Australia is a place that backs looking after number one, if you judge it by who gets the biggest slice of the economic pie. Wealthy white folk do way better than black fellas, young people, and those doing it tough, more generally. Men do much better than women. Middle class welfare is high on the menu here in Oz. Unemployed Aussies are forced to live below the poverty line because belligerent citizens favour tough love over helping “dole bludgers”. Robodebt was a Coalition attack on welfare recipients, which ran illegally for 6 years. Among all this, exists an aged care dental crisis: geriatric oral health is mostly a national shame. Bung ’em in a home and forget them – this has long been the reality for many of our elderly. We have seen this evidenced in the release of facts found in the Royal Commission into Aged Care.

The Elderly: Out Of Sight Is Out Of Mind

Obviously, the older we get the more issues we have around our oral health. Our diets are full of sugar and processed foods, which leads to poor dental outcomes way before middle age in many instances. The prevalence of placing our elderly in care homes means these issues are out of sight and out of mind. We care about our own elderly parents and guilt is a common occurrence for a number of us in this regard. Most of us are not so concerned about other people’s elderly relatives, especially in the era of private wealth and the shrinking of the public good. The social conscience of the nation has been diminishing as fast as the residential property sector has been rising – it is currently worth some $11 trillion. Homes are investments first and shelter a distant second or last place.

Aged Care: The Home Of Institutional Neglect In Australia

Aged care in Australia has been largely created as a for-profit sector combining real estate property development with care. Whilst not quite an added on extra the care part of the equation has lagged behind in many instances in facilities around the nation. The Royal Commission into Aged Care brought this into sharp focus right after Covid. Dentistry, as we all know well in Australia, is an expensive business. Dentists having never been shackled by Medicare are a different breed from the rest of the health providers operating in Oz. Indeed, oral care has been considered by many Australians as an unaffordable luxury largely for the wealthy and privileged. Ordinary working folk avoid the dentist where possible and when forced to seek emergency assistance pay, if not through the nose, then at least an arm and a leg.

“Many Australians face financial barriers in accessing dental services (COAG 2015). Overall, individuals directly fund a significant proportion of total expenditure on dental services, 59% in 2020–21 (AIHW 2022).”
– AIHW.gov.au

“Almost four in ten Australians (37%) aged 55+ have delayed or completely put off going to the dentist in the past year due to cost, research released today by COTA Australia – the leading advocacy organisation for older Australians has found. That number increases to 44% of older Australians on lower incomes, which includes many pensioners and those in aged care.”
– Cota.org.au

If aged care facilities are watching their spending, as they all do, then they are going to skimp on expensive procedures for their elderly residents. Combine this with the very real fact that as we get older most of us resign ourselves to putting up with stuff and not complaining as loudly. Aged care homes lacking trained staff, especially nurses and health care professionals, means a greater likelihood of elderly residents suffering in silence with poor oral health. This is what is already happening and has been occurring for many years now. What we now know, however, is that poor oral health correlates directly with much more serious health outcomes for these individuals.

Aged Care Reality vs Pie In The Sky

What we get in Australia, with our rapidly aging population, is governments making promises about improvements in aged care standards which they consistently fail to realise. Vulnerable folk Downunder have been voiceless for a long time. Those looking out for their own interests in terms of generous tax concessions via things like capital gains, negative gearing, and self-managed superannuation are hell bent on feathering their own nests. Private property and the accumulation of wealth via it is almost a religion in Australia. Productivity is at an all time low economically and our focus on domestic property investment is a big part of this. The country has lost its way on this score and may well be headed for a very nasty correction on this basis. The sad truth is that we are all going to end up in these less than satisfactory aged care facilities eventually. We are living longer and will join the conga line of frail folk inside these less than ideal aged care residential homes. What goes around comes around.

Oral Health Really Matters At All Ages

“As people get older, their need for oral health care increases. Older people more commonly experience certain oral health diseases and related problems as they become less able to self-manage and self-report with age due to issues of cognitive impairment, physical frailty, functional dependence, and comorbidities. Good oral hygiene, early treatment and maintenance can help ensure they can enjoy all aspects of their life and age positively. It includes having functional teeth, an appropriately moist mouth and most importantly, not being in physical pain or discomfort from active oral disease or ill-fitting dentures.”
– The Dental Foundation

Will Governments Step Up To Improve Oral Care Outcomes?

“All older people should be able to access adequate and timely oral healthcare. Government must address the needs of an older, frail, and care-dependent population through adequate funding to ensure that dental practitioners and aged care facilities are able to provide appropriate oral health care. 1.1. The number of older people in Australia is increasing. In 2015 3.5 million (15.1% of the population) were older than 65 years of age. This is estimated to increase to 8.8 million in 2051 (22%) and to 12.8 million in 2097 (28%).”
– ADA.org.au

The Albanese federal government has just released its new aged care policy reforms. The centrepiece of this is funding more Support at Home care so that older Australians can stay in their own homes for longer with greater assistance. $5.6 billion will be invested in these reforms. Wealthy Australians will be asked to pay more for their own care, whereas previously the Coalition facilitated a scheme where tax payers paid for them to a greater extent. This will save around $13 billion in total going forward over the next 11 years. We will have to wait and see whether the oral care of the elderly will be addressed in these new reforms. Some of us reading this now will, in the not too distant future, soon be finding out for ourselves. One hopes that this personal experience won’t be too painful. Suffering in silence, however, seems to be the way for our elderly.

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