29 October 2020
Australian Ageing Agenda 
Reporter: Sandy Cheu

RC’s oral health recommendations a ‘win’

Counsel Assisting’s proposals on improving dental care for aged care recipients are welcome and need to remain a priority in the royal commission’s final report, the head of a dental peak body tells Australian Ageing Agenda. The Royal Commission into Aged Care Quality and Safety heard Counsel Assisting propose d124 recommendations to overhaul 18 aspects of the aged care system including health and allied health care across a two-day hearing last week.

They include that aged care providers engage at least one oral health practitioner for preventative treatments including daily oral health management, such as tooth brushing and denture cleaning, and a funded dental scheme including outreach services for all aged care residents and seniors in the community who qualify for Commonwealth health care. The proposed Senior Dental Benefits Scheme aims to ensure access to dental services from dentists and dental surgeons when and where required and a referral pathway for oral health practitioners conducting routine assessments in aged care, Counsel Assisting’s final submission said.

Senior Counsel Assisting Peter Gray said the recommendations aimed to address poor oral health, which has adverse consequences including functional impairment, pain and discomfort, ill‑health and even death as well as social isolation. To overcome the reduced mobility of many aged care recipients, dental services should be provided to older people wherever they’re residing including in an aged care home if needed, Mr Gray said.
“At a minimum, outreach dental services … require a clean, well‑lit area that has access to running water and capacity for portable equipment [and] … those spaces within the facility should be made available so those services can be facilitated,” Mr Gray said. Australian Dental Association NSW president Dr Katheen Matthews said Counsel Assisting’s dental proposals match those the association has been calling for.

“It’s a great win if it goes from proposal into a recommendation. In the end, I think that will be a fabulous and terrific can win for the health of older Australians,” Dr Matthews told AAA. “We hope that the proposals make it into the final recommendations and then once the commission has made those recommendations, we hope the government has the commitment to sign up and look at this area of aged care.” Dr Matthews said the proposals show that the royal commission has heard the concerns of older Australians as well as the various health professionals and practitioners who have been advocating for change and improvement. However, Dr Matthews said she would like to see more measures addressing dental care in aged care, such as linking oral health assessments into medical assessments that happen along the way before people transition to residential or aged care programs. “We’d also like to see some oral health standards as part of the accreditation framework for residential aged care facilities and for community care so that it does not get forgotten with all the other things that need to happen.”

Call to design scheme with users

Dr Matthews said the Senior Dental Benefits Scheme should be designed with the input of aged care residents and those providing care and services. “It’s better to sit down and have a good, designed scheme that involves the people that it’s going to service, so older Australians at the centre of it. It should also involve the people that might provide that service, including health professionals and registered dental practitioners and the care worker , who will be supporting older Australians to access care,”

She suggested the Child Dental Benefits Scheme, which is a basic scheme that has a focus on preventative care, is a reasonable framework to base the seniors’ dental scheme on. “It should focus on primary dental care that delivers prevention and pain relief, and maintains some of the psychosocial functioning,” Dr Matthews said. “It’s probably not going to be focused on high-end complex dentistry, but I think it’s about maintaining people’s function, maintaining their social wellbeing, and helping them to eat, chew and smile better.” The aged care royal commission is seeking responses to Counsel Assisting’s final submissions by 12 November. Find out more here.

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