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Inequality in Australia is dental as anything

Barry Gittins |  12 May 2016


'I think you've been grinding your teeth in your sleep.'

x-ray of teeth'Me, gnashing my teeth in distress?' That's what I would have said to the dentist, if her hands and those of her nurse weren't occupying my big mouth.

Our family dentist is professional and kind; she tells you methodically what she is doing, and why it's necessary. 'That pain? That's because of the years of tartar build-up I'm removing,' she informs me.

'Uuuurrgghmaburble.' I'm retrospectively grateful for the previously-administered needles.

I'd put off dental care for several years, not through fear but because of the necessity to prioritise other expenses within the family. Dentistry hurts more financially than experientially. But at least, as a worker in a dual-income household, I could — and have — budgeted and paid for the work required on my chompers. For many of us, it's not that easy.

Post-budget, one element to sink our teeth into is the question of dental care for marginalised Australians. A smile says a lot about who we are, how we are doing and where we have come from.

British research presented at the 2013 International Association of Dental Research posited 'a link between missing teeth and a patient's quality of life' and cited other research on observers' 'perception of men and women with straight and crooked teeth'.

Respondents perceived those with straight teeth as 45 per cent more likely to get a job than those with crooked teeth, when competing with someone with a similar skill set and experience. People with straight teeth were seen as 58 per cent more likely to be successful and 58 per cent more likely to be wealthy.


"Sixty-six per cent of the Salvos' welfare clients could not afford dental treatment, and two in five could not afford a yearly dental check-up for their children."


Indicative of employability, wealth (could your family afford braces for you as a child?), socioeconomic status and self-esteem, a dodgy smile is also recognised as a key indicator of homelessness.

In the soon-to-be-released fifth annual national Economic and Social Impact Survey research by the Salvation Army, it's recorded that 66 per cent of the Salvos' welfare clients 'could not afford dental treatment [and] two in five could not afford a yearly dental check-up for their children'. These figures are recorded in several years' worth of surveys: from 2013–2015 the number of clients who couldn't afford dental care varied from 60–68 per cent; the percentage of their children who couldn't afford an annual dental check-up varied from 34–39 per cent.

This is Australia we are talking about. Only the US and Canada have higher average net wealth than us. And yet, one in five of the Salvos' welfare clients interviewed can't 'afford medical treatment and the medicine prescribed by a doctor'.

How we treat the least affluent of our citizens reveals much. The discomfort that led me to the dental surgery was resolvable, and I could have made earlier appointments. Again, this is often not so with welfare recipients and working class patients.

At the end of last year, in New South Wales alone, there were '9203 children and 104,156 adults waiting for general public dental care'. If you needed public treatment for your teeth in Victoria, data from the Productivity Commission shows that in 2014–15 you'd have been waiting for 237 days on average. That was extended to a 260-day wait for succour in South Australia, a 309-day wait in Queensland, and a freakish 933-day wait in Tasmania. 

Numbers are still being crunched, but some analysts see the government's budgeted dental policy resulting in a cut of $235 million from provision of services. Gnashing of teeth indeed ... it's hard to laugh off inequity if you are in pain, or embarrassed because your aching canines are an eyesore.


Barry GittinsBarry Gittins is a communication and research consultant for The Salvation Army.

The Salvos' 2016 Economic and Social Impact Survey is due to be published in late May.

Main image: Shutterstock



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Submitted comments

I was at a bus stop one day and I spoke to young man who was also waiting there. When he opened his mouth to reply I was confronted by the sight of blackened gums. It is something I have not forgotten. I think of him - how is he getting on in this world that cares not for anyone who can't produce money?

Cheryl 13 May 2016

Various Governments should realise that dental health is the most important in a persons life/It has now been established that tartar build up could result in clogging of the arteries which in turn could lead to a stroke/heart attack/If this happened the time spent on hospital bed could be long resulting in a paucity of beds and ultimately a clogging of the hospital SYSTEM

Maurice O'Reilly 13 May 2016

I have grandchildren whose parents love them but simply cannot pay the cost for proper dental care. This is Australia? Why is this not a serious election issue?

Steven Etherington 13 May 2016

Many people with dreadful teeth have been remarkably successful at the upper echelons of society. In 501 commissioned portraits amongst the elite of England, the celebrated painter Sir Joshua Reynolds did not depict one smiling face - allegedly because of the unattractive gaps revealed by a broad smile. The famous Dutch masterpiece, The Laughing Cavalier, depicts the cavalier with his mouth firmly shut! The enigmatic look on the face of Da Vinci's model for the Mona Lisa almost certainly came from the suppression of an intended smile struggling not to reveal the tombs to dental caries hiding behind a beautiful countenance. In our society a cap on a tooth attracts a fee for the dentist twice that of the fee to a surgeon for a kidney transplant (in the 20% of cases where he/she is allowed by Medicare to charge a fee). We have come a long way - the worry, however, is the direction in which we travel these days!

john frawley 13 May 2016

Closure of the effective Child Dental Benefits Scheme will now mean that for over a million children, they will be added to an already under resourced public sector list. With waiting lists already too long to meet demand, these children are effectively unable to access care. The government's new scheme is placing over 7 million Australian adults and children in a queue where they will not be reached and therefore won't access treatment. The government's pursuit of budget savings should not put at risk basic health delivery.

Robert Boland 16 May 2016

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