VicHealth comments on Food and Beverages Marketing Communications Code

On a matter that will be of interest to all members who support oral health promotion, VicHealth CEO Rob Moodie has published an interesting commentary on the recently released Food and Beverages Marketing Communications Code, drafted by The Food and Grocery Council and the Australian Association of National Advertisers. The Code was presented to the National Health Minister's Conference in Brisbane this week.

VOHA meets Minister Pike

Representatives of the Victorian Oral Health Alliance (VOHA) met Victorian Health Minister Bronwyn Pike on Friday 25 August to seek her Government's commitment to implement a range of measures designed to improve public dental health. These measures were outlined in VOHA's Ideal Dental Health Policy Platform.

VOHA was formed in 2004 in the lead up to the last Federal Election, and campaigned on the basis of agreed positions on areas of need that should be addressed by the Commonwealth. Its current focus is on the Victorian State Election scheduled for 25 November 2006.

The meeting with the Minister emphasised that whilst the Victorian Government had made significant improvements to dental funding since 2003, much more still needs to be done to reduce waiting times to an acceptable level, especially in rural Victoria. Many other measures, including stronger preventive measures were also advocated, in recognition that most dental disease is preventable. Targetted funding for groups with greater need was also advocated, in particular for residents of aged care facilities and Koori communities.

The Minister was supportive of more being done to improve public dental health, but no specific commitments were given.

VOHA is now seeking meetings with other parties and candidates.

Victorian Oral Health Alliance Blog

The ADAVB is a member of the Victorian Oral Health Alliance (VOHA), which is an informal and non-aligned group of consumer, welfare and professional bodies committed to improving public dental health. VOHA now has its own Blog, which those interested in the oral health issues being addressed in the 2006 Victorian State election are welcome to visit.

A VOHA website is currently under development and once ready, an announcement about its avaiability will also appear here.

One of the major focal areas in submissions made by Alliance members during the 2004 Federal election was the lack of adequate funding. This was addressed to some extent when the State Government increased recurrent dental funding by around 30% in the 2004/05 budget. As welcome as this was, it still only goes some way to meeting the critical problems in the oral health system. The Alliance is therefore reminding the Government and other parties of the National Oral Health Plan which notes that adult Australians have the second worst oral health status of all OECD countries, and those on Concession Cards the worst status within Australia.

The widespread support for the National Oral Health Plan in late 2004 by the Commonwealth and States was also encouraging, and bipartisan support for this in Victoria provides a most positive context for effective policy development before the forthcoming election. However VOHA notes with alarm that relatively little progress has been made in implementing it.

Members and supporters of the Victorian Oral Health Alliance include:

• Australian Dental Association Victorian Branch Inc
• Australian Dental Therapists Association
• Brotherhood of St Laurence
• Dental Hygienists Association of Australia, Victorian Branch
• Health Issues Centre (Victoria)
• Public Health Association of Australia Inc.
• Rural Workforce Agency, Victoria
• Victorian Aboriginal Cooperative Community Health Organisation
• Victorian Council of Social Services
• Victorian Healthcare Association
  

Rural Scholarships 2007

Qualified, practicing rural and remote allied health professionals are able to apply for scholarship funding to support them to undertake a continuing professional education activity. Such as:·

• attendance at a conference (remember the National Rural Health Conference is in March 2007; or discipline specific conferences occurring in 2007); ·
• short courses; ·
• individual clinical placements (do you want to upgrade skills in a particular area by visiting a metropolitan specialist clinic in that area and undertaking a placement); and ·
• formal postgraduate qualifications.

The application package including application form and scholarship guidelines can be downloaded from the SARRAH website.

Applicants are encouraged to apply online as this greatly assists the SARRAH staff to process the application form information. The closing date for applications is 15 September 2006.

Sugared drinks out of school canteens

Most major bottlers of non-alcoholic carbonated, non-carbonated, juice and water-based drinks have agreed to guidelines which will remove sugared drinks from primary school canteens and stop advertising directly to children. The policy, announced today by the Australian Beverage Council (ABC), is in response to increasing pressure to fight child obesity. Dentists will welcome the move as a step in helping to improve the oral health of children.

The ABC recently issued a Media Release on Soft Drinks and Tooth Decay - at the same time as the ADA was conducting Dental Health Week around the theme of 'oral health for young people'.

More background on HIV Testing of Queensland Patients

Queensland Health has published Questions and Answers regarding their approach to testing of patients treated by the dentist who has recently tested positive to HIV.

This information accompanied their Media Release of 23 August about the need for testing.

