**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 Details - 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* > [!note] Lecturer — System Structure > Australia’s oral health system operates within a hybrid health system. > > - A public system > - A private system > - Public funding provided through different levels of government > - Private payments made directly by patients > - Private health insurance > > Although these components may appear to contribute equally in principle, dental funding is substantially weighted toward private payment. > [!note] Lecturer — Medicare Eligibility > Medicare provides access to healthcare for several groups beyond the cardholders shown. > > - Australian citizens > - Permanent residents > - Individuals applying for permanent residency > - Temporary residents covered by specific ministerial agreements > - Residents of countries with reciprocal healthcare agreements, including the United Kingdom and New Zealand > > Most temporary residents are outside Medicare coverage. > [!note] Lecturer — Private Payment > Approximately 81% of dental expenditure came directly or indirectly from individuals. The distribution demonstrates that dental care in Australia remains heavily dependent on private payment. # Who pays for dental services in Australia? Percentage share of dental spend 2022–23 Individuals 61% Health insurers 20% Commonwealth 11% States and Territories 8% 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. Source Parliament of Australia: https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/Research/Policy_Briefs/2025-26/Commonwealthfundingfordental?utm  #### Percentage Share of Dental Spend (2022–23) - Individuals: 61% - Health insurers: 20% - Commonwealth: 11% - States and Territories: 8% #### Total Expenditure Breakdown In 2022–23, $12.5 billion was spent on dental services in Australia: - Individuals spent more than $7.6 billion - Health insurers spent close to $2.5 billion - The Commonwealth spent nearly $1.4 billion - State and territory governments spent nearly $1 billion *Source: Parliament of Australia: https://www.aph.gov.au/About_Parliament/Parliamentary_departments/Parliamentary_Library/Research/Policy_Briefs/2025-26/Commonwealthfundingfordental?utm* > [!note] Lecturer — Public Funding > The public sector contributed approximately 19% of total dental spending. > > - Commonwealth Government: 11% > - State and territory governments: 8% > > The lecturer described the level of public funding as very low, despite the substantial total amount spent on dental services. Chart: A donut chart illustrating the percentage share of dental spend in Australia for 2022–23, divided into four segments representing different funding sources. ## **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** States establish public dental services, mainly focusing on school children and people in need. **1946** A constitutional change allows the Commonwealth to fund dental services, but states remain responsible for delivery. **1973–1981** Commonwealth funds a national scheme to improve children's oral health through school dental services. **1973 & 1981** Dental care is left out of Australia's universal health insurance and remains mostly a private expense. **1994–1996** First major program for adults. Aimed to reduce public dental waiting lists and improve access for those most in need. **2000s** - Veterans' Dental Program expands - Medicare Chronic Disease Dental Scheme (2007) provides Medicare-funded dental care for people with chronic conditions (ended in 2012). **2014–present** Medicare-funded scheme for eligible children (0–17 years) for basic and preventive dental care delivered by private dentists. **2014–present** Ongoing funding partnerships to support public dental services for adults, especially concession card holders, and reduce waiting lists. **2020s and beyond** 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. **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_                   #### Core Principles - **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:** States establish public dental services, mainly focusing on school children and people in need. - **1946:** A constitutional change allows the Commonwealth to fund dental services, but states remain responsible for delivery. - **1973–1981:** Commonwealth funds a national scheme to improve children's oral health through school dental services. - **1973 & 1981:** Dental care is left out of Australia's universal health insurance and remains mostly a private expense. - **1994–1996:** First major program for adults. Aimed to reduce public dental waiting lists and improve access for those most in need. - **2000s:** - Veterans' Dental Program expands. - Medicare Chronic Disease Dental Scheme (2007) provides Medicare-funded dental care for people with chronic conditions (ended in 2012). - **2014–present:** Medicare-funded scheme for eligible children (0–17 years) for basic and preventive dental care delivered by private dentists. - **2014–present:** Ongoing funding partnerships to support public dental services for adults, especially concession card holders, and reduce waiting lists. - **2020s and beyond:** 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. - **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_* - ==Oral health has not generally been treated by policymakers as integral to general health.== - ==The current system is a hybrid model shaped by historical policy decisions and funding arrangements.