The+Rotten+Tooth+of+Australia's+Health+Care+System

Name: Kelti Hope Student#: n5415357 Tutor: Abbey Diaz

//“Good oral health is to have the opportunity to eat, speak and socialise without discomfort or embarrassment, and without active disease in the mouth that affects overall well being”//
(The University of Sydney, Australian Health Policy Institute, 2004, pg 1)

=** Cultural Artefact **= media type="youtube" key="h21jl2pLc1o" height="315" width="420" (AustralianAds, 2010).

The series of Colgate commercials featuring Mrs Marsh, first aired on Australian television in the 1970s. The first of the commercials shows Mrs Marsh, a primary school teacher, discussing with her students the benefit of cleaning teeth with Colgate Fluoriguard, a fluoridated toothpaste. The demonstration using coloured water and chalk to show how fluoride enters and protects tooth enamel is an iconic image with which many Australians are familiar. The Mrs Marsh series of commercials continued until the late 1980s, with each commercial featuring the chalk demonstration and the students in the class asking about the dental health of various animals with large, sharp teeth. Despite being too young to have seen any of the commercials in the series, I was still aware of the coloured water and chalk demonstration as my parents used to show it to me when discussing the importance of cleaning teeth as a young girl. Colgate is an iconic brand people have grown up with for generations and is associated with dental health and preventative oral care. Over the years, Colgate has been a valuable source of dental health information for people of all ages.

=Importance of Good Dental and Oral Health= Poor oral health can dramatically affect a person's general health and well being. Many people with tooth loss or who suffer from periodontal diseases often complain of constant pain and problems with eating and having an unsatisfactory diet due to difficulty chewing, which makes it uncomfortable to eat many foods (Brennan, Spencer, Roberts-Thomson, 2008; Petersen, Bourgeois, Ogawa, Estupinan-Day, Ndiaye, 2005). Tooth loss and oral decay can also affect a person's quality of life by reducing their self-esteem, causing them to feel self conscious and embarrassed and limiting their smile or communication due to missing, discoloured or damaged teeth (Petersen et al., 2005; Brennan, Spencer, Roberts-Thomson, 2008). A Colgate commercial which aired in the 1960s broaches the topic that clean teeth has more importance than just preventing decay and instead is also important for maintaining and establishing self-confidence, self-esteem and improve social interactions (Conniptions886, 2009; Lilac028, 2006).

media type="youtube" key="epubdaqJ__Q" height="315" width="420" (Conniptions886, 2009)

media type="youtube" key="xFydzXFcA-Y" height="315" width="420" (Lilac028, 2006)

Good dental health is also an important part of maintaining overall health and well being as oral diseases such as dental caries and periodontal diseases, those affecting the supporting tissues of the teeth like gingivitis and periodontitis, can affect people in many different ways. Studies have shown the bacteria responsible for periodontal diseases have been associated with the development of cardiovascular disease, stroke, pneumonia, osteoporosis and type 2 diabetes (Zarbock, 2009; Ford et al., 2010). The increased amounts of periodontal bacteria responsible for oral diseases can cause an inflammatory response linked to an increased risk in cardiovascular disease and type 2 diabetes (Periodontal bacteria linked to heart disease, 2006). Further studies have found the treatment of periodontitis and other oral diseases has resulted in a reduction of systemic inflammation, improvement of blood vessel and heart function and has had a positive affect on overall general health outcomes (Ford et al., 2010). This article with look at the prevalence of oral health problems in Australia, the access and costs associated with dental care and treatment, discuss the cultural and social factors increasing the prevalence and finally touch on the importance of the Colgate brand in maintaining good oral health.

=Prevalence of Oral Health Problems in Australia= Oral health problems have some of the highest prevalence and incidence rates of all health problems in Australia (Marshall & Spencer, 2006). The National Survey of Adult Oral Health (2008) found that 5.8% of Australians have no natural teeth and of those Australians who still have natural teeth, an average of 4.3 teeth per person were missing and an average of 13.1 teeth were either missing, filled or decayed (Australian Institute of Health and Welfare, 2007). Inflamed gums were reported by 24.7% of the Australian population, moderate or severe gum disease by 24.1% and 27.6% of people have untreated dental decay (Brennan, 2008). Throughout Australia 31.5% of the population avoid or delay dental care due to the cost involved and 15.1% avoid certain foods due to dental problems (Brennan, 2008). The national survey and previous study findings suggest there is a greater prevalence of tooth loss in those with low socio-economic status, those with a government health care concession cards and those who are uninsured (Australian Institute of Health and Welfare, 2007; The University of Sydney, Australian Health Policy Institute, 2004). However, the studies showed little variation between socio-economic groups with regards to untreated dental decay and dental diseases (Australian Institute of Health and Welfare, 2007; The University of Sydney, Australian Health Policy Institute, 2004).