Good oral health for all, for life

To reinforce the New Zealand Government’s commitment to improving oral health services, the NZ Ministry of Health has developed a strategic vision document, called Good oral health for all, for life, which is similar to Australia's National Oral Health Plan 2004.

In his introduction to this paper, NZ Health Minister, The Hon Pete Hodgson said,

"New Zealand has reached a turning point for oral health. Several decades of dramatic improvements in the oral health of young people have begun to reverse. Inequalities in oral health and in access to oral health services have become increasingly evident, with Māori, Pacific, rural and low socioeconomic populations all showing progressively poorer oral health relative to other groups. Recent reviews of the School Dental Service showed that services are often hampered by ageing equipment and buildings, and models of service delivery that are no longer meeting communities’ needs. Secondary services are under pressure from larger case loads of patients requiring more complex treatment. Barriers to oral health facing older adults, who are increasingly keeping their own teeth, are also presenting a challenge at the other end of the age spectrum. The future can be very different. The Ministry of Health has a vision ..."

The document introduces the NZ Government's new vision for oral health, and the immediate steps needed to achieve this. It is intended to inspire funders and planners, providers and communities as to the possibilities for improving oral health - and also to spark debate.

ADA Statement re HIV Risk

Following extensive coverage of the decision of Queensland Health to arrange screening tests for around 500 patients of a dentist who has tested HIV positive, the ADA Inc has issued a Statement Regarding HIV Risk.

The release strongly reinforces the high standards of infection control in Australia and notes the extremely low risk of patients contracting HIV in a dental surgery. It also praises the ethical and professional action of the dentist in reporting her HIV status to the Health Department immediately it became known.

The most recent media coverage notes that many patients have expressed their support for the dentist, while refusing to name her to the media. One was quoted as saying "Everyone that came here loved her ... She was great at what she did".

Board adopts new policy re students with an incapacity

The Dental Practice Board of Victoria has issued its new policy on Registration of dental students with an incapacity (PO14), following a consultative process and review of submissions from various parties, including the ADAVB. This policy took effect from 8 August 2006.

In the context of this policy, the terms 'incapacity', 'impairment' and 'disability' are all considered to mean:

"a. total or partial loss of a bodily function;
b. the presence in the body of organisms that may cause disease (this includes bloodborne viruses);
c. total or partial loss of a part of the body;
d. malfunction of a part of the body, including mental or psychological disease or disorder and conditions that may impede learning;
e. malformation or disfigurement of a part of the body."

Welcome adjustments in the final policy include recognition that a student who has progressed through most of the course before an incapacity becomes evident, should be permitted to complete the course wherever possible, under an agreed set of terms and conditions designed to protect public health and safety.

This policy was clearly justified in the public interest, but sensitively handled by the Board with regard to the possible impact on the lives and livelihoods of students with an incapacity.

Child health survey

Poor dental health affects nearly half of all six-year-olds. Of those, 10% have at least two damaged or missing teeth. This is a finding of The Child Dental Health Survey. Published by the Australian Institute of Health and Welfare Dental Statistics and Research Unit, it examines the differences in oral health of children residing in differing areas of socioeconomic advantage. The findings show that caries experience differs across areas of varying socioeconomic status and that these differences are quite extensive.

The report also reveals the state of oral health in Australia’s school-age children, including age-specific and age-standardised measures of dental caries experience and treatment within each state and territory, and national estimates of these measures for 2001. Australian children experience comparatively low levels of dental caries. However, a minority of children still experience extensive decay and carry most of the burden of this disease.

Trends in Health Fund Coverage

The Private Health Insurance Administration Council (PHIAC) has just published updated Health Fund Membership Statistics for the period ending 30 June 2006, including:

• Coverage of Ancillary Insurance Tables offered by registered Health benefits Organisations by State and
• Contributors of Ancillary Insurance Tables offered by Registered Health Benefits Organisations by State
• PHIAC A Reports - A quarterly report detailing, by State, the membership and benefits paid by Registered Health Benefits Organisations for the period

Victoria has one of the lowest rates of ancillary table membership in Australia, with only 33%, compared with a national average of around 42%.

The dental benefits paid from ancillary tables in Victoria for the quarter ending 30 June 2006 were as follows:

Services...........1,201,850
Cost..................$116,957,953
Benefits ...........$54,547,182

This represents over half of all ancillary benefits paid in Victoria (total $107,127,877) with the other 28 areas covered in the ancillary table generally having quite small allocations. Optical ($16,408,197), Chiropractic ($9,266,711) and Physiotherapy ($8,941,073) were the next highest.