== > [!note] Lecturer — School Dental Services > School dental services became especially important in the early twentieth century. > > - Queensland developed large-scale school dental programs as early as 1911, and South Australia established a program around 1923. > - Australia was influenced by the New Zealand school dental nurse model, with specially trained dental nurses providing preventive and basic restorative care in schools. > - These services responded to high levels of untreated childhood caries, a shortage of dentists, rural and remote access difficulties, and the need for a cost-effective population-based preventive strategy. > [!note] Lecturer — Commonwealth Responsibility > From 1946, the Commonwealth began taking greater responsibility for supporting state health services while maintaining Australia’s federal structure. > > - Negotiated funding agreements with states and territories developed as part of this shared-responsibility model. > - These agreements continue to support the delivery of health services, including dental services. > [!note] Lecturer — Excluding Dentistry > Medibank was introduced before Medicare, which was introduced in 1984, but dentistry was excluded from both universal health insurance arrangements. > > - Reasons discussed included concerns about uncontrolled demand, the high level of dental need, the potentially very high cost to the Commonwealth, and opposition from professional organizations. > [!note] Lecturer — Commonwealth Dental Program > The Commonwealth Dental Health Program provided approximately $300 million in federal funding to reduce public dental waiting lists, support disadvantaged adults, and strengthen state public dental systems. It was a time-limited injection of funding rather than a structural reform and was discontinued in 1996 following a change in government. > [!note] Lecturer — Chronic Disease Scheme > The Chronic Disease Dental Scheme integrated dental care with chronic disease management, including diabetes and cardiovascular disease. > > - Patients were referred by a general practitioner and received Medicare rebates, with the government paying up to approximately $4,000 over two calendar years. > - The scheme was used extensively, and government costs increased to almost $2 billion before it was discontinued in 2012. Icon of a classical building with a triangular pediment and four columns, symbolizing government institutions or public administration. A solid teal silhouette map of the Australian continent. A purple pictogram showing three stylized human figures of varying heights standing side-by-side, representing a family unit or group. This visual illustrates the concept that dental programs have mainly targeted children and vulnerable people. Stylized graphic icon: A white silhouette of a molar tooth centered inside a thick, rounded orange rectangular border. Illustration: A stylized graphic featuring a smiling family (father, mother, and child) alongside a large, anthropomorphic tooth character with a smiley face. A stylized icon of a building featuring a medical cross symbol on its facade and a tree to the side, representing an institutional facility. This figure illustrates the 'Early public dental services' milestone from the 1900s–1970s, where states established public dental services focusing on school children and people in need. This figure shows the Coat of Arms of Australia, featuring a kangaroo and an emu flanking a shield with state badges, surmounted by a seven-pointed star (the Commonwealth Star) and resting on a wreath of golden wattle. It illustrates the concept of 'Commonwealth gains power to fund dental services' as indicated by the slide text associated with this position. This icon illustrates the 'National School Dental Scheme' (1973–1981), a Commonwealth-funded initiative to improve children's oral health through school dental services. The visual form is a stylized graphic of two smiling children, representing the scheme's focus on school-aged beneficiaries. Graphic illustration of a green Medicare card overlaid with a large red 'X' symbol. This visual metaphor illustrates the concept that dental care is excluded from Australia's universal health insurance scheme, Medicare. This figure is a purple icon or silhouette of a dental chair, illustrating the equipment used in dental care services. Pictogram illustration showing three orange silhouette icons representing different demographic groups: a generic male figure, a female figure, and a male figure wearing a hat (likely representing a veteran or worker). This visual concept illustrates the 'Targeted programs for specific groups' mentioned in the slide text, specifically referencing initiatives like the Veterans' Dental Program and the Medicare Chronic Disease Dental Scheme. Illustration of a smiling child's face, representing the target demographic for the Child Dental Benefits Schedule (CDBS). A green pictogram icon depicting a family unit consisting of an adult female, an adult male, and a child. This figure illustrates the concept of 'all Australians' mentioned in the text regarding calls for universal dental care to achieve better oral health. Icon of a handshake, symbolizing the partnership and funding agreements between the Commonwealth and State governments for adult public dental services. Icon: A stylized blue tooth silhouette inside a light blue oval. This graphic serves as a visual symbol for the topic of dental care and funding discussed in the slide's text. This graphic is a stylized icon featuring a dark blue silhouette of the map of Australia with a white tooth shape cut out from the center, symbolizing the national focus on dental care. Graphic icon of a white building with columns and a cross-topped spire set against a green circular background, serving as the visual marker for 'The Big Picture' section. Icon: A stylized white outline of a tooth held by two hands set against a solid purple oval background. This graphic illustrates the concept of 'The Goal' described in the slide text: a fair and accessible dental system where every Australian can get the care they need to keep their mouth healthy and their body healthy. **Funding of health care in Australia – a shared responsibility** | **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%20%20population%20%20health%20%20goals_0.pdf #### 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%20%20population%20%20health%20%20goals_0.pdf* - ==The Commonwealth also supports dental care through the Royal Flying Doctor Service, dental research funding, the Northern Territory Remote Aboriginal Investment Oral Health Program for people under 16, and funding for Aboriginal Community Controlled Health Services.