Dental Feature in The Age

Following editorial comment earlier this week on the need for a national dental database for forensic purposes, The Age has today published a lengthy article on the problems of long waiting lists and poor funding of public dental care.

The article notes that "Each year more than 30,000 people in Australia are hospitalised because of a dental condition, usually a tooth or gum infection that has been left to fester", and asks "So why the neglect for our teeth and gums?"

AHMC Communique includes Oral Health

The Australian Health Ministers Conference (AHMC) met in Brisbane yesterday to discuss a range of priority health issues including Remote Area Renal Services, National Health Call Centres, Pandemic Influenza, Childhood Obesity, Quality and Safety, and various Health Workforce issues.

The Conference Communique highlights the Ministers' agreement that "recruitment and retention of the oral health workforce continues to be problematic especially in regional and rural areas. State and Territory Ministers agreed to request the Australian Government to introduce a range of initiatives including:

• Identifying if the requirement of 300 additional graduates will be achieved by January 2007 as outlined in the National Oral Health Plan.
• Ensuring that 90 per cent of fee paying students are domestic
• Extending scholarships and cadetships for oral health practitioners and introducing bonded dental places of areas of workforce shortage."

CPI up

Australia’s inflation rate for the June quarter was 1.6%. This figure took the Consumer Price Index for the year from the June quarter 2005 to 4%, according to the Australian Bureau of Statistics.

The most significant contributors to the increase for the quarter were fruit (particularly bananas) – up 52% - and automotive fuel, an increase of 11.2%.

Health costs increased 2.4% due to dental services (an increase of 1.4%) and hospital and medical services (up 4%).

Melbourne’s CPI for the quarter was up 1.4%, giving an annual increase of 3.9%.

Graphic oral cancer warning

Smokers – watch out for mouth and throat cancer. It may very get you. This is the bleak warning in the in the latest campaign to warn smokers that they are at risk of getting mouth and throat cancer.
The latest data from The Cancer Council Victoria shows that smokers are up to 10 times more likely to die from mouth and throat cancer than non-smokers. And, nearly five Victorians a week are diagnosed with mouth cancer.
The release of the data coincided with the launch of a confronting new quit smoking TV advertisement.

ADAVB member Dr John O’Grady, a dental oncologist at the Peter MacCallum Centre, who was consulted about the advertisement, told the audience that smoking had potentially devastating effects on the mouth.nt depicting a woman with mouth cancer now being screened nationally.

The Age carried this story http://http://www.theage.com.au/news/national/exsmoker-finds-cancer-warning-is-hard-to-utter/2006/07/26/1153816253354.html This was the second consecutive day that The Age has published a dental story.

The Age calls for a national forensic dental database

Following news coverage yesterday of evidence given by forensic odontologist Dr Tony Hill at the Coronial Inquest into the death of Mr Matthew Bibby, The Age newspaper has published an editorial today (scroll down past the lead editorial to view) calling for the establishment of a national database of dental records to permit identification of unidentified bodies.

In his evidence to the Inquest, Dr Hill told the court "there is no system to match dental records collected by Victoria Police for missing people with those of unidentified bodies taken to the Victorian Institute of Forensic Medicine".

He also noted that there is currently "no way to connect any of the 49 unidentified bodies held in Victoria with registered missing people nationwide".

The court was also told that "until recently, the state mortuary did not routinely collect dental records or DNA from all unidentified bodies, which was the case with Mr Bibby's body".

The Coroner is due to hand down his finding on 4 August.

Dental Health Week 2006

During Dental Health Week, 1-7 August 2006, the Australian Dental Association Inc. (ADA) will be raising awareness about oral care for Australian teenagers.

Resources supporting the following themes are available on the ADA Inc. website

Oral piercings - What you need to know
Dental erosion - a silent epidemic
Nutrition to help fight dental decay

Further editorial about this year's Dental Health Week also appears in the July edition of the ADA Inc. News Bulletin.

Ultrasound to help regrow teeth?

The July edition of New Scientist contains a story about Canadian research into the use of an "ultrasound transmitter that fits neatly inside a person's mouth like a brace and could help to regrow damaged teeth".

The article notes that "Jie Chen and Ying Tsui, engineers at the University of Alberta in Canada, developed the miniature device after ultrasound stimulation encouraged damaged teeth and jawbone tissue to regrow in animals".

Dental accessories

According to the AC Nielsen Grocery Report 2005, dental accessories were the fastest growing grocery category in 2005 with a 31% increase in sales value over 2004, chiefly attributed to powered dental flossing and textured teeth wipe products.