=Access to and Cost of Oral Health Care and Treatment in Australia= Dentists in Australia can work in either the public or private sector, however, due to lack of funding and support in the public sector over 80% of dentists work in the private sector (Marshall & Spencer, 2006). This limits the access to and number of dentists available for out-of-hours emergency dental treatment (Marshall & Spencer, 2006). Currently in Australia, there are approximately 650,000 people waiting for non-emergency dental care and treatment (Hermiston, 2008) on waiting lists 8 months to 5 years long, depending on the state or territory (National Advisory Committee on Oral Health, 2004).

Government concession card holders, including the Pensioner Concession Card and the Health Care Card, are those eligible to receive dental treatment either fully subsidised or for a minimal fee through the public dental clinics (Marshall & Spencer, 2006). However, for their last visit, 70% of government concession card holders visited a private dentist due to lack of access and availability of a public dentist (Australian Research Centre for Population Oral Health, 2005). The current demand for dental care and treatment from concession card holders is far greater than the availability of publicly funded dentists in Australia (National Advisory Committee on Oral Health, 2004). In fact, despite being eligible to receive free or heavily subsidised public dental care, 23% of government concession card holders actually have private dental insurance due to the lack of access to public dental clinics (Australian Research Centre for Population Oral Health, 2005).

Not only is the access to dentists in Australia a worrying sign, the shortage is only getting worse. The Australian Government Department of Education, Employment and Workplace Relations identified a shortage of dentists in 2008 (Australian Institute of Health and Welfare, 2010). Since 2004, the number of dentists working in both the public and the private sectors has decreased by approximately 1500 (National Advisory Committee on Oral Health, 2004). Although there has been a significant increase in the number of students studying dentistry at university over the past decade, there are still only 200 new dentists who graduate each year Australia-wide (Australian Institute of Health and Welfare, 2010). There are currently an average of 50 practising dentists per 100000 people in Australia; the vast majority of whom work in private practise in metropolitan areas (Marshall & Spencer, 2006). Individuals who reside in rural or remote areas have a dentist distribution of only 18 practising dentists per 100,000 people (Australian Institute of Health and Welfare, 2010), thus making access to a dentist in a time of need significantly more difficult.

Oral health is one of the most expensive areas of health care and treatment in Australia, second only to cardiovascular disease. Of the total annual health expenditure from government and private sectors and individuals alike, 10% goes towards dental and oral health care treatments whereas 11% goes towards cardiovascular disease (Australian Institute of Health and Welfare, 2010). However, with regards to the total annual dental health expenditure, 64.6% of the costs are covered by individual's out-of-pocket payments, 20.1% is paid by the government and only 15.2% is covered under private health insurance funds (Australian Institute of Health and Welfare, 2010). Recent studies have found as many as 25% of the Australian population delay seeking dental treatment due to the costs involved (Marshall & Spencer, 2006). Studies have also found that while most people will attempt to visit a dentist if they are experiencing oral pain or problems, there are some people that will actually visit a general practitioner instead due to the decreased cost and increased availability at short notice (Marshall & Spencer, 2006).

====//“Currently, patients with acute oral conditions should hope that the problem occurs during normal business hours in a major population centre, that the condition is not part of a larger problem and that they are wealthy enough to have a regular dentist who has time to see them”//==== (Marshall & Spencer, 2006, pg 60)

=Water Fluoridation= Water fluoridation has always been a controversial topic, especially in Queensland. The first Australian town to be fluoridated was Beaconsfield, Victoria in 1953. By the late 1960s and early 1970s all states and capital cities had followed suit, with the exception of Queensland (Hermiston, 2008). Townsville, in 1964, was the first Queensland city to have its water supply fluoridated, and since then studies have confirmed the children of Townsville have significantly fewer caries than those from Brisbane (Australian Dental Association, 2011). Brisbane and the surrounding south-east Queensland area did not start fluoridating their water supply until 2008 (Queensland Health, 2009). Despite the fact most toothpastes contain fluoride, water fluoridation has decreased the incidence of tooth decay much more significantly (Victorian Government, Department of Health, 2011).

In the mid-1950s 12-year-old children in Australia had an average of nine decayed teeth, and this level of decay increased for older children and adults (Victorian Government, Department of Health, 2011). By the late 1990s, after three decades of fluoridated water the presence of tooth decay had fallen so dramatically that 12-year-old children in Australia only had an average of one decayed tooth (Victorian Government, Department of Health, 2011). Besides the obvious improvement in tooth decay, water fluoridation has also had an added cost benefit. For each $1 invested into water fluoridation there has been an estimate of $20-$80 saved in avoided dental costs, lost work hours and saved leisure time (National Advisory Committee on Oral Health, 2004).

