# Oral health care delivery system in Australia ## **Dr Mohammad Junaid** **BDS, MDS (Public Health Dentistry), MFDS RCPS (Glasg.), DDPH RCS (Eng.), MDentPH (USyd), SFHEA, PhD (UWA)*** **Senior Lecturer – Dental Public Health** <!--CAPTIONS_JSON_START--> {"BOX_A": "", "BOX_B": "Australian Government Services Australia"} <!--CAPTIONS_JSON_END--> <!--CAPTIONS_JSON_START--> {"BOX_A": "", "BOX_B": "Oral Health Centre\nof Western Australia"} <!--CAPTIONS_JSON_END-->  ### Presenter **Dr Mohammad Junaid** BDS, MDS (Public Health Dentistry), MFDS RCPS (Glasg.), DDPH RCS (Eng.), MDentPH (USyd), SFHEA, PhD (UWA) Senior Lecturer – Dental Public Health - Australian Government Services Australia - Oral Health Centre of Western Australia > [!note] Lecturer — Lecture Structure > This lecture is part of the Dent 5311 Public Health Dentistry 1 module and is titled *Oral Healthcare Delivery System in Australia*. > > - The first recording addresses the elements that make up an oral healthcare delivery system. > - The second recording focuses on the Australian context. > [!note] Lecturer — Health System Context > Health systems are complex and continually evolving, rather than being limited to clinical settings or individual healthcare encounters. > > - They are influenced by social, political, economic and workforce factors. > - Policy and funding are especially important because they shape how services are delivered. Clinical photo: A photograph showing a dental treatment in progress within a clinical room, featuring a dentist and assistant working on a patient in a dental chair while another patient is visible in the background. This image illustrates the practical delivery of oral health care services, likely within a community or regional setting. Acknowledgement of country I would like to acknowledge the traditional custodians of the land, in whose land, I recorded this lecture and where you are listening to this recording, and pay my respects to elder's past, present and emerging. Image sourced from Sister Kate's Home Kids Aboriginal Corporation [https://www.skhkac.org.au/art-is-healing/](https://www.skhkac.org.au/art-is-healing/)  ### Acknowledgement of Country I would like to acknowledge the traditional custodians of the land, in whose land, I recorded this lecture and where you are listening to this recording, and pay my respects to elder's past, present and emerging. *Image sourced from Sister Kate's Home Kids Aboriginal Corporation [https://www.skhkac.org.au/art-is-healing/](https://www.skhkac.org.au/art-is-healing/)* A painting sourced from the Sister Kate's Home Kids Aboriginal Corporation, depicting a landscape scene that blends naturalistic elements like two black swans and a river with traditional Indigenous Australian dot art patterns in the foreground. Learning outcomes 1. Understand the basic oral health care delivery framework. 2. Oral health care delivery models followed globally and in Australia. 3. Describe the current dental public system in Australia and Western Australia (specifically). 4. Improve understanding and appreciate relevance of current public dental schemes in Australia.  1. Understand the basic oral health care delivery framework. 2. Oral health care delivery models followed globally and in Australia. 3. Describe the current dental public system in Australia and Western Australia (specifically). 4. Improve understanding and appreciate relevance of current public dental schemes in Australia. > [!note] Lecturer — Lecture Scope > The lecture also considers how public dental services are funded and delivered. > > - Public dental schemes support access to care and improved oral health outcomes for different population groups. A conceptual illustration showing a light bulb with hand-drawn black lines radiating from it to symbolize an idea or learning outcome, set against a yellow background. Overview of the oral health system **Oral health care** Financing and Organization Resources **Socioenviromental characteristics** Social/political/economic Oral health specific General health care system **System-level variables** **Personal characteristics** Predisposing Enabling **Oral health behaviour** Oral hygiene behaviour Dental service utilization **Oral health status** Dentition and periodontal status **Oral quality of life** Symptoms Well-being Functioning **Individual-level variables** Klingenberger, D. (2008). Health System in Dentistry . In: Kirch, W. (eds) Encyclopedia of Public Health. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-5614-7_1481  ### Overview of the Oral Health System #### System-Level Variables - **Oral health care** - Financing and organization - Resources - **Socioenvironmental characteristics** - Social/political/economic - Oral health specific - General health care system #### Individual-Level Variables - **Personal characteristics** - Predisposing - Enabling - **Oral health behaviour** - Oral hygiene behaviour - Dental service utilization - **Oral health status** - Dentition and periodontal status - **Oral quality of life** - Symptoms - Well-being - Functioning *Klingenberger, D. (2008). Health System in Dentistry. In: Kirch, W. (eds) Encyclopedia of Public Health. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-5614-7_1481* > [!note] Lecturer — System Interactions > The oral healthcare delivery system, the broader social, political and economic environment, and the individual are interconnected. > > - Policies and funding shape service delivery. > - Services influence people’s oral health behaviours. > - Individuals determine whether and how they engage with the health system. > - Understanding these interactions helps future practitioners recognise barriers, provide more person-centred and equitable services, navigate referral pathways, and advocate for patients when required. This flowchart illustrates an overview of the oral health system, visually dividing variables into 'System-level variables' on the left and 'Individual-level variables' on the right. The system-level section contains 'Oral health care' (Financing and Organization, Resources) and 'Socioenviromental characteristics' (Social/political/economic, Oral health specific, General health care system), with arrows indicating these influence the four individual-level boxes: 'Personal characteristics' (Predisposing, Enabling), 'Oral health behaviour' (Oral hygiene behaviour, Dental service utilization), 'Oral health status' (Dentition and periodontal status), and 'Oral quality of life' (Symptoms, Well-being, Functioning). # Factors influencing development of health care systems ## 1. Demographic change The world's population to peak at **11 Billion** People over **65** 2022 **10%** 2050 **16%** By 2050 **40%** of all people under **18** will live in Africa ## 2. Evolving patterns of disease and their impacts Environment Habits Diet Kyle Biofilm Rx Medications 2 Oral hygiene Genetics ## 3. Public demand for healthcare ## 4. Technology ## 5. Globalisation ## 6. Economy Content Source: Daly, Blânaid, and others, 'Overview of health care systems', **Essential Dental Public Health** (Oxford, 2013; online edn, Oxford Academic, 12 Nov. 2020), https://doi.org/10.1093/oso/9780199679379.003.0024, accessed 20 June 2024. Image sources: Sydney Business Insights https://sbi.sydney.edu.au/megatrends/demographic-change/ accessed 20 June 2024. Shanmugasundaram, S., Nayak, N., Karmakar, S. *et al.* Evolutionary History of Periodontitis and the Oral Microbiota—Lessons for the Future. *Curr Oral Health Rep* 11, 105–116 (2024). https://doi.org/10.1007/s40496-024-00370-7 accessed 20 June 2024. Journal of Economic Society of Australia, https://eap-journal.com.au/public-demand/ accessed 20 June 2024. Dentist Magazine, https://dentistmagazine.co/insight/teledentry-and-its-future-potential/ accessed 20 June 2024. StreetFins, https://streetfins.com/intro-to-healthcare-economics/ accessed 20 June 2024.       #### 1. Demographic Change - The world's population is projected to peak at **11 billion**. - Proportion of people aged over 65: - 2022: 10% - 2050: 16% - By 2050, 40% of all people under 18 will reside in Africa. #### 2. Evolving Patterns of Disease and Their Impacts Interacting factors influencing disease patterns include: - Environment - Habits and lifestyle - Diet - Biofilm - Treatments (Rx) and medications - Oral hygiene - Genetics #### 3. Public Demand for Healthcare #### 4. Technology #### 5. Globalisation #### 6. Economy *Daly, B., et al. (2013). 'Overview of health care systems', Essential Dental Public Health (Oxford; online edn, Oxford Academic, 12 Nov. 2020), https://doi.org/10.1093/oso/9780199679379.003.0024.* *Shanmugasundaram, S., Nayak, N., Karmakar, S., et al. (2024). Evolutionary History of Periodontitis and the Oral Microbiota—Lessons for the Future. Curr Oral Health Rep 11, 105–116. https://doi.org/10.1007/s40496-024-00370-7.* > [!note] Lecturer — Demographic Change > Health systems are dynamic rather than static and must evolve as populations change. > > - Older populations and longer life expectancy increase demand for services associated with chronic diseases. > - People are living longer and retaining their teeth for longer, while the geriatric population has a greater chronic disease burden. > - Many existing health systems were developed for particular population demographics, raising the question of whether they can adequately respond to current needs. > [!note] Lecturer — Disease Patterns > Many countries have shifted from focusing mainly on acute infectious diseases towards chronic, long-term conditions such as dental caries and periodontal disease. > > - People are retaining their teeth for longer and edentulism is declining. > - Periodontal disease is increasing, so health systems must respond to people retaining teeth into older age. > - Changes in disease patterns influence how health systems are organised and delivered. > [!note] Lecturer — Public Expectations > As populations become more informed, expectations for access, quality and equity of healthcare continue to increase. > > - Dental implants illustrate this change: they are now a major treatment option, whereas dentures and bridges were more commonly considered around twenty years earlier. > - Patients may ask about implants even when the dentist does not initially raise the option, although the clinician may need to explain why an implant is not appropriate. > [!note] Lecturer — Dental Technology > Contemporary dental practice is substantially different from dental practice at the time the presenter graduated. > > - Amalgam has more or less disappeared from practice, while laser dentistry, scans and cosmetic dentistry are now more common. > - Technology can improve care but also increase its cost and create access inequities. > - Health systems designed to deliver older forms of dentistry must adapt, while increasing costs may leave behind people who need but cannot afford modern dental treatment. - ==Globalisation influences workforce movements, knowledge exchange and policy trends across countries.