When dental suppliers are considered against the top ranked suppliers by grocery value however, the highest ranked dental supplier (Colgate Palmolive) came in at No 13, behind a top 10 that contained three tobacco firms, 3 confectionary and/or soft drink firms, and assorted food suppliers. Other dental accessory suppliers listed in the Top 100 for 2005 were Procter and Gamble (ranked 29) and Gillette (ranked 32). The acquisition of Gillette by Procter and Gamble since then will change the ranking for the 2006 Grocery Report.

Tobacco suppliers ranked first, third and tenth by dollar value in the 2005 Grocery Report's Top 100 .

Clearly, the health professions and Governments still have much work to do in promoting better consumer choices in the interests of improved oral and general health.

Private Health Insurance Ombudsman - new powers

The Private Health Insurance Ombudsman (PHIO) was granted extended powers, including information gathering powers covering all subjects of complaints and investigations (e.g. dentists), when the Health Legislation (Private Health Insurance) Bill took effect on 1 July 2006.

As previously mentioned in ADAVB Blog posts on 27 April and 9 May, these new functions are designed to empower the PHIO to "protect the interests of people who are covered by private health insurance". In Victoria, that group makes up around 30% of the population. Health insurance companies fund around 15% of dental services across Australia each year.

A media release issued by the PHIO on 14 July, summarises the key changes and their implications.

COAG agrees to major health workforce reforms

The Communique from today's Council of Australian Governments (COAG) meeting includes a commitment to improve structures "supporting health workforce reform". The following extract refers:

"COAG noted the importance of ensuring that health education and training is better aligned with workforce needs. To assist with this, the Commonwealth and the States and Territories signed a Memorandum of Understanding for better consultation on health‑related university places. COAG agreed that the responsibilities of the Ministerial Council on Education, Employment, Training and Youth Affairs (MCEETYA) would be expanded to include annual agreement on national workforce priorities and advice on education and training that addresses current and emerging national skills shortages. COAG also agreed to establish a taskforce on the national health workforce, reporting to the Australian Health Ministers’ Conference through the Australian Health Ministers’ Advisory Council, to undertake project-based work and advise on workforce innovation and reform."

In a section addressing a wish to facilitate workforce responsiveness and mobility, the following extracts are significant as they commit all Governments to establish single national registration and accreditation systms by July 2008:

"In order to facilitate workforce mobility, improve safety and quality, and reduce red tape, COAG has agreed to establish by July 2008 a single national registration scheme for health professionals, beginning with the nine professions currently registered in all jurisdictions. COAG has agreed to undertake consultation with stakeholders on its preferred model of a national cross-professional registration body which would also involve health professions participating in the scheme’s governance through profession-specific panels and committees. COAG noted that this is the first tranche of national registration and that other professional groups (including Aboriginal Health Workers) may be added over time."

"COAG further agreed to establish by July 2008 a single national accreditation scheme for health education and training, in order to simplify and improve the consistency of current arrangements. COAG has agreed to undertake consultation with stakeholders on its preferred model for the scheme which would ensure that accreditation activities retain and draw on essential health profession‑specific expertise."

"Both the national registration scheme and national accreditation scheme would be self-funding, with establishment costs jointly funded by the Commonwealth and the States and Territories."

The ADA Inc. immediately issued a Media Release in response to the announcements.

Other Links

COAG Response to the Productivity Commission Report on Australia's Health Workforce

Health Workforce - National Professional Registration

Health Workforce - National Accreditation

Human Capital Indicative Outcomes and Associated Progress Measures

COAG Decisions on reducing the Regulatory Burden

New Quit Campaign

Quit Victoria advises that a new quit smoking advertising campaign later in July will highlight the relationship between smoking and oral disease. It aims to increase awareness of these potentially devastating effects on the mouth and help address the lack of understanding about the health effects of smoking.

A brochure on smoking and oral health for people who smoke, and posters for display are available to support the campaign. To print an order form, click here.

Suzanne Stillman, Quit Victoria's Deputy Director said, "Although the risk of dying from mouth and throat cancer is significantly higher among smokers compared with someone who has never smoked, awareness about the relationship between smoking and oral disease remains alarmingly low".

"What is particularly tragic is that most of the deaths and often-devastating effects of cancers of the mouth and throat could have been prevented. Advanced cancers of the mouth and throat can cause chronic pain, loss of function and disfigurement. Breathing, talking, eating, chewing and swallowing can all be affected," she said.

Dentists and their staff can share the good news with smokers however, that they can reduce their risk of mouth and throat cancer by making the decision to quit and using strategies that will make their quitting more successful.

The advertisement, produced by The Campaign Palace/Red Cell, is part of a new national quit smoking campaign that has been developed in collaboration between state and territory smoking and health programs.

