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Kids’ oral health decays after COVID restricts visits to the dentist

Victorians could face long-term dental disease problems for years to come after a dramatic drop in regular visits to the dentist in 2020.

Children and low-income earners are likely to suffer the most serious deterioration in dental health, according to a study co-written by Associate Professor Matthew Hopcraft, CEO of the Australian Dental Association’s Victorian branch.

Associate Professor Matthew Hopcraft, CEO of the Australian Dental Association’s Victoria branch, says dental health has suffered during lockdown.Credit:Vince Caligiuri

Dentists, like many other health professionals, were heavily restricted during lockdown to avoid the risk of COVID-19 transmission. With clinics closing, dentists were no longer be on the front line in detecting dental problems.

“There is real concern about the delayed diagnosis of oral cancers and potentially poorer outcomes for a lot of people,” said Professor Hopcraft. “If patients have put off their regular check-ups, then our ability to identify something at an early stage and intervene to prevent something worse happening has gone.”

Reduced access to regular care could also lead to a crisis among vulnerable patients dependent on the public health system, he said.

According to the study, “April saw an 86.9 per cent decrease in treatment provided through the Child Dental Benefits Schedule to vulnerable children in Australia and this was replicated in Victoria later in the year”.

The CDBS acts as a dental safety net for children from lower socio-economic backgrounds and it emphasises preventive care.

“The leading cause of preventable hospitalisation in Australian children is dental diseases,” Professor Hopcraft said. “About 26,000 kids a year are hospitalised for this.” They are admitted for disorders such as severe tooth decay and oral infections, and some require general anaesthetic.

“One in three kids has tooth decay in their baby teeth by the age of 5 to 6, and two in five kids in their adult teeth by the age of 12 to 14. Dental disease is effectively the most common disease affecting Australian children and it’s pretty much entirely preventable,” he said.

The study, titled Impact of COVID‐19 on the Provision of Paediatric Dental Care, focused on children, however Professor Hopcraft warns poor oral health will be a long-term problem for Australians of every age long after restrictions are lifted.

“We’re going to see poorer oral health outcomes in the next six to 12 months at least. This year, people were told they shouldn’t leave home or go outside unless they really needed to. People were deferring all sorts of medical appointments.”

We’re going to see poorer oral health outcomes in the next 6 to 12 months at least.

The study acknowledges this as a global dilemma: “Much of dentistry was deferred because it was determined to be non-urgent. Indeed, the World Health Organisation has recently recommended that routine non-essential oral health care — which usually includes oral health check‐ups, dental cleanings and preventive care — be delayed until there has been sufficient reduction in COVID‐19 transmission rates.”

Professor Hopcraft said that when patients did start making appointments, dentists were “inundated with significantly more emergency presentations”.

“People staying at home were probably snacking more frequently and also with increased stress there’s more teeth grinding and broken teeth.”

Economic hardship might also put pressure on the overall dental sector, with many unable to afford private dental treatment.

“There’s already a big waiting list for public dental care. It’s about 19 months. Anecdotally, we’re hearing it’s gone up in some regions by 20 to 50 per cent. I expect as more people are unemployed or underemployed, they would then become eligible for public dental services, so that puts even more pressure on public waiting lists. That average number in Victoria could go well above 20 months or even two years," Professor Hopcraft said.

“We’ve been trying to talk to the state government even pre-COVID about a bigger investment in public dental services. We need to look at managing the waiting lists. There is capacity in the private sector so we’re looking at how the public sector could work more closely with the private sector to take on some of the patients from the waiting list.”

A Department of Health and Human Services spokesperson said that statewide, the average waiting time for general dental care as at September 30 was 15.6 months, and eligible Victorians could still access emergency care during the pandemic.

The Victorian government is investing $319 million in public dental services in 2020-21; and since 2019, $321 million has been invested in free dental services for children in Victorian public schools, the spokesperson said.

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