== > [!note] Lecturer — Economy and Policy > The economy strongly influences available funding, service prioritisation and whether health systems can function effectively. > > - Economic decisions are also influenced by politicians who develop policies that fund health systems. > - Although “economy” describes this factor, policy is fundamental and may be influenced by populism, which could endanger the health system itself. > [!note] Lecturer — Changing Delivery Models > The order of discussion of the six oral healthcare delivery models did not indicate that one model was better than another. > > - The models reflect different historical, political and economic decisions. > - Many systems emerged or were consolidated in the late nineteenth century and particularly after the Second World War, in response to industrialisation, population growth and increasing demand for equitable access. > - Most systems are now hybrid systems, with one model dominant while other funding sources also support oral health services. This infographic visualizes demographic changes using a combination of charts and illustrations. It features a bar chart comparing the percentage of people over 65 in 2022 (10%) versus 2050 (16%), and a comparative illustration showing a shift in workforce dependency from '4 working people for every 1 retired' in 2023 to '2 working people for every 4 retired' in 2050. Labelled diagram: A central illustration of an open mouth surrounded by icons representing factors influencing oral health, with magnified insets showing biofilm and bacteria. The labels correspond to the slide text for 'Evolving patterns of disease': Environment (house/trees), Habits (beer/cigarette), Diet (plate/cutlery), Biofilm (microbial layer on teeth), Medications (Rx bottle/pills), Oral hygiene (toothbrush/toothpaste), and Genetics (DNA silhouettes). Illustration: A graphic depicting economic factors and public demand, featuring icons of a house, car, piggy bank, money, and a megaphone held by a hand, corresponding to the slide sections '3. Public demand for healthcare' and '6. Economy'. Digital illustration: A futuristic conceptual artwork depicting a laptop and smartphone displaying dental interfaces, surrounded by wireless connectivity symbols (Wi-Fi icons) and various dental instruments. This visual represents the concept of 'Technology' in healthcare systems, specifically illustrating advancements like teledentistry and digital diagnostics. Labelled diagram: A stylized illustration of a world map featuring interconnected icons representing global trade and communication, including airplanes, cargo ships, currency symbols, factories, and people interacting via video call. This figure illustrates the concept of 'Globalisation' (point 5 in the slide text) as a factor influencing healthcare systems. Clinical photo: A stethoscope resting on a background of United States one-hundred-dollar bills, illustrating the concept of 'Economy' (point 6) as a factor influencing healthcare systems. ## Components of health care systems Gift and Andersen (2007) suggest that health care systems can be divided into a number of aspects. These are: - Structure: how the system is structured. - Functions: what the system set out to achieve. - Personnel: who delivers the work. - Funding: where the funds are derived from. - Reimbursement: how workers are paid. - Target population: which groups are prioritized. Content Source: Daly, Blánaid, and others. ‘Overview of health care systems’, *Essential Dental Public Health* (Oxford, 2013; online edn, Oxford Academic, 12 Nov. 2020), https://doi.org/10.1093/oso/9780199679379.003.0024, accessed 20 June 2024. Image source: Australian Institute of Health and Welfare, https://www.aihw.gov.au/  Gift and Andersen (2007) suggest that health care systems can be divided into several core dimensions: - **Structure:** How the system is structured. - **Functions:** What the system sets out to achieve. - **Personnel:** Who delivers the care. - **Funding:** Where the financial resources are derived from. - **Reimbursement:** How healthcare workers are paid. - **Target population:** Which demographic groups are prioritized. *Daly, B., et al. (2013). 'Overview of health care systems', Essential Dental Public Health (Oxford; online edn, Oxford Academic, 12 Nov. 2020), https://doi.org/10.1093/oso/9780199679379.003.0024.* Logo of the Australian Institute of Health and Welfare: a white silhouette on a teal background showing a kangaroo and an emu flanking a shield, with foliage below and a star above. # Components of health care systems **Fig 17-2 Taxonomy for systematic cross-national comparative analysis of oral health care systems** | **Personnel** | **Structure/location** | **Financing** | |---|---|---| | Dentist | Government facilities | General government revenue | | Dental hygienist | Universities | Specific taxation | | Dental therapist | Worksites | Compulsory insurance | | Expanded-duty assistant | Hospitals, institutions | Insurance or prepayment | | Dental assistant | Schools | supported by employer | | Oral health community worker | Health/dental clinics | or individual | | Community worker | Mobile Units | Direct payment, private income | | Other health care and | Individual dental offices | | | social work professionals | General community facilities | | | (e.g., physicians, nurses) | | | | **Target population** | **Functions** | **Reimbursement** | |---|---|---| | Infants | Policy development and | Fee-for-service | | Preschool children | implementation | Capitation | | School-age children | Administration | Contract | | Young adults | Quality control | Salary | | Adults | Research | | | Older adults | Professional education | | | Special care populations | Public oral health education | | | (e.g., nursing home residents) | Preventive services | | | Identified occupational groups | Emergency services | | | (e.g., military) | Treatment services | | | Identified racial or income groups | | | | (e.g., Native American in the USA) | | | | **With what effect (examples)** | |---| | Appropriate dental care | | Improved knowledge, values, | | opinions and behaviors regarding | | oral health | | Less dental caries among adults | | Reduced tooth loss | | Improved oral health | *A comprehensive assessment of a national oral health care system minimally requires description of who provides what services/functions for whom in what locations with what resources by what payment mechanisms with what effect.* Content Source: Cynthia Pine and Rebecca Harris, 'The Principles of Organisation and Models of Delivery of Oral Health Care', Community Oral Health (Quintessence books, 2007), page no:426, #### Taxonomy for Systematic Cross-National Comparative Analysis of Oral Health Care Systems | Personnel | Structure / Location | Financing | |---|---|---| | - Dentist<br>- Dental hygienist<br>- Dental therapist<br>- Expanded-duty assistant<br>- Dental assistant<br>- Oral health community worker<br>- Community worker<br>- Other healthcare and social work professionals (e.g., physicians, nurses) | - Government facilities<br>- Universities<br>- Worksites<br>- Hospitals, institutions<br>- Schools<br>- Health/dental clinics<br>- Mobile units<br>- Individual dental offices<br>- General community facilities | - General government revenue<br>- Specific taxation<br>- Compulsory insurance<br>- Insurance or prepayment supported by employer or individual<br>- Direct payment, private income | | Target Population | Functions | Reimbursement | |---|---|---| | - Infants<br>- Preschool children<br>- School-age children<br>- Young adults<br>- Adults<br>- Older adults<br>- Special care populations (e.g., nursing home residents)<br>- Identified occupational groups (e.g., military)<br>- Identified racial or income groups (e.g., Native Americans in the USA) | - Policy development and implementation<br>- Administration<br>- Quality control<br>- Research<br>- Professional education<br>- Public oral health education<br>- Preventive services<br>- Emergency services<br>- Treatment services | - Fee-for-service<br>- Capitation<br>- Contract<br>- Salary | ##### Expected Effects and Outcomes - Appropriate dental care - Improved knowledge, values, opinions, and behaviors regarding oral health - Less dental caries among adults - Reduced tooth loss - Improved oral health > A comprehensive assessment of a national oral health care system minimally requires description of who provides what services/functions for whom in what locations with what resources by what payment mechanisms with what effect. *Pine, C., and Harris, R. (2007). 'The Principles of Organisation and Models of Delivery of Oral Health Care', Community Oral Health, Quintessence books, p. 426.* ```html <table border="1" cellspacing="0"> <thead> <tr> <th>Health care models</th> <th>Important features</th> <th>Countries</th> </tr> </thead> <tbody> <tr> <td><b>Bismarck model</b> (government-regulated social insurance system)</td> <td> <ul> <li>Oral care mainly financed through compulsory social insurance.</li> <li>Contributions from employees and employers as a fixed percentage of their income.</li> <li>Provision relies on private dental practitioners</li> <li>Benefits cover restorative care.</li> </ul> </td> <td>Austria, Belgium, France, Germany, Luxembourg, Netherlands, Switzerland, Japan</td> </tr> <tr> <td><b>Beveridge model</b> (government-organised and tax-financed national health system)</td> <td> <ul> <li>Financing through general taxation.</li> <li>Oral health services are provided by publicly owned and managed institutions.</li> <li>-Universal access to oral care.</li> </ul> </td> <td>Denmark, Finland, Sweden, United Kingdom, Norway, Portugal, Spain, Italy, Greece, Ireland, Iceland, New Zealand, Cuba</td> </tr> <tr> <td><b>Semashko model</b> [(mixed system of Bismarck (financing) and Beveridge (provision)]</td> <td> <ul> <li>Oral care mainly financed through compulsory social insurance.</li> <li>Dentists are salaried public employees.</li> <li>Oral health facilities are publicly owned.</li> </ul> </td> <td>Central and eastern European countries (CEE)</td> </tr> <tr> <td><i>The National Health Insurance Model</i></td> <td> <ul> <li>Government run insurance program funded by citizen.</li> <li>Dental services not covered adequately but will cover uninsured Canadians family annual income under CA$ 90,000 from 2025.</li> </ul> </td> <td>Canada, Taiwan and South Korea</td> </tr> <tr> <td><i>Out of pocket model</i></td> <td colspan="2">- Individuals responsible for costs of dental care</td> </tr> <tr> <td><i>Hybrid model</i></td> <td colspan="2">Combination of any of the above systems along with private insurance BUT DENTAL COVERAGE INADEQUATE.</td> </tr> <tr> <td colspan="2">Klingenberg, D. (2008). Health System in Dentistry. In: Kirch, W. (eds) Encyclopedia of Public Health. Springer, Dordrecht. <a href="https://doi.org/10.1007/978-1-4020-5614-7_1481">https://doi.org/10.1007/978-1-4020-5614-7_1481</a><br>Cynthia Pine and Rebecca Harris, 'The Principles of Organisation and Models of Delivery of Oral Health Care', <i>Community Oral Health</i> (Quintessence books, 2007), <br>Wallace LS. A view of health care around the world. Ann Fam Med. 2013 Jan-Feb;11(1):84. doi: 10.1370/afm.1484.