Reporting of public dental waiting lists

ADAVB this week issued two media releases on the latest figures (as at March 2006 and published on 21 September) for the Department of Human Services' public dental waiting lists.

The releases received extensive coverage by TV, radio and newspapers, especially in provincial Victoria where the waiting times range from 68 months for Portland to 37 months for Daylesford.

ADAVB President Dr Greg Morris and Vice President Dr Mark Bowman conducted a number of interviews. ADAVB issued the releases to assist the Victorian Oral Health Alliance in its campaign to get better oral health services for Victorians. (ADAVB is a member of this non-aligned group of consumer, welfare and professional bodies.)

New clinics opened at Shepparton and Mooroopna

Two new dental clinics were opened in the Goulburn Valley yesterday by Minister for Aged Care and Aboriginal Affairs, Gavin Jennings MLC, supported by Federal Member for Murray and Minister for Workplace Participation, Dr Sharman Stone, representing Federal Health Minister Tony Abbott.

A stunning and light-filled twelve chair teaching clinic was opened at Goulburn Valley Health (GVH), and a two-chair clinic opened at Rumbalara Aboriginal Cooperative at Mooroopna.

Both clinics are run in partnership with the University of Melbourne School of Dental Science, thus giving final year BDSc and BOH students opportunity to learn and work in rural settings, including the special indigenous service at Rumbalara Health Service.

Professor Mike Morgan, Deputy Head of the School of Dental Science at the University of Melbourne, stated in the University's media release "Working hand in hand with the School of Rural Health and Goulburn Valley Health this program will significantly improve local dental services and has the goal and potential to increase the workforce in rural and remote areas".

In his opening speech, Minister Jennings noted that the GVH clinic was jointly funded by the Victorian Government ($10 million), the Comonwealth Government ($4 million) and the Pratt Foundation ($0.5 million). In his media release about the event, he also noted that the State Government "had provided $3 million to help establish the Rural Dental Health Program in conjuction with the University of Melbourne".

The new teaching facility at GVH forms part of an Integrated Care Centre, in which the dental unit is co-located with the Care Coordination Team, the Disease Management Team, Complex Care Services, Integrated Diabetes Services, Podiatry, Drug and Alcohol Services, Falls and Mobility Clinic, Hospital in the Home, Wound Management and Continence Services. These programs have been co-located so that clients can find services more easily, and staff can work more closely together to meet patients' total needs more effectively. This model is now apparently the template for all new clinics throughout the State.

The Rumbalara clinic deserves special mention because it is one of a very few indigenous dental services located within a rural community. Most other aboriginal communities in Victoria have to use bus services to take patients to Melbourne for treatment. The community controlled health service at Rumbalara is one of which they can be very proud, and the enthusiasm and commitment of their dental team was heart-warming to see.

We are going to hear a lot more from both these new rural clinics over the coming years.

Employers win reprieve

New employee record keeping requirements introduced under the Workplace Relations Regulations took effect on 26 March this year, however sanctions for failure to implement these arrangements were originally due to take effect from 26 September 2006.

The Government has decided to delay the time from which employers may be prosecuted for failing to meet these requirements until 26 March 2007.

The Minister for Workplace Relations, Hon Kevin Andrews MP, issued a media release today, advising this change and a number of other technical amendments to the Regulations.

Registration Fee increases

The Government Gazette of 21 September 2006 confirms that new registration fees have been approved under the Dental Practice Act 1999.

"In accordance with section 96 of the Dental Practice Act 1999 the Dental Practice Board of
Victoria has fixed the following fees which will take effect from 9 October 2006:

• Application for registration and application for renewal of registration as a dentist - $435.00
• Online application for renewal of registration as a dentist - $418.00
• Application for registration and application for renewal of registration as a dental specialist - $135.00 per special branch of dentistry (in addition to dentist fee)
• Online application for renewal of registration as a dental specialist - $122.00 per special branch of dentistry (in addition to online dentist fee)"

In correspondence advising the Branch of these changes, Board CEO Peter Gardner notes that "the need to prepare for the changes required to implement the new Health Professions Registration Act is in part responsible for the increase in fees".

Youth smoking rates down

Youth smoking rates in Victoria have hit their lowest point since records began more than 20 years ago, according to results from a new survey released last week by Health Minister Bronwyn Pike.

Ms Pike said the results showed Victorian youth smoking rates in 12 to 17 year olds had decreased from 21 per cent to 11 per cent over the past six years (1999 – 2005).

Smoking cessation reminder

The Australian Bureau of Statistics has published a new article called Tobacco Smoking in Australia: A Snapshot, 2004-05.

