Position Statements

Current challenges in Australia with respect to the disease, dental caries

Dental caries (tooth decay which can lead to cavities) is still one of the most prevalent chronic diseases worldwide1.  However, too many Australians do not fully understand that caries is a largely preventable disease, and do not engage in good oral health behaviours that would reduce the burden of that disease.  A burden that is avoidable.

In the face of increasing expenditure from Australian families, health insurance funds, Australian government premium rebates and direct outlay on dental services, oral health in Australia continues to decline.

Current-challenges-in-Australia-with-respect-to-the-disease,-dental-caries

Dental caries is a common chronic disease in children.  After three decades of improvements, decay incidence in Australian children is now increasing, according to a report released by the Australian Institute of Health and Welfare3.

Over the next few decades the number of dentate elderly (those with their own teeth) will increase markedly.  As people age they are more likely to suffer from illnesses that may require ongoing medication.  Many medicines affect saliva flow and can increase the risk of dental disease.

The Oral Health Advisory Panel supports increasing awareness and education about the impact of dental caries on Australian families during all stages of life.

1 Australian Institute of Health & Welfare (AIHW) no 54 p1
2 Australian Institute of Health & Welfare (AIHW) http://www.aihw.gov.au/expenditure-­‐data/#health (accessed 26 November, 2013)
3 Australian Institute of Health & Welfare (AIHW) 26 August 2005

Benefits of adopting a holistic approach to oral health and general wellbeing

There are many common risk factors in chronic diseases, including diet and lifestyle factors such as smoking that not only affect your oral health but have been shown to be associated with heart disease, uncontrolled diabetes (and its complications), obesity and overall quality of life.

The Oral Health Advisory Panel urges Australians to be mindful that the mouth is part of the body and if the oral tissues are unhealthy, there are potential consequences for general health and impact on quality of life.

Importance of establishing good oral health habits at early age

Both tooth decay (dental caries) and gum (periodontal) disease are biofilm1 related diseases.  The twice­‐daily removal of oral biofilm1 (commonly referred to as plaque) from on and between tooth surfaces and gum margins is important for the prevention and control of these diseases. 

The Oral Health Advisory Panel recommends parental assistance and supervision (for children up to 8 years) of twice­‐daily effective brushing as an important habit to establish early in life as this behaviour is hard to introduce effectively later on.

1 Bacteria which stick to each other on the tooth surface 

Inequalities in oral health

Global  inequalities  in  oral  health  persist,  both  between  and  within  different  regions  and  societies,  and  they  undermine the productivity, and quality of life of many of the world’s populations.  There has been much research into the biological and social factors influencing general and oral health, including the influence of psychological, social, environmental, economic, cultural, and political factors on health outcomes1, but this has not led to the improvements that could be expected2.

The  underlying  causes  of  global  inequalities  in  general  and  oral  health  are  key  influences  on  daily  life.  These  include gross economic differences between and within countries, and policies and programs that come from the failure of governments to address the social determinants of health. This leads to the conclusion that if systematic improvements in peoples’ health are to be achieved, then all sectors of society must become engaged, and not only the health sector3

A  full  understanding  of  inequalities  in  health  requires  insight  into:  (1)  the  social  factors  influencing  peoples’  health; (2) the fact that oral diseases are socially determined, with consequences that may pass from generation to generation; and (3) the sources of the social gradient, often referred to as the “causes of the causes” (Marmot and Bell, 2011).

The Oral Health Advisory Panel takes a holistic approach to education and promotion of oral health to help address inequalities in oral health.  The broad aim is to help drive systematic improvements to oral health across the Australian population.

1 Marmot M, Bell R (2011). Social determinants and dental health. Advances in Dental Research 23:201-­‐206.
2 Sgan-­‐Cohen HD, Evans RW, Whelton H, Villena RS, MacDougall M, Williams DM, and IADR-­‐GOHIRA Steering and Task Groups (2013).  IADR Global Oral Health Inequalities Research Agenda (IADR-­‐GOHIRA): A call to action. Journal of Dental Research 92(3): 209-­‐211.
3 Sheiham  A,  Alexander  D,  Cohen  L,  Marinho  V,  Moysés  S,  Petersen  PE,  et  al.  (2011).  Global  oral  health  inequalities:  task group—implementation and delivery of oral health strategies. Advances in Dental Research 259-­‐267.

Preventive dentistry approach

Fluoride is the most effective preventive agent used against dental caries1. However, dental practitioners do not necessarily utilise fluoride in a proven comprehensive preventive management system. Australian researchers, such as those at the University of Sydney,2 have developed a proven cost effective caries management system3 that involves the assessment of patient risk for developing dental caries, improved diagnosis and non-­invasive treatment options for early lesions plus coaching of tooth brushing skills.
The Oral Health Advisory Panel encourages the wide adoption of a caries risk assessment tool and management system to improve the prevention of dental caries (tooth decay can lead to cavities).

1 Bratthall et al, 1996; ADA Policy Statement 2.2.1, 2012
2 Evans et al. 2008 Australian Dental Journal 53: 83-­92

3 Curtis et al. 2011 Australian Dental Journal 56: 48-­55

The Oral Health Advisory Panel’s focus is firmly aimed at improving oral health of all Australians as a means to enhance general health and wellbeing. Our aim is to help lessen the impact of some systemic diseases and address the outcomes of oral health conditions, such as tooth decay.

John Smith - Name Subtitle