Dental Public Health: School Dental Services in Australia - Essay Example

???? ???? ?????? ?????? Chapter 3: School Dental Services in Australia The public dental health services face several challenges especially among isolated communities and in large geographical areas. This led to the establishment of school dental services that take care of dental health requirements for preschool children up to 17 years. This service mainly targets children unable to obtain treatment from private dentists. School children access free dental checkups at least once every year. About half of children from low income households experience dental decay. The school dental programs aim at reducing the occurrence of dental carries among school children. This is based on the medical plan aimed at improving the overall health of Australians by improving their dental health. Oral health means that the children can eat, speak and socialize without embarrassment, discomfort, or active diseases in their mouths. Improving dental health of children is a major step towards improving their general health. The school dental service is a comprehensive dental care to school children under the age of 15 years. School children are examined by dental workers to determine the state of their dental health. The services carry out simple restorative treatment and preventive procedures for school children. These procedures mainly aim at services such as topical fluoride application and prophylaxis. Small groups of children in classrooms are taught the importance of fluoridation in preventing dental caries. These therapists also aim at changing the children’s attitudes towards oral health care and other aspects of health behavior. Children affected by dental caries undergo treatment procedures such as teeth filling. This is mostly done to children between the ages of 10-14 years. There are mobile dental clinics that provide these services to school going children. The young children attend demonstration hosted by the dental service providers, which show the brushing procedures and application of fluoride. Older children attend lectures where dentists discuss signs of dental caries and prevention procedures. Families receiving Family Tax Benefit A are provided with preventive dental check vouchers. These vouchers are worth $150 and are issued to children between the age of 12 and 17 years and are issued annually. The preventive dental check covers oral examination, scale and cleaning, oral hygiene instruction, fluoride application, and fissure sealants depending on the child’s requirements. These vouchers are used in both private and public dental clinics. Children diagnosed with dental problems continue receiving free dental services from the school dental clinics. Preventive Dental Check vouchers can be redeemed for free at these clinics. These services increase the number of children who have access to dental care in WA. The services are available to government and non-government schools, which increases the number of children accessing early dental care. Schools have dentists who provide these services to children attending the school. The dentists provide oral health to children who have undergone registration at the school. Home-educated children access dental services from these dentists after booking appointments and showing evidence of registration. Dental therapists are also used in the provision of school dental services. Therapists provide these services under the control of registered dentists. Dental therapists are used in areas where dentists are too expensive in providing dental services. Dental laboratory services in field clinics are provided by dental technicians. The technicians operate from mobile clinics located in the training school and carry out diagnostic activities. Dental health educators also participate in school dental services by carrying out dental health education lectures. These educators undergo training for the purpose of carrying out dental health education programs. They receive instructions in teaching techniques on subjects such as oral hygiene, plaque control, and fluoridation. They provide lectures to school children on the importance of dental health and procedures of taking care of teeth. The federal and state governments provide funds used in school dental services programs. The federal government provides funds through the public dental health program (Davis, 2008). The government has rolled out a $4 billion dental program that will provide accessible dental services. The school dental program receives around $ 150 million every year from the federal government. This budget covers dental services provided in schools and public hospitals that provide free dental services to school children. The Australian Dental Association identifies school dental services as an area where more funds are required from the federal government. The number of school going children and adolescents has increased, and more funds are required for sustainable dental health