Adult dental health services report: under researched and underdone

The Australian Dental Association Inc. (ADA) says the release yesterday of the "Bridging the Dental Gap" Report on the inquiry into adult dental services lacks credibility when it comes to workforce recommendations.

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"The Report of the House of Representatives Standing Committee on Health and Ageing demonstrates, yet again, that the Australian Government is not listening to those health professionals who best understand oral health issues," stated Dr Karin Alexander, ADA Federal President. "The ADA presented at the Committee's roundtable held in April. It was immediately concerned that only a small contingent of the members of the Committee even bothered to attend."

While the Report makes a number of sensible recommendations about the delivery of sustainable dental services, in relation to workforce issues, it seems that despite the release of 2011 workforce data by the Australian Institute of Health and Welfare (AIHW) during the consultation period, the Committee has chosen to rely on out-dated data from 2006. The scenario presented in the 2011 study makes the basis of the Committee's report fundamentally flawed. For example, the Report refers to 10,404 dentists in Australia when the 2011 study states there are in fact 12,734 practising dentists – the figure used in the Report is short by 22%! In 2013, with the increased number of dentist graduates and overseas trained dentists registering in Australia, the discrepancy is even greater. The ratios of dentist to population by remoteness area outlined in the Report are also out-dated and present an inaccurate picture of the public's access to dentists.

"To claim there is a shortage of dentists when recent graduates can't get jobs is pure nonsense," Dr Alexander added. "Furthermore, to use this non-existent shortage claim as justification for recommending that lesser-trained auxiliary dental providers work on the unsuspecting public independently of dentists shows a complete lack of understanding about the limitations of their education and training and a disregard for patient safety."

The Dental Board of Australia is already consulting on a revised scope of practice standard for dental auxiliaries as directed by the Ministerial Council. This Board is made up of various dental practitioners and consumer representatives and is best placed to consider this issue.

"With all due respect to the Parliamentary Committee, it has little, if any, expertise to evaluate any evidence upon which to base its recommendations. Allowing auxiliary dental care providers (some with as little as two years' training) to provide dental treatment, without the supervision of a dentist, severely compromises the safety and quality of dental care delivery."

The Report is also recommending auxiliaries have access to Medicare provider numbers.

"To allow these auxiliaries to provide services which can be potentially covered under Medicare may allow state and territory governments to employ less qualified people and shift the cost of services provided by public dental clinics from State budgets to Medicare," stated Dr Alexander. "So instead of providing services by qualified and experienced dentists, working in a structured team with auxiliaries as they do now, many public patients will be treated solely by lower level providers - poor dentistry for poor people."

The ADA calls on the Australian Government to disregard this under-researched and poorly prepared report.