Tara* never thought by age 55 she would have lost all her teeth.
She tried her best to look after her teeth but having only ever earned minimum wage she could not afford visits to the dentist.
Her approach to any mouth or tooth pain was simply to tolerate it. “I would let it get to the stage where it would swell up and then have to go to the doctor and get antibiotics.”
As she developed gum disease, Tara lost her teeth “one by one”. She also lost two teeth due to problems arising from seeking out the cheapest dental care possible. “One guy put a bridge on a tooth that he didn’t check and that tooth was bad so I lost both those teeth,” she says.
She waited seven years for an appointment through the public dental waitlist. That long wait resulted in an X-ray in 2020. Three years later she got a follow-up appointment where her last few teeth were removed to prepare her for dentures.
Tara hopes to receive the dentures before Christmas but the wait has been punishing. She can barely eat. As a result, she is underweight, deficient in iron, and vitamins D and B12. Her diet is a rotation of Weet-Bix cereal, eggs and smoothies and she is “sick of it all”.
But the hardest part of having no teeth, she says, is “it’s just destroyed my mental health. I am incredibly lonely but I can’t go out. I can’t socialise because I just don’t have any self-confidence.”
Tara lives on Tasmania’s north coast but feels like “I can’t go visit my sons in Sydney, because I won’t let them see me like this”.
Tara is not alone. Almost one in five (18%) adults delayed or did not see a dental professional in 2022-23 due to cost, according to the Australian Institute of Health and Welfare’s (AIHW’s) Oral Health and Dental Care report, released on Friday.
Only one in two adults visited a dental professional in the last 12 months, the report said – a figure that had remained stable over the past 10 years.
These numbers echo the 2023 Senate inquiry into access to dental services, which found Australia has a two-tiered oral and dental health care system. “Around half of Australians have acceptable oral and dental health and adequate access to services, and the other half do not,” the report said.
AIHW data showed people living in areas of least socio-economic disadvantage were more likely to visit a dentist (65%) than those in areas of most disadvantage, where the percentage dropped to 42%.
Cost was a notable barrier for people in rural and remote areas and for those with specialised health needs, including living with a disability.
The report found Indigenous people disproportionately suffered from poor dental health. About one in 20 (6%) Indigenous Australians aged 15 and older reported complete tooth loss, and just under half had lost at least one tooth.
The report found people who finished year 11 or above at high school had on average half the number of missing teeth (3.3) as those whose reached year 10 or lower (7.7).
Poor oral health can lead to lasting “physical and psychological disability”, the report said, and compromise a person’s nutrition and exacerbate other health conditions such as heart disease.
There were close to 87,400 hospitalisations for dental conditions that could have potentially been prevented with earlier treatment, the report said.
There has been a substantial increase in the number of people who reported the detrimental social impacts of their oral health in the last 30 years, the report found. In 1994, one in five Australians reported feeling uncomfortable due to dental problems. In 2021, almost half (44%) reported feeling uncomfortable.
Jason* says for the last 15 years he had never been able to afford to go to the dentist. Now, aged 39, he has found it is “too late”. He has discovered he has gum disease, a chronic disease he will never be rid of, but is having to dip $8,000 into his emergency savings to have laser surgery to try to treat it.
The disease could cause Jason to develop “black triangles” – gaps between the teeth along the gumline – which the laser helps reduce and prevent but is not guaranteed. Jason says he has no other choice. “I’m in a sales role. I can’t be going around with massive gaps in my gums, or else I’ll have to change my job. I can’t continue to be in this role doing what I’m doing looking like this.”
The AIHW report collated data from sources including the Australian Bureau of Statistics, the Australian Research Centre for Population Oral Health at the University of Adelaide and the Royal Flying Doctor Service.
The AIHW acknowledged a comprehensive picture was difficult to build because of a lack of national data sources and old, disjointed record-keeping.
Associate Prof Matt Hopcraft from the University of Melbourne’s dental school says the out-of-date information is hindering informed dental policy and improvements to oral health.
Hopcraft has called for dental services to be made available under Medicare.
The Labor backbenchers Helen Polley, Brian Mitchell, Mike Freelander and Graham Perrett have advocated for opening up a discussion over how dental could be added to Medicare.
The health minister, Mark Butler, was cool on the idea, saying in September “that’s not something we’re going to be able to do in the near term”.
But Hopcraft argues dental should be a priority for government.
“As the cost of living crisis continues to bite, we need to see significant reform in our dental care system,” he says.
“With an election due next year, it is important that we put oral health on the radar so that it is not neglected again.”
*Names changed to protect anonymity
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