== > [!note] Lecturer — Dental Funding Sources > Private health insurers contribute approximately 20% of total dental expenditure and may provide dental cover through extras policies. > > - Patients are the largest source of dental funding: direct out-of-pocket payments account for approximately 61% of total dental expenditure. > - When private insurance contributions are included, approximately 81% of total dental spending comes directly or indirectly from individuals. # Commonwealth (federal) government based dental services ## Table | 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 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* - ==Hospital dentistry funded through the National Health Reform Agreement, the Northern Territory Remote Aboriginal Investment Oral Health Program for people under 16, and Commonwealth support for state and territory public dental services through funding agreements== > [!note] Lecturer — Service Delivery Details > The lecturer noted additional details about how these services are organised and delivered. > > - Public dental services in Western Australia are primarily provided through Dental Health Services, including services provided through the Oral Health Centre of Western Australia. > - The school dental service is led in part by dental therapists, who report to an area dental officer. > - There are approximately three general dental services in the Perth metropolitan area, with Salter Point identified as the most important. > - The new special needs clinic is located at Salter Point. > [!note] Lecturer — CDBS Access Barriers > The CDBS is considered underutilized despite the number of people who may be eligible. The remuneration available through the scheme may be considerably lower than usual fees, which may discourage clinicians from using it. This figure is a diagram composed of colored rectangular text boxes that visually represent the various components of Commonwealth (federal) government-based dental services in Australia. The specific categories illustrated include 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_E/Dental-Health-Services](https://www.health.wa.gov.au/en/Articles/A_E/Dental-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_E/Dental-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 *Source: https://www.healthdirect.gov.au/partners/medicare* The figure displays the Coat of Arms of Australia, featuring a kangaroo and an emu supporting a central shield topped by the Commonwealth Star, with the word 'AUSTRALIA' inscribed on a scroll at the base. # 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 Pharmaceutical Benefits Scheme, 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, applicants for permanent residency, temporary residents covered by a Ministerial order, permanent residents of Australian overseas territories, and citizens of countries with reciprocal healthcare agreements. 3. Concurrently, costs for most medicines under the Pharmaceutical Benefits Schedule (PBS) are covered, and many prescribed medicines are subsidised by the government. #### Payment Coverage - **General Practitioners:** Full schedule fee - **Specialists:** 85% of schedule fee - **In-hospital Services:** 75% of schedule fee 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 > [!note] Lecturer — Medicare Funding > Medicare is funded through both the Medicare levy and general taxation revenue. It is a publicly funded universal insurance scheme rather than a contributory insurance model. > [!note] Lecturer — Schedule Fees > The Medicare Benefits Schedule specifies schedule fees, which represent an average fee recorded across practitioners. > > - Doctors who claim the full schedule fee from the government are described as bulk-billing doctors. > - Treatment in public hospitals is free. > - Patients may receive full coverage or partial reimbursement depending on where and how care is delivered. > - When out-of-pocket expenditure exceeds an annual threshold, higher rebate rates may apply through the Medicare Safety Net. Graphic banner displaying the Australian Government Department of Health coat of arms alongside the text 'MBS Online Medicare Benefits Schedule', illustrating the official digital platform for the Medicare Benefits Schedule mentioned in the slide context. # Medicare Benefit Schedule and Dental Care Does Medicare cover costs of general dental care? **Mostly, NO!!** But some dental/maxillofacial services are provided by: 1. **Child Dental Benefit Schedule** for *eligible children* (up to AU$ 1,158) over a relevant two calendar year period for basic dental services. Eligible children (0-17 years old), eligible for Medicare and receive a relevant Australian Government payment. 2. **Oral and Maxillofacial services**: relevant benefit and extended Medicare safety net for each applicable scheduled service. 3. **Cleft Lip and Cleft Palate Services**: to those under 28 years, enrolled in Medicare, diagnosed with an eligible cleft and craniofacial condition to cover general dental, paediatric, orthodontic, prosthodontic and oral surgical work. Child Dental Benefits Schedule: https://www.health.gov.au/sites/default/files/2024-01/cdbs-guide-to-the-child-dental-benefits-schedule.pdf  Does Medicare cover costs of general dental care? **Mostly, NO!!** However, some dental and maxillofacial services are provided under specific schemes: 1. **Child Dental Benefits Schedule (CDBS)** - Covers basic dental services for eligible children aged 0–17 years. - Benefit cap of up to AU$1,158 over a two-calendar-year period. - Eligibility requires being eligible for Medicare and receiving a relevant Australian Government payment. 2. **Oral and Maxillofacial Services** - Relevant benefit and extended Medicare safety net apply for each scheduled service. 