shanghai in
September 2020.
” Page 05
” Page 07
Rise of non-premium dental implants
in Asia Pacific region
By Jeremy Booth, Dental Tribune International
BEIJING, China: Sales of dental implants are set to grow at a phenomenal rate in the coming years in
major dental markets in the Asia
Pacific region. The value implant
segment is driving volume growth,
but still trailing behind the premium segment when it comes to
overall dollar value. International
implant manufacturers are investing in the value categor y, and
cheaper solutions in implant therapy may be the key to boosting some
of the region’s developing markets.
The world’s population is growing by an estimated 82 million people per year, but an increase in
candidates for implant therapy is
not the only factor driving growth
in the dental implant category. The
2016 Global Burden of Disease Study
underscored the prominence of the
leading conditions behind edentulism. The study found that dental
caries in permanent teeth was the
most prevalent of the oral diseases
that affected an estimated 3.58 billion people globally—half of the
world’s population—and estimated
that severe periodontal disease was
the 11th most prevalent disease on
the planet. The category is segmented into dental implants, final
abutments, instrument kits, planning software and surgical guides.
Other factors driving its growth include an increasing incidence of
sports-related injuries, ageing populations, rising demand for prostheses and more dentists being trained
to place implant restorations.
>> Page 2
Market researcher iData says the Chinese and Indian dental implant markets are set to exhibit growth rates of over 20%.
(Photograph: SnvvSnvvSnvv/Shutterstock)
Singapore to ban advertisement of certain
sugary drinks
AD
By DTI
SINGAPORE: Excessive consumption
of sugar-sweetened beverages (SSBs)
can have a deleterious effect not
just on oral health but on systemic
health conditions, such as diabetes,
as well. With this in mind, the Singaporean government has annou nced t hat it w i l l ba n t he
advertising of high-sugar drinks
across all domestic mass media
platforms.
The move is in response to growing global recognition of the contribution of excess sugar intake to
a range of negative health outcomes.
As Dental Tribune International has
previously reported, the promotion
of high-fat, high-salt or high-sugar
food or drinks in traditional media
and online media aimed at children
has been banned in the UK, and the
state government of Queensland
in Australia has forbidden the advertising of unhealthy food and
drinks on the advertisement spaces
that it owns.
Singapore has one of the highest rates of diabetes in the world,
and 13.7% of its adult population
has been diagnosed with the condition. This is commonly attributed
to an ageing population and to the
increasingly widespread adoption
of a diet high in added sugar.
Edwin Tong, the Senior Minister of State for the Ministries of
Health and Law in the country,
stated that the advertising changes
would only apply to those carbonated beverages and fruit juices that
are deemed to be the unhealthiest.
“We will introduce an advertising prohibition of product advertisements for the least healthy SSBs
on all local mass media platforms,
including broadcast, print, out-ofhome and online channels,” Tong
said in a statement.
The Singaporean government has announced that it will ban the advertising of
high-sugar drinks across all domestic mass media platforms. (Image: Trong
Nguyen/Shutterstock)
It has been confirmed that consultations with consumers, drink
producers and the advertising industry will take place prior to making a decision on the specific date
for the ban to be implemented.
Distinguished by innovation
Healthy teeth produce a radiant smile. We strive to achieve this goal on a daily basis.
It inspires us to search for innovative, economic and esthetic solutions for direct filling
procedures and the fabrication of indirect, fixed or removable restorations, so that
you have quality products at your disposal to help people regain a beautiful smile.
www.ivoclarvivadent.com
Ivoclar Vivadent AG
Bendererstr. 2 | 9494 Schaan | Liechtenstein
Tel. +423 235 35 35 | Fax +423 235 33 60
[2] =>
02
ASIA PACIFIC NEWS
Dental Tribune Asia Pacific Edition | 06/2019
<< Page 1
According to Global Market
Insights (GMI), the global dental
implant market was wor th
US$3 .9 bi l l ion l a st ye a r. A
compound annual growth rate
(CAGR) of 5% will mean that the
categor y increases in value by
around one-third to be wor th
US$5.4 billion (CNY 35.4 billion;
JPY 542.2 billion) by 2025. In the
Asia Pacific region—the fastestgrowing area for dental implants—
GMI forecasts a CAGR rate of 6.5%
between 2019 and 2025.
