These goals are in keeping with the goals of the Oral Health 2020: A Strategic Framework for Dental Health. They are to:
- Improve access to oral health services in NSW.
- Reduce disparities in the oral health status of people in NSW.
- Improve the oral health of the NSW population through primary prevention.
Goal 1: Improve Access to Oral Health Services in NSW
A significant proportion of the NSW population do not use dental services regularly, and when they do, they generally access private dental services.
This is in-line with the service provision model, where the NSW public dental system provides services to children and eligible adults who are generally the most disadvantaged members of the population.
The majority of dental services are funded on a private basis.
The rate of clients visiting dental professionals varies considerably between the most and least disadvantaged in the population. A significantly higher proportion of adults in the first or least disadvantaged quintile (68.6%), and a significantly lower proportion of adults in the fifth or most disadvantaged quintile (53.5%) visited a dental professional less than 12 months ago, compared with the overall adult population.
It has been recognised nationally that this disparity in access is evidence of the need to improve the way in which the dental system services the population. Nationally the system has been described as an “episodic, problem oriented primary health approach with little comprehensive treatment and continuity of care”. Improving the dental visiting pattern for all of the population, particularly the most disadvantaged, remains a challenge for the dental system in NSW.
Goal 2: Reduce Disparities in the Oral Health Status of People in NSW
Implementation of activities to achieve both Goals 1 and 3, such as water fluoridation, population prevention through integrated health promotion, and improved access to dental services for the entire population, will lead to an improved oral health status of the population.
However, there are subpopulations within the community that will need additional focus to ensure the disparities in oral health status are reduced. The priority groups are:
- Aboriginal and Torres Strait Islander people,
- older people,
- adults and children with special needs,
- children in out-of-home care, and;
- those in rural/remote communities where access to services is limited.
These subpopulations form the Priority Populations for the 2020 Framework.
Goal 3: Improve the Oral Health of the NSW Population through Primary Prevention
Whole of population or universal initiatives are centred on increased access to water fluoridation, health promotion, and disease prevention. These initiatives address the social determinants of oral disease and share common risk factors with other chronic diseases. An integrated risk factor approach recognises that chronic diseases and conditions such as overweight and obesity, heart disease, stroke, cancer, diabetes, and oral disease share common risk factors.
Key risk factors include poor diet, smoking, and alcohol use. The key concept of the integrated risk factor approach is that by directing action on these common risks and their underlying social determinants, improvements to a range of chronic diseases (oral disease being one) will occur more efficiently and effectively.
In the coming decade, NSW Health will continue to pursue a fluoridated water supply for the population and integrate oral health promotion within other health promotion activities in areas such as healthy eating, prevention of overweight and obesity, and smoking reduction programs.
NSW Health will also identify opportunities for oral health promotion to be included within other health care programs, such as chronic care initiatives for older adults, and early childhood programs (including home visiting). NSW Kids and Families will be a key partner, as will other parts of NSW Health with responsibility for health promotion.