3. **Cleft Lip and Cleft Palate Services** - Available to individuals under 28 years enrolled in Medicare and diagnosed with an eligible cleft or craniofacial condition. - Covers general dental, paediatric, orthodontic, prosthodontic, and oral surgical treatment. Child Dental Benefits Schedule: https://www.health.gov.au/sites/default/files/2024-01/cdbs-guide-to-the-child-dental-benefits-schedule.pdf > [!note] Lecturer — CDBS Benefit Amount > The lecturer referred to the CDBS benefit as approximately $1,058 over two calendar years and later as approximately $1,158. The amount changes over time in line with inflation and the Consumer Price Index. This figure displays the official logo and text identifier for the Australian Government Department of Health and Aged Care, featuring the Commonwealth Coat of Arms alongside the department's name. It serves as a visual indicator that the associated Child Dental Benefits Schedule (CDBS) is an initiative administered by this specific government body. # Child Dental Benefit Schedule **Child Dental Dental Benefit Schedule** **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                               The Child Dental Benefits Schedule (CDBS) helps 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 *Services Australia assesses eligibility 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 #### How It Works 1. Services Australia checks eligibility annually. 2. Confirm eligibility through Medicare via myGov or consult your dental clinic. 3. Book an appointment with a participating dentist. 4. Receive eligible dental care. 5. The dentist claims directly through Medicare (many clinics bulk bill eligible services). 6. The available balance decreases as services are claimed until the 2-year cap is reached. Source: https://www.servicesaustralia.gov.au/whats-covered-child-dental-benefits-schedule?context=22426 > [!note] Lecturer — Hospital-Based CDBS Care > Hospital-based care is generally not covered under the CDBS. This is significant because children with the greatest dental needs may require treatment under general anesthesia, and the CDBS may not be usable for all aspects of that care. Illustration: A cartoon graphic of a smiling white tooth with rosy cheeks, surrounded by blue sparkles. Illustration of a smiling boy and girl, each holding a blue toothbrush, representing the children who are eligible for the Child Dental Benefits Schedule. A green oval icon containing a white checkmark symbol, representing a positive confirmation or 'yes' status, likely used here to indicate eligibility or covered services within the Child Dental Benefit Schedule. The figure is a stylized icon of a wall calendar with a green header and a grid of days. It illustrates the concept of the 'calendar year' mentioned in the text regarding eligibility checks ('Services Australia checks eligibility each year') and the benefit period ('over two consecutive calendar years'). A green circular icon containing a white checkmark symbol. Photograph of an Australian Medicare card, which illustrates the requirement listed in section 1 ('WHO CAN GET IT?') that a child must have a Medicare card to be eligible for the Child Dental Benefits Schedule. Illustration: A cartoon graphic depicting a family unit consisting of a mother and two sons, accompanied by a green checkmark icon to symbolize eligibility or approval under the Child Dental Benefits Schedule. Graphic icon of a green oval containing a white checkmark, visually representing confirmation or eligibility status. Pictogram: A white silhouette of a molar tooth centered within a blue oval background. This graphic acts as a visual symbol for dentistry, thematically supporting the slide's content about the Child Dental Benefits Schedule. A graphic icon depicting a stylized tooth inside a rectangular frame resembling a dental X-ray, set against a blue oval background. This visual symbol represents the dental care services covered under the Child Dental Benefits Schedule (CDBS) mentioned in the text. Icon: A white toothbrush depicted on a blue oval background, illustrating the concept of basic dental care and hygiene mentioned in the Child Dental Benefits Schedule. Icon: A stylized white silhouette of a molar tooth set against a blue oval background. Icon: A stylized graphic of a white molar tooth set against a blue oval background, featuring a grey shape on the crown representing a dental filling or restoration. Graphic icon: A stylized white molar tooth featuring a grey area on the top surface, set against a solid blue oval background. This image serves as a visual symbol for the dental care services, such as fillings or check-ups, outlined in the Child Dental Benefits Schedule. Icon: A blue money bag with a white dollar sign, illustrating the financial benefit or monetary cap ($1,158) provided by the Child Dental Benefits Schedule. Graphic icon: A stylized illustration of a full set of upper and lower teeth within a blue oval background. A red oval icon containing a white 'X' symbol. This figure visually illustrates the concept of items that are NOT covered under the Child Dental Benefits Schedule, such as braces or cosmetic treatments. Illustration of a tooth with an orthodontic bracket and archwire attached to the crown. This visual represents 'Braces and orthodontics,' which is explicitly listed in section 3 ('WHAT IS NOT COVERED?') as a service excluded from the Child Dental Benefits Schedule. Icon: A red circle containing a white 'X' is placed next to an illustration of a tooth being examined with a dental mirror, visually representing the section of the slide titled '3. WHAT IS NOT COVERED?' which lists excluded treatments like braces and cosmetic work. Illustration: A hospital building icon accompanied by a large red 'X' symbol. This visual represents the exclusion of dental treatment provided in hospital operating theatres from the Child Dental Benefits Schedule. A cartoon illustration of a white molar tooth positioned behind a dental mouth mirror, representing the concept of dental check-ups and basic care covered by the Child Dental Benefits Schedule. Clipart icon of a clipboard with a document containing horizontal lines, illustrating the concept of checking eligibility or reviewing the schedule of covered services. A red oval icon containing a white 'X' symbol. This visual marker illustrates the concept of section 3, "WHAT IS NOT COVERED?", representing excluded services such as braces, orthodontics, and cosmetic dental treatment. A red oval icon containing a white lowercase 'i', serving as an information symbol to highlight the Child Dental Benefits Schedule (CDBS) details. Illustration of a laptop computer displaying the green 'myGov' logo on its screen, with