The dental benefit also represents only about 45% of the costs of services provided to health fund members, and this factor, perhaps combined with the intrusive and abrasive manner of some of the larger health funds when dealing with dental practices, helps to explain why the Victorian rate of ancillary table membership is only around 33% of the population.

Nationally, total dental benefits of $295,053,068 were paid by health funds in the June 2006 quarter, so despite Victoria having around 25% of the Australian population, only about 18.5% of health fund benefits were paid to Victorian health fund members. Extrapolating from the June quarter figure of almost $300 million, it seems health funds are now contributing around $1200 million p.a. towards the cost of dental treatment, out of a total estimated at around $6.5 billion for 2006/07.

Of a total of $4,694 million spent on dental services in Australia in 2003/04, only 15% ($708 million) was contributed by health funds. The Federal Government (mainly via its DVA scheme) and State Government public dental schemes combined made up just over 15%, with the remaining 70% paid for privately. (Source: Health Expenditure Australia 2003-04)

Full fee courses as costly as a mortgage

The Australian yesterday highlighted figures published in the 2007 edition of the Good Universities Guide, which confirm that UNSW, the University of Melbourne and Bond University will charge more than $200,000 for medicine degrees.

This story was followed today with a futher article noting that "University loans offering aspiring doctors up to $100,000 for full-fee degrees will not cover the cost of nine out of 10 courses."

The story confirms "that about 350 courses will not be covered by the FEE-HELP loans scheme."

Comments published about medical degrees can also be read to apply to dental degrees, which are recognised as amongst the most expensive courses.

The Good Universities Guide 2007 is not available for download, and must be purchased from Hobsons Guides (RRP $24.50 inc. GST).

Updated code of practice

The Dental Practice Board of Victoria's Code of Practice on General Anaesthesia & Conscious Sedation (C007) has been updated to bring it into line with changes made by the Australian & New Zealand College of Anaesthetists to its documents PS9(2005) & T1(2006).

OMS training endorsed

The Australian Dental Council and the Australian Medical Council have endorsed the Royal Australasian College of Dental Surgeons’ training of oral and maxillofacial surgeons. This follows a comprehensive review, which assessed the College’s training against the standards of both the ADC, which is the national standards body for dental education and training and the AMC, the national standards body for medical education and training.

A Media Release issued jointly today by the AMC and ADC, noted that "the assessment by the joint AMC/ADC expert team included visits to hospitals in Australia and New Zealand where training occurs; a review of College documents and interviews with College representatives; surveys of oral and maxillofacial surgery trainees and their supervisors; and interviews and submissions from stakeholders such as health departments, dental and medical professional bodies and the university dental schools".

In commenting on the standard of OMS training, the release reported the ADC/AMC team’s overall impression "was of trainees and graduates of very high quality, whose training is strongly supported at the state and/or regional level by practicing oral and maxillofacial surgeons. This view was supported by the feedback from medical administrators, health and medical practitioners and health service managers".

"As well as identifying strengths, the team’s detailed report identifies areas where further work is required. The College is investing significantly in a review of its training and is developing a more national approach to training, but the team found that this is still very much a work in progress. The team has also commented on the capacity of the university dental schools to bring additional academic rigour to the College’s training program, enhance research opportunities, and provide skilled academic teachers and administrative support for the trainees. The report recommends the College negotiate a heads of agreement with the dental schools concerning their role in the oral and maxillofacial surgery training program."

In response to the report College President, Dr David Thomson, said “Accreditation by the ADC and AMC is a major milestone in the development of oral and maxillofacial surgery in Australia and New Zealand. It is a first for the specialty and represents acceptance of the College as the provider of training for this specialty that bridges dentistry and medicine. “

J&J acquires Listerine

The August edition of Retail Pharmacy reports that "Johnson and Johnson has recently announced that it has entered into a definitive agreeement to acquire Pfizer Consumer Healthcare for $16.6 billion in cash".

Brands that J&J will now own include Nicorette smoking cessation treatments and Listerine. The addition of Listerine alone, is reported to triple J&J's oral healthcare business to a franchise worth more than $US 1 billion and a presence in over 60 markets.

Dental Crisis Feature in The Senior

The Senior is a monthy published in most States, with both common national themes, and local stories for each State's edition. The August editions in all States carry a feature on the public "dental crisis", accompanied by editorial urging the Commonwealth and State Governments to "stop the finger pointing and fix the problem".

The editorial also notes that "States and Territories don't spend enough of their multi-billion dollar budgets on dental care".