Click here for further information about smoking and mouth and throat cancer from Quit Victoria’s Background Brief ‘Smoking and the mouth’.

Additional dental places at NSW and Qld universities

Federal Education Minister The Hon Julie Bishop MP yesterday issued a media release following an earlier anouncement by the Prime Minister regarding the allocation of an addditional 2,850 university places in health related disciplines at various Australian universities.

The University of Sydney has been allocated an additional 40 places for their BDSc and BOH courses, while Griffith University in Queensland has been allocated a futher 20 BOH places. No other additional dental places appear to have been allocated in any other States.

Social Costs of Smoking

The Department of Human Services has published a new report on the Social Cost of Smoking called "Counting the costs of tobacco and the benefits of reducing smoking prevalence in Victoria".

Health professionals usually consider the health costs of tobacco and focus on the methods leading to smoking cessation. This research provides a broader perspective.

According to the Department "Social costs include both tangible and intangible costs. Tangible costs refer to costs spent on resources which would have been available had there been no smoking, for example hospital costs. They are borne by individuals, businesses and governments and when reduced release resources for other uses. Intangible costs are borne solely by individuals and are generally much harder to value. They include costs associated with pain, suffering and loss of life".

Professor David Collins and Professor Helen Lapsley were commissioned to undertake research into the Social Costs of Smoking in Victoria.

The objectives of the research were to:

• Estimate the social costs of smoking for Victoria for the 1998/99 financial year;
• Estimate the benefits in terms of a reduction in the social costs of smoking which are likely to arise from a reduction in smoking prevalence in Victoria from 17% (1) to 12%;
• Estimate the social benefits to be gained from effective anti-smoking programs.
  

The report found that:

• The total social costs of smoking in Victoria for the 1998/99 financial year were approximately $5.05 billion.
• Victoria bore 24 per cent of the total Australian social costs of smoking in 1998/99.
• Smoking in Victoria costs residents about $4.3 billion each year. Businesses and governments bear about $494 and $207 million in costs each year respectively

First Management Forum Success

Members who attended the first of the ADAVB Moneywise Management Forums at Rydges Riverwalk Hotel last night left buzzing with ideas and issues on which they will be taking follow up action.

Albert Gigl from Moneywise Partners provided a number of tips and insights into tax structures and strategies, and urged those who had service trusts to consider alternative arrangements.

Chris Riordon from Riordon and Riordon Lawyers, outlined a number of compelling reasons for members to use discretionary trusts (not service trusts) in preference to a company or sole operator approach.

This forum session was the first in an ongoing series, and the next is scheduled for 6.00 pm on Tuesday 12 September at the same venue ($35 for ADAVB members and staff or $55 for non-members). Presenters at that program will include Dan Payne, Chairman of Moneywise, on "Investment strategies -what works, what doesn't?' and Richard Crabb, Victorian State Manager of Medfin Finance, on 'Benefits of leasing your equipment'.

If you have not yet registered to participate in this event, contact the Branch office for a registration form on 9826 8318.

US Surgeon General report on secondhand smoke

The U.S. Surgeon General Richard H. Carmona has just issued a comprehensive scientific report The Health Consequences of Involuntary Exposure to Tobacco Smoke: A Report of the Surgeon General (NB the report itself is 19Mb but an Executive Summary is available), which concludes that there is no risk-free level of exposure to secondhand smoke. See also the Surgeon General's press release on this.

According to the report "nonsmokers exposed to secondhand smoke at home or work increase their risk of developing heart disease by 25 to 30 percent and lung cancer by 20 to 30 percent. The finding is of major public health concern due to the fact that nearly half of all nonsmoking Americans are still regularly exposed to secondhand smoke.”

ADAVB members are reminded that they can obtain resources to aid their patients to stop smoking through Quit Victoria.

Tooth-in-eye implant undertaken in Australia

The Channel 9 News reported last week that an Australian patient has undergone the first operation in a two stage process to use one of his canine teeth to restore his sight.

Peter Halleday has been blind since 1978 when chemicals exploded at the power station of Carter Holt Harvey in Mt Gambier.

Dr Trevor Hodson, interviewed on ABC South East SA Radio, said that the surgical procedure would see the tooth being implanted with a small microscope inside of it that could allow at least thirty-degree vision in one eye. He said the procedure was being carried out by Professor Tan in Singapore. Dr Hodson praised the continued support of the employer who assisted in getting Mr Halleday to Singapore.