provision services. These funds target the children below 15 years from families with economic hardships due to low income. The state government in WA also provides funds for school dental services. The state government is the primary financier of the program and receives subsidizes from the federal government. The federal government sets up and equips school dental clinics and provides resources for mobile clinics. Dental assistants providing these services are also paid by the state government. Approximately $50 million is spent on SDS programs. These funds help schools children access free or subsidized dental care services, which has enabled over 80 percent of children between 5 and 15 years access dental services. Schools receive direct funding from the state government, which are used to purchase equipment, maintain clinics, and conduct training sessions for school children. According to WACSSO, the state government should increase SDS funds to improve the condition of the school dental clinics. In most cases, the clinics lack vital equipment such as computers and fail to attract new staff due to poor pay. Most children enroll for SDS when they start school, usually at the age of 5 years. Dental carries is the common disease among the school children in Western Australia. Decay is the fifth common cause of hospitalization for school children in WA. Over the past 20 years, the prevalence of caries among school children has diminished. This can be attributed to improved oral health care, water fluoridation, and lifestyle changes. A study by CDHS in 1999 of WA indicated that dental caries had a mean DMFT of 1.16 for children aged 4 years and below and a DMFT of 1.47 for 5 year olds. About 70 percent and 60 percent of the 4-year-old and 5-year-old groups do not have dental caries respectively. The introduction of school dental services has reduced the prevalence of caries among school children due to preventive measures and early treatment. School dental staff provides oral health intervention treatment for controlling dental caries. Children undergo screening examination procedures such as bite-wing roentgenograms. These procedures aim at identifying dental diseases such as caries. Children with signs of dental caries undergo excavation of softened dentine and temporary restorations are inserted. Oral prophylaxis of fluoride solutions are also provided to children as a preventive measure. Fluoride solutions are mostly administered to children living in areas without fluoridated water. Children with severe dental caries undergo restoration of cavities with silver amalgam or composite resin. The dentists may also resolve to extract the primary teeth depending on the damage caused by the disease. School dental educators teach children the importance of brushing their teeth as a preventive measure. The educators conduct demonstrations that teach children the correct procedures of brushing. Children are provided with fluoride toothpaste, which they use during the demonstration. Dental educators also conduct lectures on the importance of brushing teeth with fluoride and methods of identifying dental caries. School dental services have helped decrease the rates of dental diseases in WA. The treatment procedure provides a cheap and efficient way of combating dental caries among school children. Fluoride is a preventive element against the occurrence of caries. Children without access to fluoridated water are provided with fluoride solutions and toothpaste in SDS clinics. The brushing demonstrations help children follow the recommended brushing procedures that eliminate dirt from their teeth. Parents are also involved in the SDS programs. Children are issued with dental charts that are filled at home after meals. This aims at involving parents in the prevention program and securing their cooperation. Some parents are also involved directly in the SDS demonstrations and training programs. Teachers and dental therapists conduct follow up on the dental state of the children. This involves examining the dental charts and conducting dental health lessons. These preventive and treatment measures have helped decrease the occurrence of dental caries among WA school children. The prevalence of dental caries in the rural areas is higher than in metropolitan areas. School children in the rural areas are 1.3 times more likely to be hospitalized for dental caries than metropolitan children (Mount and Hume, 2005). Most children living in the remote and rural zones of WA have little access to dental services before they become registered in a school. Children in WA registered to a school are eligible for the SDS program. According to previous research, only 5 percent of children in WA attend dental services before they start school. Rural residents face several restricting factors such as high costs, lack of dental clinics, and lack of awareness by parents. Several rural areas of WA have limited access to dental clinics, which is the main cause of high dental caries rates among