The editorial is supported by news stories highlighting key aspects of the dental care crisis, and noting ADA Inc CEO Robert Boyd-Boland's call for reinstatement of a Commonwealth Dental Scheme, and for commitment by all levels of Government to act on the recommendations in the National Oral Health Plan of 2004. That plan urged Governments to:

• recognise oral health as an integral part of general health
• give Australians access to appropriate and affordable services
• educate a skilled workforce
• initiate oral health promotion and disease prevention strategies
• fluoridate water supplies across Australia
• increase funding for public dental care

New course targets more dentists in NSW

Charles Sturt University (CSU) has announced that it will offer a Bachelor of Clinical Science at its campus in Orange NSW, intended to provide 10 medical and 10 dental placements for rural and regional CSU graduates who meet entry requirements to to study graduate entry medicine or dentistry at Sydney University.

This initiative is part of a Rural Pathway Program due to commence in 2007.

Their media release noted that "for the last two years, CSU has been increasingly concerned about the chronic shortage of qualified dentists and dental workers, particularly in regional NSW."

“The number of dentists in regional NSW does not meet the recommendation of the Organisation for Economic Co-operation and Development (OECD),” says Mark Burton, CSU’s Dean of the Faculty of Health Studies. “The situation in the Central West of NSW is approaching the levels in some developing countries…just 17.3 dentists per 100 000. The OECD average is 56 dentists per 100 000 people.”

Improving the standards of dental health in NSW

The NSW Opposition has certainly raised the bar in oral health policy debates around the country by issuing its $200m package of additional measures by which to improve oral care in NSW.

This 'Good Teeth, Good Health' policy makes extensive reference to the recent Parliamentary Inquiry into Dental Services in NSW (see our Blog post of 3 April this year), and highlights submissions made by the ADA NSW (amongst others).

The Liberal/National package will commit:

• $65 million to reduce dental treatment waiting lists and improve public dental health, including funds for comprehensive and preventative treatment;
• $40.18 million to increase remuneration for all dental professionals in the public service. This will align remuneration more closely with the private sector and other health-care providers in the public sector and will help attract and retain dental health professionals into the NSW public health system;
• $28.62 million for more dental and para-dental clinicians attracted and retained over time as working conditions improve for dental health workers;
• $7.95 million for fluoridation and oral-health promotion campaigns;
• $5.6 million to establish a Clinical Institute of Dental Health to be responsible for policy development and disbursement of the public dental budget;
• $57.3 million to provide dental internships to improve training and immediately increase the public dental health workforce; and,
• $3.6 million for Rural And Remote dental education scholarships to support the training and development of dentists dedicated to rural and remote service

Dental Health Week coverage

The ADA at both State and National levels has been achieving extensive coverage of this year's Dental Health Week themes, addressing oral health for young people.

Yesterday's Herald Sun carried two stories in different editions about oral piercings, the first was "Studs chipped for giving lip", and a later expanded version was called "The Wrecking Ball" (no link available). Both stories carried key messages about tooth and gum damage, quoting Branch President Dr Greg Morris. The "wrecking ball" quote appears again today in a sidebar to the Letters page in the Herald Sun.

ADAVB Vice President Dr Mark Bowman was interviewed by Red Symons on ABC Radio 774 yesterday regarding the same topic. He later did an interview with The Pulse, a radio station in Geelong.

The Geelong Advertiser today carries a story highlighting a warning from Dr Derek Lewis, Chairman of the ADA Inc Oral Health Education Committee on teenage consumption of bottled water, sports and soft drinks and other non-fluoridated drinks as a key contributing factor in increasing teenage decay rates in recent years.

Numerous other Dental Health Week stories are appearing in metropolitan dailies in all States, and in regional press and radio.

Worrying rise in tooth decay amongst teenagers

The Australian Centre for Population Oral Health has recently published Child Dental Health Survey reports as at 2002 for Victoria, South Australia, the ACT, Western Australia and Queensland.

Comment within the Victorian report on selected trends over the period 1998-2002, included the following observation about an increase in decay rates in permanent teeth:

"In contrast to the deciduous dentition, the mean number of permanent decayed teeth has increased for most age groups compared to 2001 (Figure 8). For most age groups, a decrease was observed between about 1998 and 2000/01. The mean number of filled teeth has increased for some age groups but decreased for others, between 1998 and2002 (Figure 9). Mean permanent DMFT traces a similar path to trends in mean decayed teeth, reducing from 1998 to about 2000/01 before increasing to 2002 (Figure10). However, the percentage of children with dmft = 0 has been gradually increasing for most age groups between 1998 and 2002 (Figure 11). (emphasis added)