Osteo-odonto-keratoprosthesis (OOKP) is a method of corneal substitution, which uses a prosthesis composed of an acrylic optical cylinder mounted within a section of one of the patient’s own teeth. Because the implant uses autologous tissue, it has been used in people who are at high risk of graft rejection following conventional transplantation.

This technique was first used in Italy about 40 years ago and more recently surgeons in Britain, Germany and Singapore have reported success in using the OOKP procedure.

Readers interested in more information about the procedure might like to start with the following sites:

Singapore Medicine report of a 2004 implant

Singapore Medicine report on the OOKP process and international recognition of the Singapore based surgical team involved

Royal College of Opthalmologists Guidelines (UK) for OOKP

Land Tax Trusts - Nomination Deadline Extended

A number of members hold their practices or other land through a Trust, and so will be interested to note that Trustees now have until 30 September 2006 to nominate a beneficiary as part of the State Government’s new approach to Land Tax on trusts. A Media Release announced this change on June 27, 2006.

The Commissioner of State Revenue, Mr Paul Broderick, announced the extension in response to requests from practitioners for more time to complete the nomination process. Nominations had been due by 30 June 2006.

ADAVB Submission re Students with an Incapacity

The ADAVB has made a submission to the Dental Practice Board of Victoria in response to their draft 'Policy on Students with an Incapacity'.

The Branch provided support for the draft policy, as it generally aligned with the ADA Inc. Policy Statement on Health Care Workers (including students) with Blood-Borne Viruses.

A number of members had expressed concerns about the need to ensure that students who became infected or injured after some years of training should be able to complete their qualification and work in some way in a non-practicing classification of the register. This suggestion was highlighted in the submission.

Death in the dental chair

A coronial inquest is being held in Sydney into the death of a patient who was being sedated in the dental practice preparatory to implant procedures. Stories in The Australian on 3 July and the Sydney Morning Herald on 4 July refer.

No anaesthetist was present and the Inquiry has been told that the patient was "starved of oxygen during surgery". A lawyer for the patient's family has told the coroner that he would be asking him to recommend criminal charges against the dentist involved. The inquest continues.

National Student Convention in Melbourne

The ADAVB congratulates the students at Melbourne University's School of Dental Science who have been responsible for organising the 2006 National Dental Student Convention. The future of dentistry is in good hands when we have such dedicated and energetic students taking responsibility for their colleagues' 'professional' development.

The Convention has been running this week at various venues in Melbourne and surrounds, including a bus trip to Ballarat to inspect public dental facilities and consider rural practice perspectives. Delegates have attended excellent clinical presentations by leading practitioners and academics, and also had opportunity to attend a trade display at which they met representatives of a range of dental companies and organisations offering them help as they move into their professional lives. The ADA Inc. was one of the Convention sponsors and ADAVB provided logistical and other support, including participation in the trade display.

Almost 200 delegates have enjoyed the program, with about 50 coming from interstate - mainly Western Australia and South Australia.

Higher Employer Support payments for Defence Reserve Dentists

Employers of dentists may be entitled to payments of $4500 a week when they release their employees for Australian Defence Force Reserve service.

Chief of the Defence Force, Air Chief Marshal Angus Houston, approved an increase to health professional Employer Support Payments (ESPs) this week. "When a health professional serves part-time in the Navy, Army or Air Force Reserves, they are making a substantial contribution to Australia's national defence. They are also picking up both professional and general skills, and gaining from experiences that are quite different from those they normally encounter in their civilian health positions", he said.

For further information on the higher level payments for health professionals under the Employer Support Payment Scheme, see the Employer Support Payment section of the new Defence Reserves website (look under ‘Claims under CDF Capability Provisions’), phone the Employer Support Payment Scheme help line on 1800 803 485, or email esp@defence.gov.au.

Burden of Disease study published

Victorian Health Minister Bronwyn Pike yesterday announced the publication of the Victorian Burden of Disease Study (20o1), which reports on the 50 most common diseases and injuries in Victoria and the prevalence of these in each of the 78 local government areas in the State.

Those interested in dental epidemiology can search for statistics on dental caries and oral cancers and compare results against other common diseases and conditions.

New Dental Research Reports

During June the Australian Institute of Health and Welfare's Dental Statistics and Research Unit published three new research reports

Access to dental services among Australian children and adults
Urban and rural variations in child oral health
Dental therapist labour force in Australia, 2003

Key findings in the first of these include:

• Approximately 13% of dentate adults across Australia reported that they would have difficulty paying a $100 dental bill
• Between 46-47% of Ausralian children and adults have private dental insurance. Victorian residents were less likely (35-36%) to have dental insurance than other Australians
• Only 10% of Victorian children usually visit the dentist for treatment of a problem compared with 22% of children in NSW