According to medical market
research company iData Research,
which published a new report this
year on dental implants in the Asia
Pacific region, the region is the third
largest for dental implants and currently accounts for 28.1% of the total value of the global market. The
market researcher revealed last year
that implant sales in the region
were expected to experience high
levels of growth in the coming
years, to be worth US$890 million
by 2024, and that the region was
transitioning towards inexpensive
implant solutions.
In 2018, according to iData, the
region’s key dental markets, Australia, China, India, Japan and South
Korea, had a near fifty–fifty split in
terms of the market value for premium versus non-premium dental
implants. The non-premium segment edged slightly ahead to account for 51.2% of market value
versus 48.8% for the premium segment. Cheaper implant solutions
are expected to hold a 55% share of
total market value in the region by
2024, according to iData’s analysts.
Are value implants set to transform Asia Pacific markets?
Jeffrey Wong, Analyst Director
at iData, says it is not that simple. The
value segment in the region is experiencing a healthy growth rate and
an increase in volume sold, but the
contribution of cheaper implants, in
dollar value, is much smaller when
compared with that generated by the
premium implant segment. This
trend is expected to unfold in the
burgeoning Chinese market and in
the lesser-developed Indian market,
and significant growth has been forecast for dental implants in both of
these countries in the coming years.
Training and educational activities for dentists placing implant restorations will help to speed up growth in the region. (Photograph: Straumann Group)
“Within the Asia Pacific region,
both the Chinese and Indian dental
implant markets are poised to exhibit year-on-year market growth
rates of over 20%,” explains Wong.
“In both countries, the value and
discount segments will exhibit
higher growth rates compared with
the premium segment. However,
the premium segments will be add-
ing more to the overall value of the
markets, despite the lower growth
rates.”
Wong also points out that not
all growth rates are created equal:
“Even though both the Chinese
and Indian markets are expected
to experience similar rates in
market growth, it is worth noting
that the Chinese market is nearly
four times the size of the Indian
market.”
Despite a lower contribution to
overall market value, an increasing
prevalence of dental implants being placed will boost visibility and
acceptance of this form of dental
therapy.
“Even though both the Chinese and Indian markets
are expected to experience similar rates in market
growth, it is worth noting that the Chinese market is
nearly four times the size of the Indian market.”
Jeffrey Wong, iData
Investment required on several
fronts
Implant manufacturers are planning to do more business in the Asia
Pacific region, and iData says the
market landscape in the region is
becoming increasingly competitive.
Major implant manufacturers, such
as the Straumann Group, have increased investment in their implant
portfolios in key Asia Pacific markets, particularly in the growing
non-premium category.
The Straumann Group acquired
the popular Indian implant brand
Equinox in 2016 and Anthogyr’s
Chinese implant business. This year,
the company’s acquisitions have
continued. The company said in its
2019 half-yearly report that it was
AD
AO ANNUAL MEETING
EVOLVING TECHNOLOGIES
in Implant Dentistry
March 18-21, 2020
Seattle, WA • osseo.org
[3] =>
investing in the South Korean company Warantec to boost its penetration into the non-premium
implant segment. Straumann said
that it would provide a capital injection to bolster the established
implant
manufacturer’s production and
international business and would
gain in return a stake of just over
one-third in the company and the
exclusive rights to distribute Warantec implants outside of South
Korea. Straumann said that the
company’s Oneplant implant system offers affordability in the segment and that product registrations
had been obtained in China and in
the leading dental implant regions,
the US and Europe.
03
ASIA PACIFIC NEWS
Dental Tribune Asia Pacific Edition | 06/2019
who have helped to transition the
market towards more inexpensive
implant solutions. But the situation
in South Korea also reminds us that
growth in the implant market requires investment from other parties. The country’s National Health
Insurance Service lowered the age
of eligibility for dental implant coverage to 65 from 70 in 2016, which
iData says has helped to transform
South Korea to the region’s most
highly developed market for dental
implants.