<br>Australian Medical Association, <a href="https://www.ama.com.au/sites/default/files/2023-12/Discussion%20paper_Rethinking%20funding%20models%20to%20%20align%20with%20population%20health%20goals_0.pdf">https://www.ama.com.au/sites/default/files/2023-12/Discussion%20paper_Rethinking%20funding%20models%20to%20%20align%20with%20population%20health%20goals_0.pdf</a> </tr> </tbody> </table> ``` | Health Care Models | Key Features | Countries | |---|---|---| | **Bismarck Model**<br>*(Government-regulated social insurance system)* | - Oral care mainly financed through compulsory social insurance<br>- Contributions from employees and employers as a fixed percentage of income<br>- Provision relies on private dental practitioners<br>- Benefits cover restorative care | Austria, Belgium, France, Germany, Luxembourg, Netherlands, Switzerland, Japan | | **Beveridge Model**<br>*(Government-organised and tax-financed national health system)* | - Financing through general taxation<br>- Oral health services provided by publicly owned and managed institutions<br>- Universal access to oral care | Denmark, Finland, Sweden, United Kingdom, Norway, Portugal, Spain, Italy, Greece, Ireland, Iceland, New Zealand, Cuba | | **Semashko Model**<br>*(Mixed system: Bismarck financing and Beveridge provision)* | - Oral care mainly financed through compulsory social insurance<br>- Dentists are salaried public employees<br>- Oral health facilities are publicly owned | Central and Eastern European countries (CEE) | | **National Health Insurance Model** | - Government-run insurance program funded by citizens<br>- Dental services historically not covered adequately (expanding to uninsured Canadian families with annual income under CA$ 90,000 from 2025) | Canada, Taiwan, South Korea | | **Out-of-Pocket Model** | - Individuals are directly responsible for the costs of dental care | Broadly applicable globally | | **Hybrid Model** | - Combination of multiple delivery systems along with private insurance; dental coverage often remains inadequate | Diverse international settings | *Klingenberg, D. (2008). Health System in Dentistry. In: Kirch, W. (eds) Encyclopedia of Public Health. Springer, Dordrecht. https://doi.org/10.1007/978-1-4020-5614-7_1481.* *Pine, C., and Harris, R. (2007). 'The Principles of Organisation and Models of Delivery of Oral Health Care', Community Oral Health, Quintessence books.* *Wallace, L. S. (2013). A view of health care around the world. Ann Fam Med, 11(1), 84. doi: 10.1370/afm.1484.* # Quick revision... ## 1. Factors that influence development of health systems. ## 2. Components of a health system. a. Structure b. Target population c. Functions d. Personnel e. Funding f. Reimbursement ## 3. Oral health delivery models – globally.  1. Factors that influence the development of health systems 2. Components of a health system: - Structure - Target population - Functions - Personnel - Funding - Reimbursement 3. Oral health delivery models globally > [!note] Lecturer — Global Health Systems > The oral health system is an interplay between the oral healthcare delivery system, external social, political and economic factors, and individual factors. > > - Health systems must respond to changing demographics, disease patterns, public expectations, technologies, global conditions, and economic and policy environments. > - The next recording will focus on the structure and governance of the Australian health system, public dental schemes, and access to dental services from a public perspective. Cartoon illustration: A blonde character is depicted sitting on a dental stool, leaning forward to work on a patient's open mouth using a dental handpiece while resting their arms on a support. **medicare** # 1234 56789 1 **1 JOHN A CITIZEN** **2 JANE A CITIZEN** **3 JAMES A CITIZEN** **4 JESSICA A CITIZEN** # Oral health care system in Australia VALID TO 08/2020 Image source: https://www.healthdirect.gov.au/what-is-medicare Medicare Card Example: - Card Number: 1234 56789 1 - Cardholders: 1. JOHN A CITIZEN 2. JANE A CITIZEN 3. JAMES A CITIZEN 4. JESSICA A CITIZEN - Valid to: 08/2020 *Image source: https://www.healthdirect.gov.au/what-is-medicare* Who pays for dental services in Australia? In 2022–23, $12.5 billion was spent on dental services in Australia. Individuals spent more than $7.6 billion, health insurers close to $2.5 billion, the Commonwealth nearly $1.4 billion, and state and territory governments nearly $1 billion.  In 2022–23, $12.5 billion was spent on dental services in Australia: - **Individuals:** More than $7.6 billion - **Health insurers:** Close to $2.5 billion - **Commonwealth Government:** Nearly $1.4 billion - **State and territory governments:** Nearly $1 billion Chart: A donut chart illustrating the percentage share of dental spend in Australia for 2022–23, broken down by payer. The segments are labeled with their specific contributions: Individuals (61%), Health insurers (20%), Commonwealth (11%), and States and Territories (8%). # History of public dental funding in Australia ## A shared responsibility: State delivery, Commonwealth support **Not in Medicare** Unlike medical care, dental care has never been included in Medicare. **State led, Commonwealth supports** States and territories have always delivered public dental services, with funding help from the Commonwealth. **Focus on need** Programs have mainly targeted children, vulnerable people, and those with specific health conditions. **Still evolving** Australia continues to debate how to make dental care fairer, more accessible and affordable for all. --- ## KEY MILESTONES | 1900s–1970s | 1946 | 1973–1981 | 1973 & 1981 | 1994–1996 | 2000s | 2014–present | 2014–present | 2020s and beyond | | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | :--- | | **Early public dental services** | **Commonwealth gains power to fund dental services** | **National School Dental Scheme** | **Medibank (1975) and Medicare (1984) exclude dentistry** | **Commonwealth Dental Health Program (CDHP)** | **Targeted programs for specific groups** | **Child Dental Benefits Schedule (CDBS)** | **Commonwealth–State agreements for adult public dental services** | **Looking to the future** | | States establish public dental services, mainly focusing on school children and people in need. | A constitutional change allows the Commonwealth to fund dental services, but states remain responsible for delivery. | Commonwealth funds a national scheme to improve children's oral health through school dental services. | Dental care is left out of Australia's universal health insurance and remains mostly a private expense. | First major program for adults. Aimed to reduce public dental waiting lists and improve access for those most in need. | • Veterans’ Dental Program expands<br>• Medicare Chronic Disease Dental Scheme (2007) provides Medicare-funded dental care for people with chronic conditions (ended in 2012). | Medicare-funded scheme for eligible children (0–17 years) for basic and preventive dental care delivered by private dentists. | Ongoing funding partnerships to support public dental services for adults, especially concession card holders, and reduce waiting lists. | Growing calls for universal dental care and inclusion in Medicare to achieve better oral health for all Australians. | --- ## HOW FUNDING WORKS TODAY **Commonwealth Government** Provides targeted funding and payments (e.g. CDBS) and contributes to state programs. **State and Territory Governments** Plan, fund and deliver public dental services to eligible people. **Funding agreements and payments** ($) **Australians** Most dental care is still provided by private dentists. ## THE BIG PICTURE * Australia has never had universal public dental coverage. * Funding has focused on children, vulnerable people and those with specific health needs. * States deliver the services; the Commonwealth provides support. * Better oral health improves overall health, equality and quality of life. ## THE GOAL A fair and accessible dental system where every Australian can get the care they need to keep their mouth healthy and their body healthy. Source Adapted from Parliament of Australia: **https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/Research/Policy_Briefs/2025-26/Commonwealthfundingfordental?utm_**                   #### A Shared Responsibility: State Delivery, Commonwealth Support - **Not in Medicare:** Unlike medical care, dental care has never been included in Medicare. - **State led, Commonwealth supports:** States and territories have always delivered public dental services, with funding help from the Commonwealth. - **Focus on need:** Programs have mainly targeted children, vulnerable people, and those with specific health conditions. - **Still evolving:** Australia continues to debate how to make dental care fairer, more accessible, and affordable for all. #### Key Milestones | Period | Milestone | Description | | :--- | :--- | :--- | | **1900s–1970s** | Early public dental services | States establish public dental services, mainly focusing on school children and people in need. | | **1946** | Commonwealth gains power to fund dental services | A constitutional change allows the Commonwealth to fund dental services, but states remain responsible for delivery. | | **1973–1981** | National School Dental Scheme | Commonwealth funds a national scheme to improve children's oral health through school dental services. | | **1973 & 1981** | Medibank (1975) and Medicare (1984) exclude dentistry | Dental care is left out of Australia's universal health insurance and remains mostly a private expense. | | **1994–1996** | Commonwealth Dental Health Program (CDHP) | First major program for adults. Aimed to reduce public dental waiting lists and improve access for those most in need. | | **2000s** | Targeted programs for specific groups | - Veterans’ Dental Program expands<br>- Medicare Chronic Disease Dental Scheme (2007) provides Medicare-funded dental care for people with chronic conditions (ended in 2012). | | **2014–present** | Child Dental Benefits Schedule (CDBS) | Medicare-funded scheme for eligible children (0–17 years) for basic and preventive dental care delivered by private dentists. | | **2014–present** | Commonwealth–State agreements for adult public dental services | Ongoing funding partnerships to support public dental services for adults, especially concession card holders, and reduce waiting lists. | | **2020s and beyond** | Looking to the future | Growing calls for universal dental care and inclusion in Medicare to achieve better oral health for all Australians. | #### How Funding Works Today - **Commonwealth Government:** Provides targeted funding and payments (e.g., CDBS) and contributes to state programs. - **State and Territory Governments:** Plan, fund, and