a purple circle containing the number '1' floating above it. This figure corresponds to step 2 in section '4. HOW DOES IT WORK?', illustrating the action to 'Check eligibility through Medicare on myGov'. This figure is a stylized icon illustrating step 2 of the 'HOW DOES IT WORK?' process, showing a tablet device displaying a green checkmark to represent checking eligibility. A stylized icon of a calendar with a green checkmark overlay, accompanied by the number '3' in a purple circle above it. This visual corresponds to step 3 in the 'HOW DOES IT WORK?' section of the slide text: 'Book an appointment with a participating dentist.' Illustration of a dentist examining a child's teeth, labelled with the number '4'. According to section 4 ('HOW DOES IT WORK?') in the slide text, this figure represents step 4: 'Receive eligible dental treatment'. This figure is a cartoon illustration of a smiling tooth with a purple oval containing the number "6" positioned above it. According to the section "4. HOW DOES IT WORK?" in the slide text, the label "6" corresponds to the step: "Your available balance reduces as services are used until the 2-year cap is reached." Illustration of a clipboard featuring the Medicare logo, surmounted by a purple oval containing the number 5. This label corresponds to step 5 in the 'HOW DOES IT WORK?' section: '5 = The dentist claims directly through Medicare (many clinics bulk bill eligible services).' # Cleft and Craniofacial scheme ## Cleft & Craniofacial Conditions Medicare Services Medicare-funded dental and surgical treatment for eligible patients with cleft and craniofacial conditions. ### R بمcoup **No age restrictions** Since November 2023, eligible patients of any age can access treatment according to clinical need. ### 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** | **SPECIALIST DENTAL CARE** | | * Dental examinations | * Orthodontic treatment | | * Preventive care | * Paediatric dentistry | | * Fillings and restorations | * Prosthodontic treatment (including some prostheses) | | * Tooth extractions | | | **SURGICAL CARE** | **Treatment is tailored** | | * Oral and maxillofacial surgery | * to individual needs and may involve a team of dental and medical specialists. | | * 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 For more information 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. <!-- N/NNCC 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 provides funded dental and surgical treatment for eligible patients with cleft and craniofacial conditions. #### Eligibility - Patients diagnosed with an eligible cleft lip, cleft palate, or eligible craniofacial condition by an approved healthcare professional. - Must be enrolled in Medicare. - **No age limit:** Since November 2023, eligible patients of any age can access treatment based on clinical need. #### Covered Services | General Dental Care | Specialist Dental Care | | :--- | :--- | | - Dental examinations<br>- Preventive care<br>- Fillings and restorations<br>- Tooth extractions | - Orthodontic treatment<br>- Paediatric dentistry<br>- Prosthodontic treatment (including select prostheses) | | Surgical Care | Care Delivery Model | | :--- | :--- | | - Oral and maxillofacial surgery<br>- Surgical dental procedures<br>- Simple and surgical tooth extractions | Treatment is tailored to individual needs and may involve a coordinated team of dental and medical specialists. | #### Eligible Providers - Dentists - Paediatric Dentists - Orthodontists - Prosthodontists - Oral & Maxillofacial Surgeons *Note: Not all providers are registered or familiar with Category 7 claiming; verify before treatment begins.* #### Pathway to Care 1. **Diagnosis:** Eligible cleft or craniofacial condition identified by an accredited health professional. 2. **Referral:** Referral made to an eligible dental specialist or provider (if required). 3. **Treatment:** Treatment provided using Medicare Category 7 MBS item numbers. 4. **Medicare Benefit:** Medicare contributes toward the cost of eligible treatment. #### Important Considerations - Some services require a specialist referral. - Patients may incur out-of-pocket costs if provider fees exceed the Medicare rebate. - Providers must bill under relevant Category 7 MBS item numbers. - Not all services or items are covered across every clinical circumstance. #### Conditions Covered In addition to cleft lip and palate, an array of eligible craniofacial anomalies and specific rare developmental conditions are covered under Medicare Category 7. #### Key Benefits - 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 For more information, visit `servicesaustralia.gov.au/cleft-and-craniofacial-conditions` or call Services Australia on 132 011. *Current as of May 2024.* > [!note] Lecturer — Provider Remuneration > The amount returned to providers under the cleft and craniofacial arrangements may be lower than their usual remuneration. This may discourage clinicians from using the scheme. A stylized icon showing three purple figures of varying heights, representing a group of people or a family unit. This visual illustrates the concept that the scheme covers eligible patients of 'any age', as indicated by the section header 'No age restrictions' and the text stating there is 'No age limit (since Nov 2023)'. A teal circular icon containing a white checkmark, functioning as a visual bullet point or status indicator. This figure illustrates the inclusion of specific items (such as 'Dental examinations' and 'Preventive care') within the 'DENTAL CARE' category listed in the adjacent table. A teal circular icon featuring a white silhouette of three people (representing a group or team) with a smaller circle containing a checkmark in the bottom right corner. This graphic illustrates the concept of 'Specialist Dental Care' mentioned in the slide text, which notes that treatment may involve a team of dental and medical specialists. Icon: A teal circle containing a white checkmark, serving as a visual indicator for the 'No age restrictions' policy update mentioned in the slide text. Icon: A teal circular button containing a white checkmark. This visual symbol represents the inclusion or