“Calls have been made in China for the development of
domestically manufactured dental implants in order to
lower the costs of implant therapy for consumers.”
Europe and the US dominate
implant sales
According to iData, Europe and
the US still take the lion’s share of
the global dental implants market.
Europe accounts for 34.3% of the total value of implants placed annually and the US accounts for 29.5%.
Together, these two regions hold al-
most two thirds of the entire market. At 28.1%, the Asia Pacific region
is currently the third most valuable
for dental implants, followed by the
Latin America region at 8.1%.
AD
Tetric N-Line
®
The Asia Pacific region makes
up 18% of the Straumann Group
revenue and is the company’s fastest-growing region. The company
sa id i n its repor t t hat it had
strengthened its foothold in powerhouse China’s non-premium implant segment by rolling out a fully
tapered implant made by daughter
company Anthogyr and that it had
benefited from intensified training
and educational activities in the
country. “This is significant because
only a very small proportion of the
dentist population in China has received training in implant dentistry,” the company stated.
High-quality composites for esthetic anterior and posterior restorations
A key enabling factor in the success of companies like Straumann
will be a greater investment by dentists in the Asia Pacific region in
offering implant-supported restorations. Of course, a vital part of
the equation is that consumers are
willing and able to invest in their
oral health.
In an April interview, Claire Li,
Clinical and Scientific Manager at
Dentsply Sirona Implants in China,
commented that the dental implant
market in the country was expanding quickly. “Different sources estimate a growth rate between 15 and
30% in the coming years, and the
market is likely to exceed US$700 million by 2020.” She explained that the
main drivers behind the rapid growth
in numbers of implants placed in the
country were an increasing familiarity with implant-supported restorations, more dental practices now
offering implant dentistry, and economic factors that are making Chinese more willing to spend money
on their oral health.
In the South Korean market,
larger international dental companies face stiff competition from
domestic implant manufacturers,
MORE THAN
* Based on sales figures.
Earlier this year in China, the
Global Times quoted business news
portal 21jingji.com as saying that
“A full set of implanted teeth could
cost as much as a brand-new BMW
sedan.” The English-language daily
tabloid reported that demand in
China for oral treatments such as
tooth replacement was surging, but
that a lack of domestically made
implants meant consumers were
paying high prices in a market dominated by international dental companies. The newspaper said that
calls have been made in China for
the development of domestically
manufactured dental implants in
order to lower the costs of implant
therapy for consumers.
for
all
cavity classes
One efficient solution
MIO
RESTORATIONS PLACED*
www.ivoclarvivadent.com
Ivoclar Vivadent AG
Bendererstr. 2 | 9494 Schaan | Liechtenstein | Tel. +423 235 35 35 | Fax +423 235 33 60
[4] =>
04
ASIA PACIFIC NEWS
Dental Tribune Asia Pacific Edition | 06/2019
Coca-Cola criticised by NZDA for culturally
appropriating Maori language.
By DTI
AUCKLAND, New Zealand: New Zealand has an oral health problem.
Expense is one of the main factors
that prevent people from visiting
the dentist, and this results, in some
instances, in oral health conditions
similar to those of developing countries. However, sugar is another
major issue, and in a recent state-
ment, the New Zealand Dental Association (NZDA), Te Ao M rama
(the New Zealand Maori Dental As-
AD
REGISTER FOR FREE!
DT Study Club – e-learning platform
sociation) and H pai te Hauora
(Maori Public Health) have criticised
the use of the Maori language on
Coca-Cola products.
The new marketing ploy by Coca-Cola focuses its sights directly
on the New Zealand Maori population by labelling its products with
slogans such as “Share a Coke with
wh nau [family]” and “Share a Coke
with kuia [grandma]”. “This has
shades of the tobacco industry
here—a subversive insidious way
to connect with people who suffer
a disproportionate amount of dental disease and harm from a public
health perspective,” said NZDA sugary drink spokesperson Dr Rob Beaglehole.
