ADAVB Chief Executive Officer's Comments
July 2019 Hide Comments
Dental care for our children
At the November election, the Andrews Government announced their intention to roll-out a comprehensive school dental van program across the state, offering free dental care to all primary and secondary school students at government schools. The recent State Budget provided further details about the $322 million plan, with four pilot sites identified for commencement in Term 3 this year – Box Hill, Cranbourne, Barwon South and Wodonga. Ten dental vans are being built in Ballarat as part of this pilot, and models of care are being developed. However, questioning of the Health Minister at the recent Budget estimates committee highlighted huge gaps in the details of how the program will operate, and there are still many unanswered questions about this school dental program. The ADAVB is concerned that as the peak body for oral health in Victoria, we haven’t been involved in any of the planning for this program despite repeated requests.
More than 80 per cent of school children already access high quality dental care, with the majority provided in the private sector. Many eligible children receive care through the Medicare Child Dental Benefits Schedule. There is simply not the capacity in the public system to provide dental care to nearly 700,000 government school children per year, and the inequity of low-cost independent schools being excluded from this program remains. Rather than engage with the workforce and infrastructure in the private sector to assist with the roll-out of this program, the Government is spending $100 million on dental vans to solve an access problem that doesn’t exist. This money would be much better spent on treatment and prevention for those who are currently not accessing dental care.
It is not clear how children who require specialist treatment by paediatric dentists for complex care, or orthodontic treatment for functional reasons, will be managed. There is limited capacity in the public dental sector to deliver these services, which are centrally located in Melbourne. There is an opportunity to engage with private sector dental specialists, who will be able to provide the care children need closer to home through a referral arrangement. However, there are currently no plans in place to facilitate this.
Of most concern is the impact on the quality of care children will receive due to a lack of continuity with a dentist of choice. All health professionals know that one of the most important components of delivering high quality health care is establishing a relationship with their patients. A regular family dentist knows your past history, is able to more effectively monitor and manage chronic disease and detect problems early. This relationship is also critical in delivering preventive advice related to healthy diet and oral hygiene. In the school dental van program, it is unlikely that children will see the same provider from visit to visit. There is no state-wide electronic dental record, which will make continuity difficult when children move. All treatment will be provided on school grounds, which means that parents will be largely removed from important face to face discussions about consent and prevention. Existing family dentist relationships will be broken as children are moved into the school dental program. Even the Grattan Institute’s Filling the Gap report last year recommended using private sector providers to deliver publicly funded care.
We are urging members to start communicating with their patients about the importance of maintaining continuity of care with their family dentist, particularly for school-aged children. Although the free school dental program will not be compulsory, the government will be strongly encouraging all families to participate through various communication channels, which is likely to have a significant impact on dental practices.
The ADAVB is committed to improving the oral health of all Victorians. Our door continues to remain open to the Premier and Health Minister to work constructively to achieve this aim together.
A/Prof Matt Hopcraft 

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Clinical A/Prof Matthew Hopcraft
Chief Executive Officer
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