deliver public dental services to eligible people. - **Funding agreements and payments ($)** - **Australians:** Most dental care is still provided by private dentists. #### The Big Picture - Australia has never had universal public dental coverage. - Funding has focused on children, vulnerable people, and those with specific health needs. - States deliver the services; the Commonwealth provides support. - Better oral health improves overall health, equality, and quality of life. #### The Goal A fair and accessible dental system where every Australian can get the care they need to keep their mouth healthy and their body healthy. *Adapted from Parliament of Australia: https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/Research/Policy_Briefs/2025-26/Commonwealthfundingfordental?utm_* This figure is a simple blue icon depicting a classical building with a triangular pediment supported by four columns. It serves as a visual symbol for government or public institutions, illustrating the concept of state and Commonwealth responsibility in the delivery and funding of public dental services discussed in the adjacent text. A solid teal silhouette map of the continent of Australia, illustrating the national scope of the public dental funding history discussed in the slide text. Iconographic illustration of a family unit consisting of two adults and one child holding hands. This visual represents the concept of 'Australians' mentioned in the adjacent text, illustrating that most dental care is still provided by private dentists to families. Icon: A stylized white tooth silhouette centered within a thick orange rounded square frame. Illustration of a smiling family (father, mother, and child) standing beside a large, anthropomorphic tooth character with a happy face. This visual metaphor illustrates the slide's goal of achieving better oral health for all Australians and the focus on families and children in public dental funding. Stylized icon of a building featuring a prominent medical cross symbol, representing a public dental clinic or healthcare facility within the context of state-delivered services. The figure is the Coat of Arms of Australia, depicted in green and white. It features a shield supported by a kangaroo on the left and an emu on the right, surmounted by a seven-pointed Commonwealth Star, with Golden Wattle branches forming the background. A stylized icon showing a boy and a girl, representing the focus of public dental funding on children as mentioned in the slide text (e.g., 'National School Dental Scheme', 'Child Dental Benefits Schedule'). Graphic icon of a Medicare card overlaid with a red 'X' symbol, illustrating the slide's point that dental care is not included in Australia's universal health insurance scheme. A purple silhouette icon of a dental chair, visually representing the subject of public dental services and funding discussed in the slide. A set of three orange pictograms representing the key stakeholders in Australia's dental funding system: a generic person (representing Australians), a female figure (representing State and Territory Governments), and a male official or worker (representing the Commonwealth Government). A stylized illustration of a smiling person with short brown hair and a yellow shirt. This graphic serves as a visual icon representing the "Australians" category in the "HOW FUNDING WORKS TODAY" section, illustrating the point that most dental care is still provided by private dentists. A pictogram icon depicting a group of three green stylized human figures, representing the Australian population or families mentioned in the context of dental care accessibility. Icon of a handshake illustrating the concept of "A shared responsibility" and partnership between State delivery and Commonwealth support in public dental funding. A stylized icon of a dark blue molar tooth centered within a light blue oval background, serving as a visual symbol for the dental care topics discussed in the slide. A graphic illustration featuring a dark blue silhouette of the map of Australia, including Tasmania, set against a light blue circular background. A white negative space in the shape of a molar tooth is centrally superimposed over the continent, visually symbolizing the national focus on dental health and oral care. A stylized icon showing a white silhouette of a classical government building with columns and a cross-topped dome set against a green circular background. This graphic serves as a visual symbol for the 'Commonwealth Government' section under the heading 'HOW FUNDING WORKS TODAY', representing the federal entity that provides targeted funding and support. A stylized icon or logo depicting a white tooth silhouette centered above two cupped hands, all set against a solid purple oval background. This graphic illustrates the concept of dental care, protection, and support. **Funding of health care in Australia – a shared responsibility** **Table 1: Funding sources for health services in Australia** | | | | :--- | :--- | | **Commonwealth Government** | • Medical services through the MBS (both referred and non-referred medical services, as well as some allied health services) | | | • Limited dental services | | | • Pharmaceuticals through the PBS | | | • Community-controlled Aboriginal and Torres Strait Islander primary healthcare | | | • Aged care services (including residential aged care and home care) through the AN-ACC residential aged care funding model, as well as capital grants and programs | | | • Contributions to support access to private health insurance, such as the private health insurance rebate | | | • Health and medical research through the National Health and Medical Research Council | | | • 45 per cent of public hospital activity service delivery (under the National Health Reform Agreement 2020-2025) | | **State and territory governments** | • 55 per cent of public hospital activity service delivery (under the National Health Reform Agreement 2020-2025) | | | • Ambulance services | | | • Limited dental services | | | • Some community and public health services | | | • Some medical research | | **Local governments** | • Public health promotion | | | • Community health services | | **Non-government organisations** | • Charitable healthcare services, such as medical clinics | | | • Health promotion initiatives and educational programs | | **Private health insurers** | • Private health services delivered in public hospitals | | | • Services delivered in private hospitals | | | • Some community services | | | • Some dental services | | | • Medicines | | | • Some referred medical services | | | • Some allied health services | | | • Some medical research | | **Patients** | • Out-of-pocket expenses (medical, dental, diagnostic investigation and allied health services) | | | • Private health insurance premiums, excess payments | | | • Medicine costs | | | • Medicare levy and Medicare levy surcharge | Australian Medical Association, https://www.ama.com.au/sites/default/files/2023-12/Discussion%20paper_Rethinking%20funding%20models%20to%20%20align%20with%20population%20health%20goals_0.pdf #### Funding Sources for Health Services in Australia | Level of Governance / Sector | Funded Services | | :--- | :--- | | **Commonwealth Government** | - Medical services through the MBS (both referred and non-referred medical services, as well as some allied health services)<br>- Limited dental services<br>- Pharmaceuticals through the PBS<br>- Community-controlled Aboriginal and Torres Strait Islander primary healthcare<br>- Aged care services (including residential aged care and home care) through the AN-ACC residential aged care funding model, as well as capital grants and programs<br>- Contributions to support access to private health insurance, such as the private health insurance rebate<br>- Health and medical research through the National Health and Medical Research Council<br>- 45% of public hospital activity service delivery (under the National Health Reform Agreement 2020–2025) | | **State and Territory Governments** | - 55% of public hospital activity service delivery (under the National Health Reform Agreement 2020–2025)<br>- Ambulance services<br>- Limited dental services<br>- Some community and public health services<br>- Some medical research | | **Local Governments** | - Public health promotion<br>- Community health services | | **Non-Government Organisations** | - Charitable healthcare services, such as medical clinics<br>- Health promotion initiatives and educational programs | | **Private Health Insurers** | - Private health services delivered in public hospitals<br>- Services delivered in private hospitals<br>- Some community services<br>- Some dental services<br>- Medicines<br>- Some referred medical services<br>- Some allied health services<br>- Some medical research | | **Patients** | - Out-of-pocket expenses (medical, dental, diagnostic investigation, and allied health services)<br>- Private health insurance premiums, excess payments<br>- Medicine costs<br>- Medicare levy and Medicare levy surcharge | *Australian Medical Association, https://www.ama.com.au/sites/default/files/2023-12/Discussion%20paper_Rethinking%20funding%20models%20to%20%20align%20with%20population%20health%20goals_0.pdf* Commonwealth (federal) government based dental services Child Dental Benefit Schedule (CDBS) and other Medicare schemes Federation Funding Agreement (FFA) for adult public dental services National Health Reform Agreement (NHRA) Private Health Insurance (PHI) rebates Grants to the Royal Flying Doctors Service (RFDS) The Department of Veterans’ Affairs dental program. Research The Northern Territory Remote Aboriginal Investment Oral Health Program (NTRAI OHP) Aboriginal community controlled health services (ACCHS) Parliament of Australia https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Dental_Services_in_Australia/DentalServices/Interim_Report/Chapter_1 – Introduction and background  - Child Dental Benefit Schedule (CDBS) and other Medicare schemes - Federation Funding Agreement (FFA) for adult public dental services - National Health Reform Agreement (NHRA) - Private Health Insurance (PHI) rebates - Grants to the Royal Flying Doctor Service (RFDS) - The Department of Veterans’ Affairs dental program - Research - The Northern Territory Remote Aboriginal Investment Oral Health Program (NTRAI OHP) - Aboriginal community controlled health services (ACCHS) *Parliament of Australia https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Dental_Services_in_Australia/DentalServices/Interim_Report/Chapter_1 – Introduction and background* Labelled diagram: A visual breakdown of Commonwealth (federal) government based dental services, illustrating nine specific funding streams and programs including the Child Dental Benefit Schedule (CDBS), Federation Funding Agreement (FFA), National Health Reform Agreement (NHRA), Private Health Insurance (PHI) rebates, Grants to the Royal Flying Doctors Service (RFDS), The Department of