A marketing ploy by Coca-Cola
targets at-risk New Zealanders by
culturally appropriating te reo M ori
[the Maori language]. (Image:
Twitter/@waikatoreo)
Join the largest
educational network
in dentistry!
www.DTStudyClub.com
Tribune Group GmbH is an ADA CERP Recognized Provider.
ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.
Tribune Group GmbH designates this activity for one continuing education credit.
According Dr Kirsten Robertson, a senior lecturer in the Department of Marketing at the University
of Otago, New Zealand has a significant problem regarding the consumption of sugar-sweetened beverages (SSBs). As reported by Dental
Tribune International, New Zealand
is the third most overweight nation
in the Organisation for Economic
Co-operation and Development
area, and 17% of adults’ total sugar
intake comes from SSBs.
“This corporation which cares
nothing for our mokopuna [children], our kuia and kaum tua [seniors], has appropriated our language to make a profit. Worse—
they’ve singled out one of the worst
areas of inequity in health outcomes—our wh nau’s oral health.
They should be ashamed,” said H
pai Te Hauora CEO Selah Hart.
The introduction of a sugar tax
is still to be debated in parliament,
and direct action to protect some
communities from persuasive marketing is also greatly needed. According to the NZDA, 2017–2018
data shows Maori are 1.36 times
more likely than non-Maori to have
teeth removed as a result of dental
caries. According to a 2018 Best
Practice Advocacy Centre New Zealand study, it was estimated that,
in the Auckland region alone, over
40% of people of Maori, Pacific or
Indian ethnicity aged 35–39 years
have prediabetes.
[5] =>
05
ASIA PACIFIC NEWS
Dental Tribune Asia Pacific Edition | 06/2019
FDI World Dental Congress 2020—
China is shaping future of oral health
By FDI World Dental Federation
SHANGHAI, China: China is a powerful ally in achieving a global community commitment to health.
Recognising that health is fundamentally linked to successful economic and social development, the
Chinese government is making
progress to protect and promote
the health and well-being of its citizens. When its World Dental Congress is held in Shanghai from 1 to
4 September 2020, FDI will be putting special focus on the country.
In China, significant differences
exist between urban and rural populations in terms of oral hygiene
practices and access to oral care.
Results of a study published in the
International Dental Journal in 2005
revealed that regular toothbrushing was three times more frequent
in urban than in rural areas. There
are also a limited number of oral
health professionals to serve the
population: the dentist to population ratio is 1:100,000. As might be
expected, the use of oral health services is somewhat lower in rural
than urban areas: significantly more
rural residents in the study had
never seen a dentist during their
lifetime. Owing to the limited availability of dentists, most people have
a symptomatic, rather than preventive, approach to dental care. The
most frequently cited reasons for
dental visits are toothache, need
for tooth extraction and prosthetic
treatment.
Dental care is offered on a feefor-service basis that not everyone
can afford: the fees for restorative
services are approximately twice
the cost of tooth extraction and are
ten times higher than for preventive services. The 2005 study re-
The World Dental Congress is a flagship event of FDI, strengthening ties and fostering collaboration within the global oral health community. (Image: FDI)
ported that many people living in
urban areas had at least part of their
dental costs covered by their employers, which was not the case in
rural areas, keeping oral care in
these areas even more out of reach.
Healthy China 2030
The Healthy China 2030 initiative is an ambitious vision to incorporate health into all policies and
engage the whole of government
in health. Healthy China 2030 includes special provisions to improve
oral health. As part of its vision,
Healthy China 2030 implements
special campaigns to raise aware-
FDI and Chinese Stomatological
Association join forces for better
oral health outcomes
habits in China’s rural areas, most
notably through the Smile Around
the World initiative. Smile Around
the World aims to introduce the
importance of oral health through
a series of educational workshops
that will help children establish
good oral health habits from a young
age. The latest initiative was implemented earlier this year in three
elementary schools in the cities of
Pingxiang and Ganzhou in Jiangxi
province.