coverage of 'SURGICAL CARE' services, which the slide text specifies include oral and maxillofacial surgery, surgical dental procedures, and simple and surgical tooth extractions. A teal circular icon containing a white silhouette of a molar tooth, a magnifying glass, and a grid-like square representing a calendar or schedule. Icon: A purple circular graphic containing a white abstract symbol composed of three block-like shapes connected by a horizontal line. This image serves as the logo or visual identifier for the Cleft and Craniofacial scheme detailed in the slide text. Icon: A stylized white graphic on a blue circular background depicting a dental light positioned above a tooth. This figure is a stylized line drawing icon of a molar tooth, depicted with sparkle symbols to represent cleanliness or care. It serves as a visual header for the 'DENTAL CARE' section of the table, which lists services such as dental examinations, preventive care, fillings, and extractions. Labelled diagram: A stylized white icon of a molar tooth centered within a teal circle. This figure serves as the visual marker for step 1 in the process, which the text identifies as 'DIAGNOSIS', where an eligible cleft or craniofacial condition is identified by an eligible health professional. Iconographic illustration of a stylized human face (likely representing a child or patient) centered within a teal circle. This figure serves as the visual marker for step 2, 'REFERRAL', in the 'HOW DOES IT WORK?' process described in the slide text. Icon: A teal circular graphic containing a white silhouette of a medical professional wearing a surgical cap and mask. This figure serves as the visual marker for step 3, 'TREATMENT', in the 'HOW DOES IT WORK?' process described on the slide. Labelled diagram: A teal circle containing the number '1', which corresponds to the first step in the 'HOW DOES IT WORK?' section, labelled 'DIAGNOSIS' (Eligible cleft or craniofacial condition identified by an eligible health professional). A teal icon depicting a clipboard with a white silhouette of a molar tooth, serving as a visual symbol for the dental services and clinical records discussed in the slide. This figure is a purple circular icon containing the number '2'. It serves as a step indicator for the second stage of the process outlined in the 'HOW DOES IT WORK?' section, which corresponds to 'REFERRAL' (Referral to an eligible dental specialist or provider). Icon: A stylized purple graphic of two people with a speech bubble, illustrating the concept of consultation or communication between a patient and a health professional (e.g., for diagnosis or asking questions). This figure is a blue circular icon containing the white number '3', which corresponds to the third step in the 'HOW DOES IT WORK?' section of the slide: 'TREATMENT' (Care provided using Medicare Category 7 MBS item numbers). A blue, right-pointing arrow icon. It serves as a visual indicator for the 'HOW DOES IT WORK' section of the slide, illustrating the sequential flow from step 1 (Diagnosis) to step 4 (Medicare Benefit). Stylized icon of a molar tooth with roots, used as a visual symbol for the "DENTAL CARE" and "SPECIALIST DENTAL CARE" sections listed in the table above. This figure is a numbered label icon, specifically a green circle containing the white number '4'. It corresponds to step 4 in the 'HOW DOES IT WORK?' section of the slide text, which represents the 'MEDICARE BENEFIT' stage where Medicare contributes to the cost of eligible treatment. Logo of Medicare Australia: a green card-shaped icon with the word 'medicare' in lowercase on a white background. A simple line drawing illustrating the concept of craniofacial conditions by showing two overlapping head profiles. A graphic icon consisting of a white five-pointed star centered within a solid yellow-gold circle. This visual serves as a bullet point or decorative marker for the 'WHY IT MATTERS' section, which lists benefits such as improving access to specialized oral healthcare and reducing financial barriers. Icon: A yellow circular badge containing a white checkmark symbol, typically used to indicate eligibility or confirmation. A purple icon depicting three stylized human figures inside a circle, symbolizing the group of eligible health professionals or patients discussed in the slide text. This figure is a purple icon depicting a clipboard with a checkmark on it. Positioned in the right-hand column of the 'WHAT SERVICES ARE COVERED?' table, it visually corresponds to the 'Treatment is tailored' category, symbolizing a personalized treatment plan or clinical checklist. Icon: A purple dollar sign ($) enclosed in a circle, illustrating the concept of Medicare benefits and financial contributions towards treatment costs mentioned in the slide text. A small, circular icon containing a lowercase letter 'i', which is a standard symbol for information. Icon: A white stylized tooth symbol centered within a solid purple circle. Icon: A teal graphic of a laptop computer. This figure illustrates the concept of accessing information online, corresponding to the website link 'servicesaustralia.gov.au' found in the 'For more information' section at the bottom of the slide. **Dental Workforce - Dentists** - 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. Data as of 2023 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 AIHW (Australian Institute of Health and Welfare) (2025) *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 #### Dentists and Dental Specialists - 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 service, while NT had 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. *Data as of 2023.* *Parliament of Australia. 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* *AIHW (Australian Institute of Health and Welfare) (2025). 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* > [!note] Lecturer — Workforce Distribution > The central workforce issue is not simply the number of dentists but their distribution. > > - Most dentists work in metropolitan areas. > - Far fewer dentists work in rural and remote areas, creating a distribution problem that affects access to care. | 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.