Young Australians will remain victims of an oral health “blindspot” because of the “stubbornly agnostic” attitudes of major political parties to include dental in Medicare, experts fear.
The section of Australian society most likely to drop off from visiting the dentist is young adults. Many never return, according to a recent study that found the demographic accessed regular oral healthcare the least.
The University of Melbourne study urged policy reform to address a vulnerability gap, where the child dental benefits schedule ends at 17 without robust financial support for youth transitioning into adulthood.
Labor and the Coalition were “stubbornly agnostic” on this issue, said Assoc Prof Ankur Singh, a senior author of the study and the chair of Lifespan Oral Health at the University of Sydney.
Anthony Albanese and Peter Dutton both made historic multibillion-dollar Medicare pledges on the campaign trail but “somehow oral healthcare has been completely missed out – there’s no mention, no roadmap what [oral health is] going to look like in this [government] cycle or the next cycle,” Singh said.
Like housing, dental care was a policy area where young adults were disadvantaged, Singh said, and the “data clearly highlights that there’s a blind spot”.
The study, recently published in the Journal of Dental Research, tracked the dental attendance of 11,189 participants aged 15 to 64 from three time points: 2009, 2013 and 2017.
Researchers found almost all participants who were 15 years old at baseline had a high probability of going to the dentist at least once every two years, but there was a “sharp decline” between the ages of 15 and 20, and for a quarter of the population, this did not improve.
“There’s a sudden drop in terms of their dental attendance, and [many] never come back,” Singh said. “That’s really scary.”
Poor oral health impairs basic functions like chewing, speaking and sleeping and can have flow-on effects for a person’s nutrition, general health – it is associated with higher rates of heart attack and stroke – and mental health. Dental diseases are the leading cause of preventable hospitalisations, according to government data.
Singh said financial insecurity was a leading factor in young people’s lack of access to dental care. More than 900 young Australians, between 18 and 39, responded to a Guardian callout asking voters how they felt in the lead-up to the federal election. They listed the cost of living, housing and healthcare among socio-economic stressors.
Unaffordable dental care was “clearly a spillover effect” from there being no Medicare rebate, Singh said.
The Australian Dental Association has proposed expanding public dental services through a senior dental scheme. Singh said while the brunt of dental problems was experienced in old age, targeted policies for young people would be complementary because oral health care had cumulative benefits over time.
The study also examined time-based trajectories for dental attendance. It found 33% of working-aged Australians were persistently not attending the dentist, and were more likely to face educational, employment and income disadvantages.
A Guardian Australia series in January explored inequality in the nation’s dental system. While patients fork out for dental fees, of the $1.3bn the federal government spends on the nation’s teeth, more than half goes to subsidising the uptake of private health insurance.
Assoc Prof Matt Hopcraft, from the Melbourne Dental School, said research highlighting young Australians’ poor dental attendance “clearly points to the need for reform of public dental funding, such as expanding Medicare to include more essential dental services”.
Peter Breadon, the health program director at the Grattan Institute, said: “These studies show yet again that Australia’s dental care system is not fit for purpose — and that everyone knows it.
“But cost isn’t just a barrier for the most disadvantaged; many middle-income Australians, and even some on higher incomes, are skipping the dentist because they simply can’t afford it. And it’s happening across all age groups. That’s why we need a clear pathway to universal dental coverage, just like we expect for every other part of the body.”
During a debate on Wednesday between the health minister, Mark Butler, and the shadow health minister, Anne Ruston, both said their focus was on primary care when asked about adding dental to Medicare.
This week, Butler told Guardian Australia he knew “many people are ambitious for dental to be covered by Medicare”.
“I’ve tried to be honest with people that the government’s focus right now is strengthening Medicare and rebuilding general practice after a decade of cuts and neglect from the Liberals,” Butler said.
“I can’t say to people that in the short term there’s going to be any change to dental, but I do recognise in the longer term there’s a lot of ambition for dental to be covered by Medicare.”