Veterans’ Affairs dental program, Research, The Northern Territory Remote Aboriginal Investment Oral Health Program (NTRAI OHP), and Aboriginal community controlled health services (ACCHS). **State government based dental services (Western Australian context)** 1. **Dental Health Services** a. School Dental Service b. General Dental Service c. Special Dental Service i. Aged care facility (visiting program) ii. Special Needs Clinic iii. Prison dental service iv. Disability Service Commission clients v. Visiting services to Royal Perth Hospital and Graylands Hospital. vi. Specialist services at Fiona Stanley Hospital d. Dental Subsidy Schemes i. Country Patients Dental Subsidy Scheme (CPDSS) ii. Metropolitan Patients Dental Subsidy Scheme (MPDSS) iii. Private Orthodontic Subsidy Scheme (POSS) 2. Aboriginal Medical Services 3. Oral Health Centre of Western Australia: Only tertiary teaching specialist dental hospital in WA. WA Department of Health, Dental Health Services: [https://www.health.wa.gov.au/en/Articles/A_EDental-Health-Services](https://www.health.wa.gov.au/en/Articles/A_EDental-Health-Services) #### Western Australian Context 1. **Dental Health Services** - **School Dental Service** - **General Dental Service** - **Special Dental Service** - Aged care facility (visiting program) - Special Needs Clinic - Prison dental service - Disability Service Commission clients - Visiting services to Royal Perth Hospital and Graylands Hospital - Specialist services at Fiona Stanley Hospital - **Dental Subsidy Schemes** - Country Patients Dental Subsidy Scheme (CPDSS) - Metropolitan Patients Dental Subsidy Scheme (MPDSS) - Private Orthodontic Subsidy Scheme (POSS) 2. **Aboriginal Medical Services** 3. **Oral Health Centre of Western Australia** - Only tertiary teaching specialist dental hospital in WA. *WA Department of Health, Dental Health Services: https://www.health.wa.gov.au/en/Articles/A_EDental-Health-Services* How much of dental care is covered by Medicare?? Australian Government Services Australia medicare Image source: https://www.healthdirect.gov.au/partners/medicare  How much of dental care is covered by Medicare? Australian Government Services Australia – Medicare *Image source: https://www.healthdirect.gov.au/partners/medicare* The figure displays the Australian Coat of Arms, featuring a shield supported by a kangaroo and an emu, with the word 'AUSTRALIA' on a scroll below. This visual serves as a logo or emblem representing the Australian Government, specifically Services Australia and Medicare, as indicated by the surrounding slide text. Health Bank # How does Medicare work? 1. Funded by Australian tax-payers (2% of their taxable income). 2. Service offered to ANZ citizens, Permanent residents, those applied for permanent residency, temporary residents covered by a Ministerial order, permanent resident of Australian overseas territories, and reciprocal health care arrangement with other country. 3. Parallelly costs for most medicines under the Pharmaceutical Benefits Schedule (PBS) are covered and cost of many prescribed medicines are subsidised by the government. ### Payment offered Full schedule fee for GPs 85% of scheduled fee for a specialist. 75% of scheduled fee for in hospital services. In addition, a Medicare Safety Net and PBS safety net is provided to individuals with extensive health care needs. Medicare: [https://www.healthdirect.gov.au/what-is-medicare](https://www.healthdirect.gov.au/what-is-medicare) Pharmaceutical Benefits Scheme, [https://www.healthdirect.gov.au/pharmaceutical-benefits-scheme-pbs](https://www.healthdirect.gov.au/pharmaceutical-benefits-scheme-pbs)  1. Funded by Australian taxpayers (2% of their taxable income). 2. Service offered to ANZ citizens, permanent residents, those who have applied for permanent residency, temporary residents covered by a Ministerial order, permanent residents of Australian overseas territories, and individuals under reciprocal healthcare arrangements with other countries. 3. In parallel, costs for most medicines under the Pharmaceutical Benefits Scheme (PBS) are covered, and the cost of many prescribed medicines is subsidised by the government. #### Payment Structure - Full schedule fee for GPs - 85% of scheduled fee for specialists - 75% of scheduled fee for in-hospital services In addition, a Medicare Safety Net and PBS Safety Net are provided to individuals with extensive healthcare needs. Medicare: https://www.healthdirect.gov.au/what-is-medicare Pharmaceutical Benefits Scheme: https://www.healthdirect.gov.au/pharmaceutical-benefits-scheme-pbs Graphic displaying the Australian Government Department of Health logo with the coat of arms on the left, and large white text reading 'MBS Online Medicare Benefits Schedule' on a green background to the right, illustrating the official schedule for Medicare fees. # Child Dental # Benefit # Schedule <br> ## **Child Dental Benefits Schedule (CDBS)** ## **Helping eligible Australian children access dental care** ### 1. WHO CAN GET IT? **Your child may be eligible if they:** * Are aged **0-17 years** for at least one day during the calendar year * Have a **Medicare card** * Receive, or have a parent/carer receiving, an eligible government payment (such as **Family Tax Benefit A** and other eligible **Centrelink payments**) during the year * **Services Australia** checks eligibility each year. ### 2. WHAT IS COVERED? **Basic dental care** * **Dental check-ups** * **Dental x-rays** * **Teeth cleaning** * **Fissure sealants** * **Fillings** * **Root canal treatment** * **Partial dentures** (when clinically required) The scheme provides up to **$1,158** over two consecutive calendar years. ### 3. WHAT IS NOT COVERED? * Braces and orthodontics * Cosmetic dental treatment (e.g., teeth whitening) * Dental treatment provided in hospital operating theatres * Other services outside the CDBS schedule *Ask your dentist if you are unsure about a treatment.* ### 4. HOW DOES IT WORK? 1. **Services Australia** checks eligibility each year. 2. Check eligibility through **Medicare** on **myGov** or ask your dental clinic. 3. Book an appointment with a participating dentist. 4. Receive eligible dental treatment. 5. The dentist claims directly through **Medicare** (many clinics bulk bill eligible services). 6. Your available balance reduces as services are used until the 2-year cap is reached. **Up to $1,158 over 2 years for eligible children** Source: https://www.servicesaustralia.gov.au/whats-covered-child-dental-benefits-schedule?context=22426 <!--CAPTIONS_JSON_START→ {"BOX_A": "Child Dental Benefits Schedule (CDBS)", "BOX_B": "Helping eligible Australian children access dental care", "BOX_C": "1. WHO CAN GET IT?", "BOX_D": "2. WHAT IS COVERED?" , "BOX_E": "3. WHAT IS NOT COVERED?", "BOX_F": "Basic dental care", "BOX_G": "", "BOX_H": "Ask your dentist if you are unsure about a treatment.", "BOX_I": "Dental check-ups", "BOX_J": "Dental x-rays", "BOX_K": "Teeth cleaning", "BOX_L": "Fissure sealants", "BOX_M": "Fillings", "BOX_N": "Root canal treatment", "BOX_O": "Partial dentures", "BOX_P": "The scheme provides up to $1,158 over two consecutive calendar years.", "BOX_Q": "Braces and orthodontics", "BOX_R": "Cosmetic dental treatment", "BOX_S": "Dental treatment provided in hospital operating theatres", "BOX_T": "Other services outside the CDBS schedule", "BOX_U": "myGov", "BOX_V": "Check eligibility through Medicare on myGov or ask your dental clinic.", "BOX_W": "Book an appointment with a participating dentist.", "BOX_X": "The dentist claims directly through Medicare (many clinics bulk bill eligible services).", "BOX_Y": "Your available balance reduces as services are used until the 2-year cap is reached.", "BOX_Z": "Services Australia checks eligibility each year.", "BOX_AA": "", "BOX_AB": "", "BOX_AC": ""}                              Helping eligible Australian children access dental care, providing up to $1,158 over two consecutive calendar years. #### Eligibility Criteria A child may be eligible if they: - Are aged 0–17 years for at least one day during the calendar year - Have a Medicare card - Receive, or have a parent/carer receiving, an eligible government payment (such as Family Tax Benefit Part A and other eligible Centrelink payments) during the year - Are assessed as eligible by Services Australia each year #### Covered Services Basic dental care includes: - Dental check-ups - Dental X-rays - Teeth cleaning - Fissure sealants - Fillings - Root canal treatment - Partial dentures (when clinically required) #### Excluded Services - Braces and orthodontics - Cosmetic dental treatment (e.g., teeth whitening) - Dental treatment provided in hospital operating theatres - Other services outside the CDBS schedule *Ask your dentist if you are unsure about a treatment.* #### How the Scheme Works 1. Services Australia checks eligibility each year. 2. Check eligibility through Medicare on myGov or consult your dental clinic. 3. Book an appointment with a participating dentist. 4. Receive eligible dental treatment. 5. The dentist claims directly through Medicare (many clinics bulk bill eligible services). 6. The available balance reduces as services are used until the 2-year cap is reached. Source: https://www.servicesaustralia.gov.au/whats-covered-child-dental-benefits-schedule?context=22426 Illustration: A stylized, cartoon tooth with a smiling face and pink cheeks, surrounded by blue sparkles. Illustration: A cartoon graphic showing a boy and a girl holding toothbrushes, representing the target audience for the Child Dental Benefits Schedule. Icon: A green oval containing a white checkmark, serving as a visual bullet point or indicator for the "WHAT IS COVERED?" section. Icon: A stylized calendar graphic with a green header and two binding rings, illustrating the time-based nature of the benefit schedule. Icon: A white checkmark centered within a green oval background. This graphic serves as a visual symbol for affirmation, eligibility, or inclusion, likely corresponding to the covered services or positive criteria listed in the Child Dental Benefits Schedule text. Graphic illustration of an Australian Medicare card, featuring the green and yellow design with the word "medicare" at the top. This visual supports the text requirement that a child must have a Medicare card to be eligible for the Child Dental Benefits Schedule. A cartoon illustration of a family group consisting of an adult woman and two children (a boy in a green shirt and a younger child in a yellow shirt), accompanied by a green checkmark icon. This figure visually represents the concept of eligible Australian families or children accessing dental care, as discussed in the slide text. Icon: A green oval containing a white checkmark, visually symbolizing eligibility or inclusion. This graphic corresponds to the '1. WHO CAN GET IT?' section of the slide text, which lists the criteria for children eligible for the Child Dental Benefits Schedule. Icon: A stylized white tooth silhouette centered within a blue oval