<br>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.<br>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 | > [!note] Lecturer — Public Dental Funding > Public dental services are funded through multiple sources, including state and territory governments, Commonwealth funding agreements, targeted Commonwealth schemes, hospital funding arrangements, and means-tested public dental systems. Specific programs also support children, veterans, Aboriginal communities, and other eligible groups. Public dental services commonly use means testing to determine eligibility. # 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 * X Does not cover orthodontics or cosmetic dentistry Budget 2026–27 strengthens existing dental programs rather than introducing universal dental care. * $ 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** * 7 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. Public Dental Funding Investment > Budget 2026–27 strengthens existing dental programs rather than introducing universal dental care. - $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 Takeaways - Ongoing support for children through CDBS - Permanent funding certainty for public adult dental services - States remain responsible for delivering most public dental care *Australian Dental Association. CDBS benefits cap to increase to $1,158 for 2026–2027. https://ada.org.au/cdbs-benefits-cap-to-increase-to-1-158-for-2026-2027* *ABC News (2026). What is in federal budget to help cost of living explainer. https://www.abc.net.au/news/2026-05-12/what-is-in-federal-budget-to-help-cost-of-living-explainer/106671806* - ==Eligibility is connected to age and Family Tax Benefit Part A== > [!note] Lecturer — Funding Certainty > The Federal Funding Agreement has become more permanent. Previously, funding was time-limited, for example for two or three years; under the newer arrangement, annual funding is intended to continue and provides greater certainty, but the amount remains insufficient for population size and growth and does not adequately match demand for public dental services. > [!note] Lecturer — Dental Funding Model > Australia spent approximately $12.5 billion on dental services in 2022–23. > > - Individuals paid 61% directly out of pocket. > - Private health insurers contributed approximately 20%. > - The Commonwealth contributed approximately 11%. > - States and territories contributed approximately 8%. > - Dental care has never been included comprehensively in Medicare. > - Public dental funding developed through state-led programs, targeted Commonwealth schemes, and negotiated funding agreements. > - School dental services have played an important historical role. > - Cleft and craniofacial dental services receive specific Medicare support. Illustration of a girl and a boy holding toothbrushes and dental floss, visually representing the "CHILDREN" section (Section 1) regarding the Child Dental Benefits Schedule. Icon: A green oval containing a white dollar sign symbol. This visual element illustrates the concept of financial investment or funding, corresponding to the slide text '$ 431 MILLION federal investment'. A cartoon illustration of a smiling tooth with rosy cheeks and blue radiating lines, representing the concept of healthy teeth and positive dental care. A green circular icon containing a white stylized calendar symbol. The graphic illustrates the concept of timeframes or scheduling, corresponding to the text mentioning that dental benefits are 'available over 2 years' and indexed from '2026'. A green circular icon containing a white 'X' symbol, which serves as a visual indicator for exclusions or items not covered. Icon: A white silhouette of a molar tooth set against a green oval background, serving as a visual symbol for the dental care theme of the slide. Icon: A white dollar sign ($) centered inside a blue oval, used as a bullet point in the slide text to highlight the $431 million federal investment. A blue circular icon containing a stylized white graphic of three human figures, representing a group or community. The icon illustrates the concept of 'Permanent Commonwealth funding established' for public dental services supporting concession card holders and low-income adults. This figure is a graphic icon consisting of a white silhouette of a molar tooth centered within a solid blue oval. A graphic icon consisting of a white 'X' symbol centered inside a solid red oval. This visual form illustrates the concept of exclusion or negation for the section titled '3. WHAT DID NOT CHANGE?', indicating items such as universal dental care and major benefit expansions that are not included in the budget. Icon: A stylized graphic of a hospital or institutional building with a central medical cross symbol, set against a blue oval background. Graphic icon featuring a white silhouette of a molar tooth centered inside a red oval shape. This visual serves as a symbolic bullet point for the 'CHILDREN' section, representing the Child Dental Benefits Schedule (CDBS) mentioned in the slide text. Icon: A red oval containing a white silhouette of a person's head and shoulders, serving as a visual bullet point for the list item 'No major expansion of dental benefits for adults outside public dental schemes'. Icon: A stylized white graphic of a child's head and shoulders set against a solid red oval background. A flat, stylized illustration of Parliament House in Canberra, featuring its distinctive flag mast and architectural columns. This figure visually represents the 'COMMONWEALTH GOVERNMENT' entity listed in the 'SHARED RESPONSIBILITY' section of the slide. A graphic icon of a white checkmark inside an orange circle. This visual form corresponds to the '✓' bullet points in the 'KEY MESSAGE' section of the slide text, illustrating positive outcomes such as ongoing support for children through CDBS and permanent funding certainty. A labelled diagram of a handshake between two hands with different colored sleeves, illustrating the concept of 'Shared Responsibility' between the Commonwealth Government and States & Territories. Icon: A stylized orange circle containing a white