FDI and the Chinese Stomatological Association (CSA) have worked
side by side to increase access to
oral care and improve oral hygiene
The 2020 FDI World Dental
Congress, which is being co-hosted
by the CSA, shows a joint commitment to continue strengthening
ness of oral diseases, among other
health concerns. FDI congratulates
the Chinese government for ensuring that oral health is recognised
as being integral to overall health
and well-being and is grateful that
the policy landscape provides such
a welcoming setting for the 2020
FDI World Dental Congress.
this partnership to improve the
oral health of populations. By working together to build the scientific
programme, the goal is to give
global relevance to local research
and learning, as well as share best
practices on how to address the
oral health challenges that are
common to all geographical settings. Attendees will also learn
more about the Healthy China 2030
initiative and how this translates
globally. The congress will offer
hundreds of continuing education
opportunities and cover hot topics
in clinical practice, research and
public health and will feature numerous hands-on workshops.
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Dental Tribune International
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[6] =>
06
ASIA PACIFIC NEWS
Dental Tribune Asia Pacific Edition | 06/2019
Improved instrumentation to reduce
endodontic complications
By DTI
BUSAN, South Korea: Reducing complications in root canal therapy is
in the best interests of dentists as
AD
well as patients. To improve the
clinical performance of endodontic
files, a research team led by Dr Sang
Won Kwak from Pusan National
University tested instruments with
specially designed rotary motion.
Over the years, root canal preparation has been improved by the
use of engine-driven NiTi files.
Compared with stainless-steel manual files, NiTi instruments offer
better flexibility and cutting efficiency in addition to reduced iatrogenic errors. However, the NiTi
files may have cyclic fatigue and
torsional failure problems during
root canal preparation. To reduce
the risk of file fracture, Kwak and
his team tested heat-treated NiTi
alloy files with specially designed
rotary motion.
A study suggests that adaptive
motion of NiTi files improves the
success rate of root canal therapy by
lowering the torque generation of
the instruments. A lower torque will
help reduce the risk of tooth damage
and file fracture. (Photograph:
alleemate/Shutterstock)
The scientists tested three combinations of instruments and motions for root canal preparation.
These were the K3XF rotary system
with continuous rotary motion, the
K3XF rotary system with adaptive
motion and the Twisted File system
with adaptive motion (TFA), all from
the endodontic product manufacturer Kerr Endodontics. Adaptive
motion combines continuous and
reciprocating motion, rotating 600°
and stopping when the file is exposed to minimal or no load. “Adaptive movement helps to reduce
torque generation during instrumentation with NiTi rotary files,”
said Kwak. Torque generation occurs while removing root dentine
by engine-driven NiTi files. The
generated torque indicates the energy required to cut the root dentine, but also represents the reaction stress on NiTi files as well as
the root dentine.
To ensure consistent test conditions, endodontic training resin
blocks were used. Each block contained an S-shaped artificial canal,
with a working length of 16 mm.
The instrumentation was performed
for a total of 45 tests (15 per instrument) by a single experienced endodontist in order to reduce operator errors.
The researchers found that TFA
generated the lowest torque. Kwak
and his colleagues thus concluded
that the adaptive motion for NiTi
files may reduce torque generation
without increasing preparation
time. Kwak also suggested that the
“torque generation is more likely
to be affected by the cross-sectional
area rather than the movement of
the file system”. A smaller cross-sectional area may account for the
lower torque generation by the TFA
file system.
[7] =>
07
ASIA PACIFIC NEWS
Dental Tribune Asia Pacific Edition | 06/2019
Australian agency has launched
investigations into clear aligner providers
By DTI
the Herald that volume discounts
were being offered to accredited
dentists. The company said that
such discounts are permitted under
Australian law and common in the
industry.
In addition to the AHPRA investigations, the Therapeutic Goods Administration confirmed to the Herald
that it had opened investigations into
potential breaches of its advertising
code with respect to clear aligners.