background. Icon: A stylized graphic showing a tooth silhouette inside a framed square, set against a blue oval background. The figure does not carry numbered or lettered labels. Icon: A white toothbrush situated on a blue oval background. This graphic illustrates general dental hygiene and corresponds to the 'Teeth cleaning' service listed under the 'Basic dental care' section of the schedule. Graphic icon: A white silhouette of a molar tooth centered within a blue oval, serving as a visual symbol for the Child Dental Benefits Schedule (CDBS) topic. Icon: A stylized graphic of a white tooth set against a blue oval background, featuring a grey shape on the upper surface that represents a dental filling. Illustration of a tooth featuring a filling, representing the 'Fillings' service covered under the Child Dental Benefits Schedule. Clip art illustration of a blue money bag featuring a white dollar sign, serving as a visual icon for the financial benefit aspect of the Child Dental Benefits Schedule. Graphic icon: A stylized illustration of a set of upper and lower teeth within a blue oval, serving as a visual symbol for the dental care services (such as check-ups, x-rays, cleaning, sealants, fillings, root canals, and partial dentures) listed in section 2 of the slide. Graphic icon: A red oval containing a white 'X' symbol. This visual element serves as a header for the section titled '3. WHAT IS NOT COVERED?', illustrating services excluded from the Child Dental Benefits Schedule such as braces, cosmetic treatments, and hospital-based care. A schematic diagram of a tooth fitted with an orthodontic appliance, specifically a metal band and bracket assembly. This illustration corresponds to the 'WHAT IS NOT COVERED?' section of the slide text, visually representing 'Braces and orthodontics' which are excluded from the Child Dental Benefits Schedule. Iconographic illustration showing a red 'X' symbol next to a dental mirror reflecting a tooth, visually representing the 'WHAT IS NOT COVERED?' section of the slide. The figure illustrates exclusions from the Child Dental Benefits Schedule, such as cosmetic dental treatment or services outside the schedule. Icon illustration: a stylized white tooth viewed in a handheld dental mirror, symbolizing the dental check-ups and basic care covered by the Child Dental Benefits Schedule. Icon of a clipboard: a grey rectangular board with a black clip at the top and five horizontal grey lines on the white paper representing text. This figure illustrates the concept of documentation or the 'schedule' aspect of the Child Dental Benefits Schedule. A red oval icon containing a white 'X' symbol, serving as a visual indicator for the section titled '3. WHAT IS NOT COVERED?'. Graphic icon: A red oval containing a white lowercase letter 'i', serving as a standard symbol for information. Digital illustration of a laptop computer displaying the green 'myGov' logo on its screen, surmounted by a purple oval containing the number '1'. This visual corresponds to the text instruction to 'Check eligibility through Medicare on myGov', which is listed as step 2 under the 'HOW DOES IT WORK?' section, though the graphic is labeled '1', possibly indicating the first active step for the user. Icon: A digital tablet displaying a green checkmark, surmounted by a purple circle containing the number '2'. This figure illustrates step 2 of the "HOW DOES IT WORK?" process: checking eligibility through Medicare on myGov or asking a dental clinic. This figure is a stylized icon of a calendar with a green checkmark, accompanied by the number '3' in a purple circle. It visually represents Step 3 from the "HOW DOES IT WORK?" section, which corresponds to the text "Book an appointment with a participating dentist." Illustration: A dentist examining a child patient, labeled with the number '4' which corresponds to step 4 in the 'HOW DOES IT WORK?' section of the slide text: 'Receive eligible dental treatment'. Icon graphic of a clipboard displaying the Medicare logo, accompanied by a purple circle containing the number 5. Based on the slide text, this figure illustrates step 5 of the "How Does It Work?" section: "The dentist claims directly through Medicare (many clinics bulk bill eligible services)." Illustrated icon of a smiling tooth with a purple oval containing the number '6' above it and sparkles to the right. This figure corresponds to step 6 in the 'HOW DOES IT WORK?' section of the slide, representing the concept: 'Your available balance reduces as services are used until the 2-year cap is reached.' # Cleft & Craniofacial Conditions Medicare Services ## Cleft and Craniofacial scheme Medicare-funded dental and surgical treatment for eligible patients with cleft and craniofacial conditions. ### WHO IS ELIGIBLE? * People with an eligible cleft lip and/or palate * People with eligible craniofacial conditions * Must be enrolled in Medicare * **No age limit (since Nov 2023)** Diagnosis must be made by an eligible health professional. ### WHAT SERVICES ARE COVERED? **DENTAL CARE** * Dental examinations * Preventive care * Fillings and restorations * Tooth extractions **SPECIALIST DENTAL CARE** * Orthodontic treatment * Paediatric dentistry * Prosthodontic treatment (including some prostheses) **SURGICAL CARE** * Oral and maxillofacial surgery * Surgical dental procedures * Simple and surgical tooth extractions ### WHO CAN PROVIDE TREATMENT? * Dentists * Paediatric Dentists * Orthodontists * Prosthodontists * Oral & Maxillofacial Surgeons Not all providers are registered or familiar with Category 7 claiming – ask before treatment begins. ### HOW DOES IT WORK? 1. **DIAGNOSIS** Eligible cleft or craniofacial condition identified by an eligible health professional. 2. **REFERRAL** Referral to an eligible dental specialist or provider (if required). 3. **TREATMENT** Care provided using Medicare Category 7 MBS item numbers. 4. **MEDICARE BENEFIT** Medicare contributes to the cost of eligible treatment. ### IMPORTANT THINGS TO KNOW * No age restriction for eligible patients. * Some services require a referral. * Patients may still have out-of-pocket costs if provider fees exceed the Medicare rebate. * Providers must use the relevant Category 7 MBS item numbers. * Not all services or items may be covered in every situation. Ask your provider for details. ### CONDITIONS COVERED In addition to cleft lip and palate, a range of eligible craniofacial anomalies and certain rare developmental conditions are included under Medicare Category 7. Ask your health professional for more information. ### WHY IT MATTERS * Improves access to specialised oral healthcare * Reduces financial barriers to treatment * Supports people with complex congenital conditions * Integrates dental and medical care across the lifespan --- **medicare** Australian Government Services Australia **No age restrictions** Since November 2023, eligible patients of any age can access treatment according to clinical need. --- Visit servicesaustralia.gov.au/ cleft-and-craniofacial-conditions or call Services Australia on 132 011 --- This information is of a general nature. It does not take into account your individual circumstances. Please visit the Services Australia website for more information. Current as at May 2024 Image source: https://www.servicesaustralia.gov.au/cleft-and-craniofacial-conditions                              Medicare-funded dental and surgical treatment for eligible patients with cleft and craniofacial conditions. #### Eligibility Criteria - People with an eligible cleft lip and/or palate - People with eligible craniofacial conditions - Must be enrolled in Medicare - No age limit (since November 2023, eligible patients of any age can access treatment according to clinical need) Diagnosis must be made by an eligible health professional. #### Covered Services ##### Dental Care - Dental examinations - Preventive care - Fillings and restorations - Tooth extractions ##### Specialist Dental Care - Orthodontic treatment - Paediatric dentistry - Prosthodontic treatment (including select prostheses) ##### Surgical Care - Oral and maxillofacial surgery - Surgical dental procedures - Simple and surgical tooth extractions #### Eligible Providers - Dentists - Paediatric Dentists - Orthodontists - Prosthodontists - Oral & Maxillofacial Surgeons *Note: Not all providers are registered or familiar with Category 7 claiming—inquire before treatment begins.* #### How It Works 1. **Diagnosis**: Eligible cleft or craniofacial condition is identified by an eligible health professional. 2. **Referral**: Referral to an eligible dental specialist or provider (if required). 3. **Treatment**: Care provided using Medicare Category 7 MBS item numbers. 4. **Medicare Benefit**: Medicare contributes to the cost of eligible treatment. #### Key Considerations - No age restrictions for eligible patients. - Some services require a referral. - Patients may still incur out-of-pocket costs if provider fees exceed the Medicare rebate. - Providers must use the relevant Category 7 MBS item numbers. - Not all services or items may be covered in every situation. #### Conditions Covered In addition to cleft lip and palate, a range of eligible craniofacial anomalies and certain rare developmental conditions are included under Medicare Category 7. #### Clinical and System Significance - Improves access to specialised oral healthcare - Reduces financial barriers to treatment - Supports individuals with complex congenital conditions - Integrates dental and medical care across the lifespan Visit servicesaustralia.gov.au/cleft-and-craniofacial-conditions or call Services Australia on 132 011. *Current as at May 2024. Source: https://www.servicesaustralia.gov.au/cleft-and-craniofacial-conditions* Pictogram icon of three stylized human figures (two adults flanking a smaller child) representing patients of all ages. A teal circular icon containing a white checkmark, serving as a visual bullet point for the 'DENTAL CARE' list. Graphic: A teal circular icon containing white silhouettes of a group of people with a checkmark badge in the bottom right corner. It acts as the visual header for the 'SPECIALIST DENTAL CARE' category, which covers orthodontic treatment, paediatric dentistry, and prosthodontic treatment. A teal circular icon containing a white checkmark. This visual form serves as a bullet point or indicator, marking the 'SURGICAL CARE' section in the list of covered services. A graphic icon consisting of a white checkmark centered inside a teal circle, used as a visual bullet point or marker for the text. A teal circular icon featuring a white silhouette of a molar tooth, a magnifying glass representing examination, and a calendar grid symbolizing scheduled care. This figure illustrates the 'DENTAL CARE' section of the slide, which covers services such as dental examinations, preventive care, fillings, restorations, and tooth extractions. Icon: A stylized graphic within a purple circle depicting three teeth connected by an orthodontic archwire and