Better use of oral therapists key to universal dental care: Deakin study

Media release
01 July 2019

A simple change in how public dental care is delivered could save millions in taxpayer funds and reduce waitlists that force disadvantaged Australians to wait years for treatment, according to new Deakin University research.

The study, published in a recent edition of Human Resources for Health, crunched the numbers on transitioning one of Australia's largest public dental programs to a delivery model led by more oral health therapists instead of dentists.

It showed that if the Federal Government's national scheme to increase dental care access for children was administered by Victoria's current workforce ratio of two oral health therapists to every three dentists, it could save $67 million from the program's annual expenditure.

Lead author Tan Nguyen, an honorary fellow in Deakin Health Economics' new oral health research stream, part of the recently launched Institute for Health Transformation, said better use of oral health therapists in the delivery of public dental services for children would significantly improve efficiencies.

"Countries that want to embed dental services in universal health care must maximise the role of oral health therapists to improve efficiency," Mr Nguyen said.

"The potential cost-savings could be re-invested in other public dental initiatives such as school-based dental check programs, or resource allocation to eliminate adult dental waiting lists in the public sector, which can run up to three years or more."

Mr Nguyen, a practising oral health therapist, said many dental services could be provided by both dentists and oral health therapists.

"The oral health therapy workforce provides high-quality and cost-effective dental services within their scope of practice, which enables dentists to focus on more complex procedures," he said.

"An oral health therapist undertakes a three year bachelor degree, compared to five to seven years of training for dentists. Their work is narrower in scope and much more focussed on prevention, including check-ups, teeth cleaning, simple fillings and some teeth removal. On average, their salary in the public sector is 30 per cent less for carrying out these procedures.

"The current Australian dental workforce mix requires the dentist, who is qualified to provide complex dental services, to deliver routine services that can be provided by an oral health therapist at a reduced cost."

As part of Mr Nguyen's study, the average 30 per cent salary difference between the two professions was used the adjust the cost for each type of service offered under the Child Dental Benefits Schedule. The research team - which also included trained dentists - then analysed the two different variables.

Firstly, they looked at a scenario where services were offered under the national workforce ratio of one oral health therapist to every four dentists. And another scenario was modelled on the Victorian workforce ratio, which has the largest oral health therapy workforce at two oral health therapists to every three dentists.

They then looked at how using those two workforce models would result in cost savings at the program's current target population uptake - 29 per cent of Australia children aged between two and 17 - and also at the Government’s target rate of 80 per cent.

"In Australia, oral conditions are the second most common cause of acute, potentially preventable hospitalisations, and currently nearly a third of children aged five to six have never visited a dental practitioner, so it's crucial we improve access to oral health services at all stages of life," Mr Nguyen said.

"It's always been a big issue for governments to fund dental because they believe it is a high cost. Our work shows it doesn't have to be as high as they think. There are more sustainable ways to deliver public dental services, and this economic analysis shows a better use of resources is possible."

Cost savings

National Workforce (1:4)

Victorian Workforce (2:3)

Current utilisation rate (29%)

$26.5 million

$61.7 million

Target utilisation rate (80%)

$73.2 million

$170.2 million

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Media release Faculty of Health, School of Health and Social Development Institute for Health Transformation (IHT)

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