AD
Promoting clear aligners on social
media without disclosing payments
is a breach of Australian law. (Image:
Edwardolive/Shutterstock)
www.idem-singapore.com
24 - 26 April 2020
Suntec Singapore
SYDNEY, Australia: The Australian
Health Practitioner Regulation Agency
(AHPRA) has launched investigations
into four providers of clear aligner
therapy amid claims of hushed incentives being provided to dentists
and the breaching of advertising laws.
AHPRA has launched investigations into market leader Invisalign
and the teledentistry providers SmileDirectClub, EZ Smile and WonderSmile. According to the Sydney Morning Herald, the four separate investigations are following up on complaints
from within the dental industry about
the business and marketing practices
of the companies.
THE LEADING DENTAL EXHIBITION
AND CONFERENCE IN ASIA PACIFIC
INTRODUCING THE IDEM 2020 MAIN CONFERENCE SPEAKERS
T h e c ompl a i nt s su r f a c e d
through articles in The Age and the
Herald and accused health regulators of failing to enforce the rules.
The authors of the articles said that
federal regulators had received
complaints about social media influencers promoting clear aligners
without proper disclosure, which,
if true, would be a breach of the law.
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The Therapeutic Goods Advertising Code stipulates that any payments received for the advocacy of
therapeutic goods—clear aligners,
in this case—must be disclosed and
a failure to do so carries a maximum
fine of A$1.05 million (€649,000).
Undisclosed promotion through social media would also breach the
Health Practitioner Regulation National Law, the authors pointed out,
which attracts fines of A$5,000 per
advertisement for individuals and
double that for companies.
“Nobody is even bothering to
pretend to follow the law,” read one
of the complaint letters from a dental industry insider, who believed
that revealing his identity would
cause him to lose his job.
W
NE
One letter from a Melbourne
prosthetist said the undisclosed
promotion presented a “clear and
present danger to vulnerable health
customers”.
Industry insiders also complained to health regulators that
Invisalign Australia was offering
volume discounts to dentists. Based
on the number of patients who ordered the Invisalign cases, the discounts, it was claimed, provided an
incentive to dentists and orthodontists to sell the company’s clear
aligners and could result in patients
being sold an unsuitable product.
Invisalign Australia confirmed to
Dental Hygienist
and Therapist Forum
Trade Exhibition
The 2020 dental hygienist
and therapist forum will
focus on issues such as
dealing with fear of dental
visits, the periodontal
probe and more.
Discover the latest
products and services
in the dental industry
and meet over 500
exhibitors at IDEM.
Special Care
Dentistry Symposium
Hands-On
Workshops
Highlighting the treatment
needs of patients with
special needs, this full day
forum is one of the first in
Asia to focus on this niche
topic in dentistry.
Hone your skills and learn
new techniques at the
limited attendance,
hands-on workshops.
SECURE YOUR PASSES ONLINE FOR IDEM 2020
Registration
Koelnmesse Pte Ltd
Ms. Isabel Shankar
T: +65 6500 6700
E: idem-reg@koelnmesse.com.sg
+65 9622 9782
Connect with us
Endorsed by
Supported by
Held in
Organised by
IDEM Singapore
IDEM Singapore
idem.sg
@IDEMSingapore
Singapore Dental Association
[8] =>
08
ASIA PACIFIC NEWS
Dental Tribune Asia Pacific Edition | 04/2019
Recent proposal revamps
Australian oral healthcare system
By DTI
then be expanded—first to people
on Centrelink payments, then all
children. After that, the Commonwealth should take the final step
to a universal scheme, ideally within
a decade.”
Many Australians suffer from
preventable oral health issues, and
the current system puts a strain on
states and health institutions whose
time could be better served working on other areas. Consequently, it
might not be too long before a change
comes. Speaking on the possibility
of the proposed scheme being taken
up, Duckett said, “The first few stages
of our scheme are inevitable; it’s
only an issue of timing.”
The Grattan Institute is an Australian public policy think tank
that was established in 2008. It
has no connection to any of the
country’s political parties, and its
primary goal is to contribute to
the discussion around Australian
public policy.