brackets. This is a stylized icon or logo featuring a white tooth silhouette positioned beneath a surgical operating light, all enclosed within a blue circle. The visual metaphor illustrates the concept of 'Surgical Care' mentioned in the slide text, specifically representing procedures like oral and maxillofacial surgery or surgical dental procedures. A stylized line-art icon depicting a molar tooth with curved arrows and sparkles, visually representing the concept of dental care or treatment improvement. This figure is a stylized icon showing a white silhouette of a molar tooth centered inside a teal circular background. It serves as a visual marker for the 'DIAGNOSIS' step in the treatment process outlined in the text. Labelled diagram: A stylized icon of a child's face (white) on a teal circular background. The figure is labelled 'REFERRAL' on the slide, corresponding to step 2 in the 'HOW DOES IT WORK?' process, which is defined as 'Referral to an eligible dental specialist or provider (if required)'. Icon: A teal circular graphic containing a white silhouette of a medical professional wearing a surgical cap, mask, and protective eyewear. This figure is a teal circular icon containing the white number '1', acting as a numbered step indicator. It corresponds to the first stage in the 'HOW DOES IT WORK?' section, where '1 = DIAGNOSIS' indicates that an eligible cleft or craniofacial condition is identified by an eligible health professional. Icon of a teal clipboard with a white tooth symbol in the center. This figure illustrates Step 2 ('REFERRAL') of the 'HOW DOES IT WORK?' process, representing the referral to an eligible dental specialist or provider. A purple circular icon containing the number '2', which corresponds to step 2 in the 'HOW DOES IT WORK?' section of the slide text, labelled as 'REFERRAL'. Iconographic illustration: A stylized purple graphic showing two abstract human figures, with a speech bubble containing horizontal lines emanating from the rightmost figure. This visual metaphor illustrates the 'MEDICARE BENEFIT' step in the process flow, representing the communication of financial contribution or information regarding eligible treatment costs. A blue circular icon containing the number '3', which serves as a step marker in the 'HOW DOES IT WORK?' section of the slide, corresponding to step 3: 'TREATMENT' (Care provided using Medicare Category 7 MBS item numbers). The figure is a stylized blue icon of a molar tooth, visually representing the dental care services covered under the scheme. This figure is a graphical label consisting of the number '4' inside a green circle. It corresponds to step 4 in the 'HOW DOES IT WORK?' section of the slide, representing the 'MEDICARE BENEFIT' stage where Medicare contributes to the cost of eligible treatment. Graphic logo of a green Medicare card, illustrating the requirement for patients to be enrolled in Medicare to access the Cleft and Craniofacial scheme. Labelled diagram: Two overlapping head silhouettes in profile, illustrating the range of eligible craniofacial anomalies and certain rare developmental conditions included under Medicare Category 7. Icon: A gold circular badge containing a white five-pointed star, serving as a visual bullet point for the 'WHY IT MATTERS' section. A yellow circular icon containing a white checkmark, serving as a graphical bullet point to highlight the key update regarding 'No age restrictions' for eligible patients. Icon: A purple circular graphic containing three stylized silhouettes of people. It visually represents the 'eligible patients' mentioned in the associated text 'No age restriction for eligible patients,' indicating the group of individuals covered by the scheme. A stylized icon of a clipboard with two checkmarks, illustrating the concept that some services require a referral or checklist step. Icon: A purple dollar sign ($) enclosed within a circle, illustrating the concept of financial costs. Icon: A standard information symbol consisting of a lowercase letter 'i' centered within a circle. A stylized icon depicting a white tooth silhouette centered within a solid purple circle, serving as a visual symbol for the dental services covered under the scheme. A teal icon of a laptop computer, symbolizing digital access to information. # Dental Workforce - Dentists Data as of 2023 - The number of full-time dentists in Australia was 61.1 per 100,000 population. - The number of full-time equivalent oral health therapists was 9 per 100,000 population. - 84% of dentists work in private sector and 4.6% public clinics. Victoria has the lowest dentists in public dental service while NT had the highest. - Five in 10 dentists work part-time (50%). - Largest group of specialists in Australia are Orthodontists (34%) of all dental specialists with nearly 68% of them were male. **Parliament of Australia**: [https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Dental_Services_in_Australia/DentalServices/Final_report/Chapter_5_-_Maldistribution_and_capacity_training_and_workforce_matters](https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Dental_Services_in_Australia/DentalServices/Final_report/Chapter_5_-_Maldistribution_and_capacity_training_and_workforce_matters) **AIHW (Australian Institute of Health and Welfare) (2025)** [Oral health and dental care in Australia](https://www.aihw.gov.au/reports/dental-oral-health/oral-health-and-dental-care-in-australia), AIHW, Australian Government, accessed 18 June 2026. Available from: [https://www.aihw.gov.au/reports/dental-oral-health/oral-health-and-dental-care-in-australia/contents/dental-workforce](https://www.aihw.gov.au/reports/dental-oral-health/oral-health-and-dental-care-in-australia/contents/dental-workforce). #### Dentists Data as of 2023 - The number of full-time dentists in Australia was 61.1 per 100,000 population. - The number of full-time equivalent oral health therapists was 9 per 100,000 population. - 84% of dentists work in the private sector and 4.6% in public clinics. Victoria has the lowest proportion of dentists in public dental services, while NT has the highest. - Five in 10 dentists work part-time (50%). - The largest group of specialists in Australia are Orthodontists (34% of all dental specialists), with nearly 68% of them being male. *Parliament of Australia. Chapter 5: Maldistribution and capacity training and workforce matters. Senate Committees, Dental Services in Australia. https://www.aph.gov.au/Parliamentary_Business/Committees/Senate/Dental_Services_in_Australia/DentalServices/Final_report/Chapter_5_-_Maldistribution_and_capacity_training_and_workforce_matters* *AIHW (Australian Institute of Health and Welfare) (2025). Oral health and dental care in Australia, AIHW, Australian Government, accessed 18 June 2026. https://www.aihw.gov.au/reports/dental-oral-health/oral-health-and-dental-care-in-australia/contents/dental-workforce* **Public dental services – source of funding – A summary** | Public dental service | Source of funding | | :--- | :--- | | Child Dental Benefit Scheme | Australian Government (Federal) | | School Dental Service | State Funded | | Cleft lip and cleft palate services | Australian Government (Federal) | | Oral and Maxillofacial Services | Australian Government (Federal) | | Private Health Insurance Incentive Scheme | Australian Government (Federal) | | Aboriginal Oral Health | Australian Government (Federal) $\rightarrow$ Community controlled Aboriginal primary dental care via National Aboriginal Community Controlled Health Organisations. State funded $\rightarrow$ Aboriginal Medical Services | | Refugee dental care | Australian Government (Federal) | | Prisoner dental care | State Funded | | Aged care dental services | State (very little) – Sadly very little funding | | Disability dental service | National Disability Insurance Scheme does not cover dental but does in exceptional circumstances. | | Dental Teaching Hospitals | Mix of State and Federal Funding | | Armed forces | Australian Government (Federal) via Royal Australian Army Dental Corps | | Public dental service | Source of funding | | :--- | :--- | | Child Dental Benefit Scheme | Australian Government (Federal) | | School Dental Service | State Funded | | Cleft lip and cleft palate services | Australian Government (Federal) | | Oral and Maxillofacial Services | Australian Government (Federal) | | Private Health Insurance Incentive Scheme | Australian Government (Federal) | | Aboriginal Oral Health | Australian Government (Federal) → Community controlled Aboriginal primary dental care via National Aboriginal Community Controlled Health Organisations. State funded → Aboriginal Medical Services | | Refugee dental care | Australian Government (Federal) | | Prisoner dental care | State Funded | | Aged care dental services | State (very little) – Sadly very little funding | | Disability dental service | National Disability Insurance Scheme does not cover dental but does in exceptional circumstances. | | Dental Teaching Hospitals | Mix of State and Federal Funding | | Armed forces | Australian Government (Federal) via Royal Australian Army Dental Corps | # BUDGET 2026–27 ## DENTAL CARE AT A GLANCE What it means for you and your family ### 1. CHILDREN **Child Dental Benefits Schedule (CDBS)** - $ Continues for eligible children aged 0–17 years - 📅 Up to **$1,158** available over 2 years (indexed from 2026) - 🦷 Covers check-ups, cleans, X-rays, fillings and extractions - ❌ Does not cover orthodontics or cosmetic dentistry ### 2. ADULTS **Public Dental Services – BIG UPDATE** - $ **$431 MILLION** federal investment - 👥 **PERMANENT** Commonwealth funding established - 🦷 Supports dental care for: - Concession card holders - Low-income adults - Eligible public dental patients - 🏥 Services are delivered through state and territory public dental systems ### 3. WHAT DID NOT CHANGE? - ❌ No universal dental care under Medicare - ❌ No major expansion of dental benefits for adults outside public dental schemes - 👵 No Senior Dental Benefits Schedule announced in the Budget ### SHARED RESPONSIBILITY **COMMONWEALTH GOVERNMENT** - ✔️ Funds the Child Dental Benefits Schedule (CDBS) - ✔️ Provides ongoing funding for adult public dental services **STATES & TERRITORIES** - ✔️ Operate public dental clinics - ✔️ Manage eligibility and waiting lists - ✔️ Deliver treatment services ### KEY MESSAGE Budget 2026–27 strengthens existing dental programs rather than introducing universal dental care. - ✔️ Ongoing support for children through CDBS - ✔️ Permanent funding certainty for public adult dental services - ✔️ States remain responsible for delivering most public dental care https://ada.org.au/cdbs-benefits-cap-to-increase-to-1-158-for-2026-2027 https://www.abc.net.au/news/2026-05-12/what-is-in-federal-budget-to-help-cost-of-living-explainer/106671806                         What it means for you and your family: #### 1. Children **Child Dental Benefits Schedule (CDBS)** - Continues for eligible children aged 0–17 years - Up to **$1,158** available