children. Metropolitan area children have DMFS mean score of 1.33 while those from rural areas have a sore as high as 2.53. Several metropolitan areas have access to fluoride water sources compared to rural areas. Some water sources in the rural areas have naturally occurring fluoride, which reduces the prevalence of dental caries. Children in metropolitan areas are more likely to consume snacks and soft drinks than their counterparts in the rural areas. Carbonated drinks and sugary snacks have a high chance of causing dental caries among children. However, the main difference is caused by differences in dental medical care in metropolitan and rural areas. School dental services are available to preprimary, primary, and high school children. Preschool children are aged between 2 and 4 years. This age group has the lowest number of children accessing school dental services especially in the rural areas (Spencer, 2004). Most preschool children access dental services by attending dental clinics without subsidizes from SDS. About 39 percent of preschool children attend dental visits for oral checkups. Majority of children in the rural areas of WA begin schooling at the age of 5 years. This gives them automatic eligibility to SDS services, and they make the largest group of children covered by SDS. Children between 5 and 11 years old have deciduous teeth and others have a mixture of deciduous and permanent teeth. Children between 4 and 6 years have the most extensive history of dental caries than older children. About 48.9 percent of children in this age group suffer from dental caries with about 10 percent of them experiencing decay in more than nine teeth. This group has the highest number of children with missing teeth due to dental caries. Children between 6 and 9 years have a mixed dentition comprised of deciduous and permanent teeth. These children are mostly in primary school and are eligible for SDS care. The prevalence of dental caries among this age group is lower than that of children below 6 years (Willis, Reynolds and Keleher, 2009). Teenagers between 12 and 15 years old experience some tooth decay with about 38 percent experiencing decay in four to eight teeth. The average number of tooth decay ranges from 0.53 for 12 year olds and 0.85 for 14 year olds. Over the last 6 years, dental decay among children aged 14 to 15 years has increased by 71 percent. This can be attributed to poor diet, soft drink consumption, and eating disorders. High school children comprise of the age group between 12 and 17 years. Several of these children are above the age group covered by school dental services and have to rely on their parents for dental services funds. Majority of people in this group have permanent teeth, which are often free of dental decay. Aboriginal children have the highest prevalence of dental caries. This can be attributed to poor living conditions experienced by aboriginal Australians. Dietary deficiencies are a major cause of dental caries among aboriginal children (Iritani, 2010). This is caused by poor breastfeeding habits and milk subsidization techniques among Aboriginal children. Recent studies have also indicated that most aboriginal Australians do not have access to tooth brushes. This has caused a high prevalence of dental caries among these children with a mean DMFT of 3.8. A small number of Aboriginal children have access to dummy feeding bottles containing milk. Calcium contained in milk helps prevent dental decay among children. Aboriginal children also access school at an older age usually 5 years. Access to SDS requires school registration and several children lack preschool access to dental care. Australia is highly ranked on the medical scale in the world with one of the best health systems. The School Dental Service is a program in the health system that provides dental care to school children below 15 years. The federal and state governments provide funds for SDS programs in the country. Children access free dental care services or their medical bills are heavily subsidized by the SDS program. This has helped reduce the prevalence of dental caries, which is the most common dental disease in WA. The governments provide funds to schools for setting up dental clinics with the necessary equipment for dental check up and treatment. Dental therapists and educators are the main workers in the SDS program. They provide dental care and education to school going children and provide mobile clinics in the rural areas. These services have helped improve the health condition of children between the age of 5 and 15 years. References AIHW Dental Statistics and Research Unit. 2006. Child Dental Health Survey, Western Australia 2002. Adelaide, SA: The University of Adelaide. Australasian Academy of Pediatric Dentistry. 