INTERNATIONAL
HEADQUARTERS
PUBLISHER/CHIEF EXECUTIVE OFFICER
Torsten R. Oemus
CHIEF CONTENT OFFICER
Claudia Duschek
DENTAL TRIBUNE INTERNATIONAL GMBH
The state of Australians’ oral health is very concerning. A recent report proposing a universal oral health scheme might have the answer to this situation.
(Image: FJZEA/Shutterstock)
MELBOURNE, Australia: Australia is
facing several challenges when it
comes to oral health. Access and education are among some of the most
significant issues, not to mention
cost, and a more modern health system might be the way forward. In an
interview with Dental Tribune International, Grattan Institute Health
Program Director Dr Stephen Duckett spoke about a recent proposal his
team developed for a universal dental care scheme for Australia.
In the proposal titled, “Filling
the gap: A universal dental scheme
for Australia”, Duckett and contributing authors Matthew Cowgill and
Prof. Hal Swerissen said of the current system: “State public dental
schemes vary in terms of who is eligible, the extent of co-payments,
and the amount of funding provided
per eligible patient. The result is a
postcode lottery, where a person’s
access to public dental care depends
on where they live. And people who
are eligible for public dental services
are confronted with excessive waits—
often well over a year—for basic oral
health care.” Australia has a federal
health system, in which both the
national (Commonwealth) government and state governments have
health responsibilities.
The proposal that Duckett and
his team put forward would be
phased in over ten years. It would
involve a mixture of public and private provision, and payment would
be according to a national fee schedule. As part of the scheme, there
would be tight monitoring requirements for participating practices
and patients would be able to choose
freely from accredited dental clinics. The authors suggest that both
public and private providers should
be eligible to participate.
Proposal implementation
Speaking about cost and implementation, the authors said: “It
would be impractical to move to a
universal scheme overnight. The
net cost would be large—around
$5.6 billion in extra spending per
year—and the oral health workforce would need to be expanded.
So, the Commonwealth should announce a road map to a universal
scheme, including plans to expand
the workforce, followed by incremental steps towards a universal
scheme.”
Despite the high cost, which
Duckett said was the main factor
opposing the scheme, the team predicted that individual states would
save around 85% of the budget that
they currently spend on oral healthcare. The report also forecasts that
there would be an increase in eligi-
ble children using the service from
37.1% to 50.0% and that eligible
adults would be as likely to visit the
dentist as high-income people of
the same age would.
Education and job creation
Speaking about the lack of oral
health education in Australia, Duckett said, “This is certainly true. We
partly recognise that, in proposing
the monitoring of practices, preventive orientation would be part
of the conditions of participation.
We also proposed an emphasis on
public oral health education.”
Speaking about job creation,
Duckett said, “The scheme would
involve a significant expansion of
public spending and thus a significant expansion of jobs. We also
contemplated in our funding, and
in the way in which we priced the
national fee schedule, that the employment expansion would be in
all categories of the oral health
workforce,” explained Duckett.
In a 2018 Dental Tribune International article, it was revealed
that the Australian Dental Association and Australian Health Policy Collaboration (AHPC) at Victoria University had released a national oral health report card. According to that report, more than
90% of Australian adults had experienced caries in their permanent teeth.
In the article, Prof. Rosemary
Calder, Director of the AHPC, said:
“In 2015 to 2016, there were 67,266
potentially preventable hospitalisations for oral health problems
and almost one-third of these were
children under the age of 9 years.
Worryingly, there’s a growing number of children in this age group
who are being admitted to hospital
for dental health reasons.”
Future of oral health care in
Australia
As alluded to in this recent report, most Australians pay for dental care straight out of their own
pockets. This means that patients
who are not able to afford treatment either wait until it is too late
for any kind of restorative treatment or go to the hospital emergency department.
To combat this issue, Duckett
and his team suggested: “The first
step is for the Commonwealth to
take over funding of existing public dental schemes, fund them properly to the tune of an extra $1.1 billion per year, and enable private-sector providers to deliver publicly-funded care. Coverage should
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