over 2 years (indexed from 2026) - Covers check-ups, cleans, X-rays, fillings, and extractions - Does not cover orthodontics or cosmetic dentistry #### 2. Adults **Public Dental Services Update** - **$431 million** federal investment - **Permanent** Commonwealth funding established - Supports dental care for: - Concession card holders - Low-income adults - Eligible public dental patients - Services are delivered through state and territory public dental systems #### 3. What Did Not Change? - No universal dental care under Medicare - No major expansion of dental benefits for adults outside public dental schemes - No Senior Dental Benefits Schedule announced in the Budget #### Shared Responsibility - **Commonwealth Government** - Funds the Child Dental Benefits Schedule (CDBS) - Provides ongoing funding for adult public dental services - **States and Territories** - Operate public dental clinics - Manage eligibility and waiting lists - Deliver treatment services #### Key Message Budget 2026–27 strengthens existing dental programs rather than introducing universal dental care. - Ongoing support for children through CDBS - Permanent funding certainty for public adult dental services - States remain responsible for delivering most public dental care *https://ada.org.au/cdbs-benefits-cap-to-increase-to-1-158-for-2026-2027* *https://www.abc.net.au/news/2026-05-12/what-is-in-federal-budget-to-help-cost-of-living-explainer/106671806* Illustration of a girl and a boy holding dental hygiene tools, specifically toothbrushes and floss. This visual corresponds to the 'CHILDREN' section of the slide text (Section 1), representing the Child Dental Benefits Schedule (CDBS) for eligible children aged 0–17 years. Graphic icon: A green oval containing a white dollar sign symbol ($). This figure illustrates the concept of financial funding and monetary benefits, corresponding to the budget allocations mentioned in the slide text such as the '$1,158' Child Dental Benefits Schedule cap and the '$431 MILLION' federal investment for public dental services. Illustration: A stylized, smiling cartoon tooth with rosy cheeks and blue radiating lines indicating health or cleanliness. This figure serves as a decorative visual icon representing the general topic of dental care. Graphic icon: A white calendar symbol on a green oval background. This figure illustrates the '2 years' duration mentioned in section 1 regarding the Child Dental Benefits Schedule. A green oval icon containing a white 'X' symbol. This visual form acts as a negative indicator or bullet point within the slide's list structure, specifically illustrating items under section '3. WHAT DID NOT CHANGE?' to denote exclusions such as the absence of universal dental care or a Senior Dental Benefits Schedule. A simple graphic icon showing a white silhouette of a molar tooth centered within a green oval. This visual form serves as a thematic symbol for the dental care programs detailed in the surrounding text, such as the Child Dental Benefits Schedule and Public Dental Services. Icon of a white dollar sign ($) on a blue oval background. This visual form serves as a bullet point symbol in the slide text to denote financial information, specifically indicating the continuation of the Child Dental Benefits Schedule and the $431 million federal investment for public dental services. A blue oval icon containing three white stylized silhouettes of people, serving as a visual symbol for the 'ADULTS' section and the concept of 'PERMANENT Commonwealth funding established' for public dental patients. Graphic icon showing a white molar tooth silhouette inside a blue oval. It visually represents the subject of dental care central to the budget information presented on the slide. Graphic icon: A red oval containing a white 'X' mark. This visual form is used as a bullet point in the slide text to indicate exclusions or items that are not covered, such as orthodontics, cosmetic dentistry, universal dental care, or the Senior Dental Benefits Schedule. Icon of a hospital or clinic building inside a blue oval, illustrating the concept that state and territory governments operate public dental clinics. Graphic icon: A white silhouette of a molar tooth featuring a small cavity or filling on the upper left side, centered within a solid red oval. This visual symbol illustrates the general concept of dental care and treatment referenced in the slide's sections regarding children and adults. Icon: A generic red silhouette of a person's head and shoulders inside an oval, serving as a visual bullet point for the 'ADULTS' section to represent people or patients. Icon: A stylized white silhouette of a child's head and shoulders inside a red circle, serving as the visual header for section '1. CHILDREN' which details the Child Dental Benefits Schedule (CDBS). Illustration of the Australian Parliament House, symbolizing the Commonwealth Government's role in funding dental programs as detailed in the 'SHARED RESPONSIBILITY' section of the slide. Graphic icon: An orange circle containing a white checkmark symbol. This visual serves as a bullet point in the 'SHARED RESPONSIBILITY' section to list specific duties, such as funding the Child Dental Benefits Schedule (CDBS) and operating public dental clinics. Illustration of a handshake between two parties, symbolizing the 'Shared Responsibility' partnership described in the text where the Commonwealth Government funds dental programs and States & Territories deliver the services. Icon: A pixelated orange circle containing a white checkmark symbol. This graphic illustrates the concept of 'SHARED RESPONSIBILITY' and confirms items that are included or funded, such as the Child Dental Benefits Schedule and ongoing funding for adult public dental services. Graphic icon: A purple circle containing a white checkmark. This symbol serves as a bullet point in the 'Shared Responsibility' and 'Key Message' sections to indicate confirmed government actions and positive outcomes, such as ongoing support for children through the CDBS and permanent funding certainty for public adult dental services. Icon: A purple circular icon containing a white checkmark, which serves as a bullet point to list positive outcomes or confirmed features in the 'SHARED RESPONSIBILITY' and 'KEY MESSAGE' sections of the slide. Icon: A purple circular icon containing a white checkmark, visually representing confirmation or inclusion. It corresponds to the checkmarks used in the slide text to list items under "SHARED RESPONSIBILITY" (e.g., Commonwealth funds CDBS) and "KEY MESSAGE" (e.g., ongoing support for children). Illustration of a dental clinic building featuring a tooth logo and the text "DENTAL CLINIC" on the facade. This figure illustrates the concept of service delivery locations for public dental care, representing the state and territory clinics mentioned in the slide's "SHARED RESPONSIBILITY" section. Graphic icon: A white silhouette of a molar tooth centered within a blue oval, surrounded by radiating white dashes to suggest brightness or care. Graphic icon: A simple blue line drawing of a smiley face. In the context of this dental care budget slide, the symbol illustrates a healthy smile or patient satisfaction, serving as a visual metaphor for the positive outcomes of the described dental programs. # **Is the oral health system working??** > “When we were diagnosed with diabetes, we weren’t even told that our teeth were an issue by the doctor” > “Honestly it is too expensive. I have got three holes in my teeth, cavities, and I cannot afford to go to the dentist. Because my money is going on things that I think are more important like my house, power, everything else, food” > “If we look at access to health care – a lot of them won’t go to the doctor until something is seriously wrong. So, if they are not going to do that in general day to day health, you’ve got Buckley’s of getting anyone going to see the dentist. ‘Oh, I need to go and see a dentist for an appointment just for my regular check-up’ – it’s not going to happen” Durey, A., McAullay, D., Gibson, B. *et al.* Aboriginal Health Worker perceptions of oral health: a qualitative study in Perth, Western Australia. *Int J Equity Health* **15**, 4 (2016). https://doi.org/10.1186/s12939-016-0299-7 > “When we were diagnosed with diabetes, we weren’t even told that our teeth were an issue by the doctor” > “Honestly it is too expensive. I have got three holes in my teeth, cavities, and I cannot afford to go to the dentist. Because my money is going on things that I think are more important like my house, power, everything else, food” > “If we look at access to health care – a lot of them won’t go to the doctor until something is seriously wrong. So, if they are not going to do that in general day to day health, you’ve got Buckley’s of getting anyone going to see the dentist. ‘Oh, I need to go and see a dentist for an appointment just for my regular check-up’ – it’s not going to happen” *Durey, A., McAullay, D., Gibson, B. et al. Aboriginal Health Worker perceptions of oral health: a qualitative study in Perth, Western Australia. Int J Equity Health 15, 4 (2016). https://doi.org/10.1186/s12939-016-0299-7* # Now I am Confused....  Now I am Confused.... A line drawing illustration of a man with a confused expression, holding both hands to his head. This figure visually represents the slide's title concept, 'Now I am Confused....'. # OVERALL REVISION 1. Factors that influence development of health systems. 2. Components of a health care system. 3. Health care delivery models – global context. 4. Structure of Health System in Australia 5. Medicare and dental care. 6. Funding sources of public dental schemes   1. Factors that influence development of health systems. 2. Components of a health care system. 3. Health care delivery models – global context. 4. Structure of Health System in Australia 5. Medicare and dental care. 6. Funding sources of public dental schemes Clip art illustration of a yellow smiley face character wearing glasses and reading a brown book. Clip art illustration of a person lying on their stomach reading an open book with a pencil in their mouth, serving as a decorative image for the 'OVERALL REVISION' section. # Thank you!! Image source: [https://www.hcamag.com/au/specialisation/diversity-inclusion/how-to-get-cultural-diversity-right/162698](https://www.hcamag.com/au/specialisation/diversity-inclusion/how-to-get-cultural-diversity-right/162698)  *Image source: [https://www.hcamag.com/au/specialisation/diversity-inclusion/how-to-get-cultural-diversity-right/162698](https://www.hcamag.com/au/specialisation/diversity-inclusion/how-to-get-cultural-diversity-right/162698)* Photograph of a diverse group of seven people huddled together, looking down at the camera from a low angle. The image illustrates cultural diversity and inclusion, featuring individuals of various ages, genders, and ethnicities, including a woman wearing a hijab. 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