Shifting the paradigm on oral health in Australia

Author: Dr Alexandra Jones, Co-Founder and Board Chair

When we talk about oral health, most of us think about things like a toothache, a cavity, or a dental appointment you’ve put off for too long.

It’s understandable, because our health system still largely treats oral health as something that begins and ends at the dentist, or when something goes wrong.

But if we want a healthier country, we need to start seeing oral health as a lifelong part of overall health, shaped as much by prevention, environments and support as by clinical treatment.

Oral health is about how well our mouths function throughout life - how we eat, speak, smile, connect with others and maintain our overall wellbeing.

And crucially, oral health is not simply the absence of disease.

Modern health policy defines health as a state of physical, mental and social wellbeing, not merely the absence of illness. The same thinking applies to our mouth and the structures that support it.

The next chapter of oral health in Australia should not be built around waiting for disease and paying to repair it. It should be built around helping people maintain oral health across the course of their lives.

Yet the way oral health is organised in Australia tells a different story.

Our system was built around treating disease after it appears. Policy debates focus on dental waiting lists, treatment costs and whether dental services should be covered by Medicare.

These are important questions. But underneath them lies a deeper issue, that the system itself is largely reactive.

Tooth decay remains one of the most common chronic diseases in the country, and tens of thousands of Australians are hospitalised each year for dental conditions that could have been prevented earlier.

At the same time, prevention across the health system remains chronically underfunded, receiving less than two per cent of total health spending. The investment in preventive oral health initiatives is a fraction of this.

The result is predictable. Many people encounter dental care only when something hurts or goes catastrophically wrong.

Achieving good oral health is underpinned by population-wide public health initiatives like fluoridated water, lower exposure to sugary foods and drinks, trusted advice, supportive health services and environments that make being healthy easier.

Much of what shapes oral health happens outside of clinical environments. The habits of our family and friends, community environments, education and health literacy all play a role.

This perspective has been recognised in public health for decades through frameworks such as the Ottawa Charter for Health Promotion, which emphasises prevention, supportive environments and community action.

As an oral health practitioner, it is humbling to see how long-term sustainable improvements in oral health often have far more to do with what happens to and with people in their daily lives, than our clinical interventions.

It is also central to the World Health Organization’s Global Oral Health Strategy, which calls on countries to shift away from treatment-heavy models toward prevention and population health.

The final report from the Select Committee into the Provision of and Access to Dental Services in Australia in 2023 concluded that oral health should be better integrated into primary health care and recognised as an essential part of overall health.

This insight matters.

If oral health becomes part of broader health promotion, uniformly embedded in schools, aged care, community services and primary care, we can reach more people earlier and more effectively.

It also opens the door to a broader workforce supporting oral health, including allied health and community services professionals.

A smarter oral health system would not expect dentistry and oral health professionals alone to do all the work. Especially when the current system does not provide pathways for everyone to attain professional care.

Australia now has a rare opportunity to rethink how oral health is approached.

The upcoming Federal Budget will shape national health priorities for years to come. At the same time, governments are finalising Australia’s new National Oral Health Plan (2025-34) to guide policy through the next decade.

A modern oral health system would invest in national education and digital tools that help people care for their oral health throughout life.

It would equip the broader health and community workforce with the knowledge to support oral health in everyday care.

It would address the commercial drivers of oral disease, including the marketing of high-sugar foods and drinks.

And it would ensure that people living in regional and remote communities, low-income households and Aboriginal and Torres Strait Islander communities have access to the information and support needed to maintain and improve their oral health.

The good news is that we already know a great deal about what protects oral health.

What has been missing is not knowledge, but system design, public investment and the will to act.

If the upcoming Federal Budget and the new National Oral Health Plan embrace this shift, Australia has the chance to build a smarter oral health system - one that continually prevents disease, reaches people earlier and treats the mouth as part of the body, not apart from it.

That would be better approach for our mouths, and for the overall health and wellbeing of the nation.