2004. Standards of Care. August 2004. Armfield, J.M, and Spencer, A.J. 2006. Socioeconomic differences in children's dental health. In: The Child Dental Health Survey, Australia 2001. AIHW Dental statistics and Research Series 35. Canberra, ACT: Australian Institute of Health and Welfare. Bratthal, D. 2000. Introducing the Significant Caries Index together with a proposal for a new global oral health goal for 12 year olds. International Dental Journal 50:378–84. Brennan, D.S., Spencer, A.J, and Roberts-Thomson, K.F. 2008. Tooth loss, chewing ability and quality of life. Quality of Life Research 17:227–35. British Society of Pediatric Dentistry. 2003. A policy document on oral health care in preschool children. International Journal of Pediatric Dentistry, 13,279-285. Davis, M. 2008. The land of plenty: Australia in the 2000s. Carlton, Vic, Melbourne University Press. Declerck, D., Leroy, R., Martens, L., Lesaffre, E., Garcia-Zattera, M.J, Vanden, B. S et al. 2008. Factors associated with prevalence and severity of caries experience in preschool children. Community Dentistry and Oral Epidemiology, 36(2), 168-178. Gussy, M.G. 2006. A qualitative study exploring barriers to a model of shared care for pre- school children's oral health. British Dental Journal, 201(3), 165-170. Hallett, K.B. 2002. Dental caries experience of preschool children from the north Brisbane region. Australian Dental Journal, 47(4), 331-338. Hallet, K.B, and O’Rourke, P.K. 2003. Social and behavioral determinants of early childhood caries. Australian Dentistry Journal, 48, 27-33. Hallett, K.B, and O’Rourke, P.K. 2006. Pattern and severity of early childhood caries. Community Dentistry and Oral Epidemiology, 34(1),25-35. Iritani, K. 2010. Oral health: efforts under way to improve children's access to dental services, but. Diane Pub. Co. Marshall, R.I and Spencer, A. J. 2006. Accessing oral health care in Australia, Why try a doctor when you need a dentist? Medical Journal of Australia, 185 (2), 40-50. Mount, G.J and Hume, W.R. 2005. Preservation and restoration of tooth structure. Sandgate, Queensland: Knowledge Books. Nainar, S.M, and Straffon, L.H. 2003. Targeting of the year one dental visit for United States children. International Journal of Pediatric Dentistry, 13,258-263. Slade, G.D. 2006. Risk factors for dental caries in the five-year-old South Australian population. Australian Dental Journal, 51(2), 130-139. Spencer, A. J. 2004. Narrowing the inequality gap in oral health and dental care in Australia, Australian Health Policy Institute Commissioned Paper Series 2004, Australian Health Policy Institute, Sydney. Tennant, M., Namjoshi, D,. Silva, D., and Codde, J. 2000. Oral health and hospitalization in Western Australian Children. Australian Dental Journal, 45, 204-207. Willis, E., Reynolds, L., and Keleher, H. 2009. Understanding the Australian health care system. Sydney, Churchill Livingstone/Elsevier. References: 1. Australasian Academy of Pediatric Dentistry, Standards of Care August 2004, 2004. 2. Brennan, D.S., Spencer A.J, and Roberts-Thomson K.F, Tooth loss, chewing ability and quality of life. Quality of Life Research, 2008. 17: p. 227–35. 3. Nainar S.M and Straffon L.H, Targeting of the year one dental visit for United States children. International Journal of Pediatric Dentistry, 2003. 13: p. 258-263. 4. Hallet, K.B. and O’Rourke P.K., Social and behavioral determinants of early childhood caries. Australian Dentistry Journal, 2003. 48: p. 27-33. 5. Bratthal, D., Introducing the Significant Caries Index together with a proposal for a new global oral health goal for 12 year olds. International Dental Journal 2000. 50: p. 378–84. 6. British Society of Pediatric Dentistry, A policy document on oral health care in preschool children. International Journal of Pediatric Dentistry, 2003. 13: p. 279-285. 7. Tennant, M., et al., Oral health and hospitalization in Western Australian children. Australian Dental Journal, 2000. 45(3): p. 204-207. 8. AIHW Dental Statistics and Research Unit, Child Dental Health Survey, Western Australia 2002. Adelaide, SA: The University of Adelaide. 2006. 9. Gussy, M.G., A qualitative study exploring barriers to a model of shared care for pre-school children's oral health. British Dental Journal, 2006. 201(3): p. 165-170. 10. Armfield, J.M. and Spencer A.J., Socioeconomic differences in children's dental health. In: The Child Dental Health Survey, Australia 2001. AIHW Dental Statistics and Research Unit Research Report, 2006. 11. Hallett, K.B., Dental caries experience of preschool children from the north Brisbane region. Australian Dental Journal, 2002. 47(4): p. 331-338. 12. Slade, G.D., Risk factors for dental caries in the five-year-old South Australian population. Australian Dental Journal, 2006. 51(2): p. 130-139. 13. Declerck, D., et al., Factors associated with prevalence and severity of caries experience in preschool children. Community Dentistry and Oral Epidemiology, 2008. 36(2): p. 168-178. 14. Hallett, K.B. and O’Rourke P.K., Pattern and severity of early childhood caries. Community Dentistry and Oral Epidemiology, 2006. 34(1): p. 25-35. 15. Marshall, R. and J. Spencer, Accessing oral health care in Australia. 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