=Social and Cultural Factors Increasing the Prevalence of Oral Health Problems in Australia= Despite the dramatic decrease in tooth decay since the mid-1950s due to water fluoridation, recent studies have shown that since the late 1990s the incidence of tooth decay in children is once again on the rise (Hermiston 2008). The findings of various studies suggest the increasing consumption of energy-dense food and drinks is the main factor driving the increased tooth decay in children (Victorian Government Department of Health, 2011). Poor diet and nutrition not only results in consuming insufficient amounts of essential vitamins and minerals necessary for good health and well being, but also has a significant impact on the prevalence of dental caries and tooth enamel erosion (Moynihan & Petersen, 2004).

Over the past decade, studies have shown the addition of sugars in food, either during production or at home, is one of the major factors in the development of dental caries (Moynihan & Petersen, 2004), and the increased consumption of acid additives and preservatives in food and drink is the leading cause of enamel erosion (Milosevic, 2004). Populations which show an increased prevalence of dental caries and enamel erosion have a direct association with a population-wide increase in added sugar and acid additive consumption (Moynihan & Petersen, 2004). Many studies over the past decade have also found an increase in soft drink consumption is directly related to a decrease is tap water consumption, thereby decreasing the amount of fluoride consumed and resulting in a diminished effectiveness of fluoride as a dental decay prevention (Victorian Government Department of Health, 2011).

The decreasing access and rising costs of dental care and treatments also leads to an increased prevalence of oral health problems in Australia. Despite being eligible to attend free public dental clinics, government concession card holders in general have a lower standard of oral health compared to the rest of Australia (Australian Research Centre for Population Oral Health, 2005). Those who can afford insurance and attend a private dental practice have better dental health than those eligible to attend public dental clinics (Brennan, 2008). The availability of public dentists is very low, so even those who have a government health care card and are eligible to attend can not use the public system as it is not available in their area, which results in most government concession card holders having to pay the full cost to attend a private dentist (Australian Institute of Health and Welfare, 2008).

As part of the budget for the current financial year, the Federal Government has pledged to direct much needed funding into dental health care reform to improve the current failing public dental health system (Biggs, 2011). This includes the funding of 150 dentistry internships in the public sector in order to help address the shortage of dentists in the public health workforce (Biggs, 2011). This extra funding is a good start, but certainly not the end of overdue policy and funding reform needed to improve the failing public dental health sector and the worsening oral health of Australians.

=Importance of Colgate in These Uncertain Times= Oral health problems and diseases are currently on the rise in Australia and it is clear more needs to be done to prevent the problems from getting any worse. The government has finally made a start to the much needed dental reform and funding promised prior to the 2007 election (Biggs, 2011). During a time when the waiting lists to visit a dentist can stretch from a number of months to a number of years (National Advisory Committee on Oral Health, 2004) and the costs are too high to contemplate, it is important to have a brand like Colgate ready to provide much needed advice and information on oral health care and prevention.

Colgate plays a very important part in improving the dental and oral health status of Australians, as they are able to provide basic, sound dental information when a dentist is unavailable or too costly. Since the 1960s Colgate commercials have been informing the Australian population that oral health is about more than just preventing tooth decay, but that it also has a profound effect on overall well being, self-confidence and self-esteem (Conniptions886, 2009; Lilac028, 2006). In the 1970's with water and toothpaste fluoridation firmly in place, Colgate was there to explain the importance of fluoride when it comes to preventing tooth decay through the teachings of Mrs Marsh (AustralianAds, 2010).

Today, the Colgate brand remains dominate in the toothpaste section of the supermarket, catering for all dental needs and the Colgate website contains useful information regarding the prevention of tooth decay and other oral problems (Colgate World of Care, 2011b); information the public relies upon for oral health when access to a dentist is not feasible. Colgate has also been behind an oral health education initiative called “Bright Smiles, Bright Futures”, which is an oral health program to provide oral health care information to children worldwide with the goals of education and prevention (Colgate World of Care, 2011a). With Australia's worsening oral health problems and a failure at Federal Government level to propose reform for decades, it is important to have dedicated brands like Colgate providing helpful information and oral education programs in Australia.

Reflections
Each time you sleep with someone, you're also sleeping with his past This is an interesting article on what is fast becoming a very serious problem in Australia. Your review and analysis of the literature on the topic is insightful and enlightening. I also really like the artefact you have chosen for your article. It is a wonderful advertisement that nicely encapsulates what you are really exposing yourself to when you go to bed with someone. Great work!

Obesity is a Capitalist Disease This wiki article is brilliantly written and the analysis of a capitalist society being the root of the obesity problem is both interesting and thought provoking. I really enjoyed your analysis of Coca-Cola's role in obesity and the idea that companies make money from having an obese population is something I've always 'known' but never actually thought about or considered until now. This is a wonderfully interesting article, and thank you for making me think more deeply about the world in which we live.