Some key points highlighted in this article, which remind dentists of the importance of providing smoking cessation advice to their patients are:

• Tobacco smoking is the largest single preventable cause of death and disease in Australia (Cancer Council 2006).
• Smoking is a key risk factor for the three diseases that cause most deaths in Australia: ischaemic heart disease, cerebrovascular disease and lung cancer. Smokers are also at increased risk of developing chronic obstructive pulmonary disease and reduced lung function (DoHA 2006).
• Smoking in pregnancy increases the risk of health problems for both mother and child. (DoHA 2006).
• Smoking is responsible for around 80% of all lung cancer deaths and 20% of all cancer deaths (smoking has been linked to cancers of the mouth, bladder, kidney, stomach and cervix, among others) (DoHA 2006).
• The 2003 Australian Burden of Disease Study indicates that tobacco smoking was second behind overweight among the leading causes of burden of disease in Australia. It was estimated that tobacco smoking was responsible for about 8% of the total burden of disease and injury for all Australians (9.5% of total for males and 6.1% of total for females) (AIHW 2006: Begg et al in press).

Bisphosphonates Alert

The Australian Adverse Drug Reactions Bulletin (Volume 25, Number 4, August 2006) contains an alert prepared by the Adverse Drug Reactions Advisory Committee (ADRAC) regarding Osteonecrosis of the jaw with bisphosphonates.

The alert notes that "any patient being considered for bisphosphonate treatment should be informed of the symptoms of ONJ and, if they occur, to bring these to the attention of their dental practitioner. Therapy should only be initiated if individual risk versus benefit assessment is thought to be favourable. Dental assessment and treatment should be completed before commencing bisphosphonate treatment. Patients receiving bisphosphonates should be strongly advised to tell their dentist that they are taking these medicines before any dental procedure is carried out."

Up to June 2006, 106 cases of osteonecrosis of the jaw (ONJ) have been reported as occurring in the context of treatment with bisphosphonates.

The September issue of Australian Doctor contains an article drawing the attention of medical practitioners to this alert, and so dentists should see some improved recognition of this problem amongst their medical colleagues. This article notes that concern about this issue "has prompted the Australian Dental Association and other main organisations to develop a joint position statement to be released soon. (ADA) spokesman Professor Alastair Goss said it was essential that patients were dentally healthy, did not have an infectious disease and did not require an extraction before they started bisphosphonates."

DVA rates adjusted

Minister for Veterans' Affairs, Bruce Bilson announced a $600m increase in funding for veterans' health care when he attended the RSL National Congress in Perth on Tuesday 12 September.

His media release about this notes that “This package recognises the high level of health care provided to Gold and White Card holders by specialists, general practitioners, allied health care providers, dentists, optometrists and pathologists”.

A Gold Card provides the holder with treatment and care for all health care conditions at government expense, while a White Card identifies the recipient as being eligible for treatment and care for specific conditions.

Click here to view dental DVA rates applicable since 1 July 2006.

Overseas skills recognition

On Monday 11 September 2006, the Joint Standing Committee on Migration tabled its report on the inquiry into skills recognition, upgrading and licensing Negotiating the maze (chapter downloads are available, but the full report is a large file 3.5Mb).

Chapter 4 relates specifically to professional skill recognition issues, and supports the COAG decision to establish national registration and accreditation boards for the health professions.

Bottled water to contain fluoride

The Australian today reports that within two years, bottled water could contain fluoride. The article suggests that this development is proposed by beverage companies fighting back "against claims that the shift away from tap water is increasing rates of decay in children".

The Bottled Water Institute has applied to Food Standards Australian New Zealand (FSANZ) to permit fluoride to be added to bottled water. FSANZ have suggested that the relevant food standards could be amended to permit this within two years.

The article also notes that the "National Health and Medical Research Council circulated documents in May that included fluoride as part of its recommended dietary intake of nutrients for the first time".

Dentsply sells injectable anaesthetic facility

In a sequel to the previously reported shortages of Citanest and the decision to sell its manufacturing facility (see postings dated 6 December 2005 and 10 February 2006), DENTSPLY International Inc. has announced that it has now sold its dental injectable anaesthetic facility and equipment located near Chicago to PIERREL S.p.A., of Milan, Italy.

PIERREL is a pharmaceutical contract manufacturing and drug development company listed on the Expandi Market in Milan. PIERREL is currently a supplier of dental injectable anesthetics to DENTSPLY in certain regions of the world. DENTSPLY has also strengthened its relationship for supply of dental injectable anesthetics from PIERREL through a separate supply agreement.

VOHA meets senior Liberals

The Victorian Oral Health Alliance (VOHA), of which the ADAVB is a member, met today with Mr Ted Baillieu, Leader of the Opposition, and Mrs Helen Shardey, Shadow Minister for Health, for very favourable consideration of VOHA proposals to improve public dental services in Victoria.

Mr Baillieu and Mrs Shardey showed considerable interest in VOHA suggestions, and asked many detailed questions with a view to determining which elements they will include in the Liberal's Dental Health Policy Platform, which is still under development. The meeting allowed an extended discussion of the key issues, and further information has also been sought on a number of matters.

The VOHA representatives emphasised that fluoridation of water supplies provides a basis for oral health, and then detailed a range of measures ranked in the following priority order:
1. Reducing dental waiting times
2. Addressing dental workforce shortages
3. Making special provisions for delivery of dental care to residents of nursing homes and other special needs groups e.g. ATSI consumers
4. Increasing the investment in oral disease prevention activities - recognising that the two most prevalent oral diseases, caries and gum disease, are preventable.