checkmark symbol. This visual element illustrates the 'KEY MESSAGE' section of the slide, specifically representing confirmed ongoing support for children through the Child Dental Benefits Schedule (CDBS) and permanent funding certainty for public adult dental services. A purple circular icon containing a white checkmark symbol. This visual form serves as a bullet point or indicator for the 'KEY MESSAGE' section of the slide, specifically illustrating the concept of confirmed positive outcomes such as 'Ongoing support for children through CDBS' and 'Permanent funding certainty for public adult dental services'. Icon: A purple circle containing a white checkmark, visually representing confirmation or positive status. Icon: A purple oval containing a white checkmark symbol. This figure illustrates the 'KEY MESSAGE' section of the slide, specifically marking confirmed points such as ongoing support for children through CDBS and permanent funding certainty for public adult dental services. Illustration of a dental clinic building, visually representing the 'STATES & TERRITORIES' role in operating public dental clinics and delivering treatment services. A graphic icon featuring a white silhouette of a molar tooth centered within a blue oval, surrounded by radiating lines to suggest health or vitality. A simple blue icon of a smiling face (a smiley) used as a visual bullet point to illustrate the concept of 'Ongoing support for children through CDBS' listed in the Key Message section. # 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 ### Community Perspectives > "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* > [!note] Lecturer — System Delivery > The lecture questioned whether the Australian oral health system is adequately delivering services. > > - Despite structured governance, public and private services, multiple funding mechanisms, shared Commonwealth and state responsibilities, and targeted dental programs, service delivery continues to fall short. > - Challenges include low public funding, high reliance on private payment, long public dental waiting lists, unequal dentist distribution, and limited rural and remote access. > - Routine dental care has limited Medicare coverage, available schemes such as the CDBS are underused, and funding does not match population growth or dental need.  Line drawing illustration: A black-and-white sketch of a man holding his head with both hands, displaying a facial expression of confusion, frustration, or distress. # 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 - ==The Australian dental system is primarily a shared responsibility between the states, which deliver much of the public dental care, and the Commonwealth, which provides funding through Federal Funding Agreements and targeted programs.== - ==Public dental services generally use means-tested eligibility, while most dental costs are paid directly or indirectly by individuals.== - ==The lecture also introduced the burden of oral disease, oral healthcare system challenges, and oral health inequities as subsequent topics.== Clip art illustration of a yellow emoji character wearing black-rimmed glasses and holding an open brown book, serving as a decorative icon for the 'Overall Revision' slide. Cartoon clip art of a girl lying on her stomach reading an open book, with a pencil in her mouth. The image is decorative and does not illustrate any specific concept from the slide text. Thank you!! Image source: **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* Photograph of a diverse group of seven people of varying ages, genders, and ethnicities huddled together in a circle, looking down at the camera with smiles. The image illustrates the concept of cultural diversity and inclusion. [^1]: Original PDF page 1: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=1|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.1]] [^2]: Original PDF page 2: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=2|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.2]] [^3]: Original PDF page 3: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=3|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.3]] [^4]: Original PDF page 4: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=4|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.4]] [^5]: Original PDF page 5: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=5|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.5]] [^6]: Original PDF page 6: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=6|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.6]] [^7]: Original PDF page 7: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=7|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.7]] [^8]: Original PDF page 8: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=8|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.8]] [^9]: Original PDF page 9: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=9|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.9]] [^10]: Original PDF page 10: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=10|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.10]] [^11]: Original PDF page 11: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=11|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.11]] [^12]: Original PDF page 12: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=12|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.12]] [^13]: Original PDF page 13: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=13|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.13]] [^14]: Original PDF page 14: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=14|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.14]] [^15]: Original PDF page 15: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=15|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.15]] [^16]: Original PDF page 16: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=16|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.16]] [^17]: Original PDF page 17: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=17|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.17]] [^18]: Original PDF page 18: [[L1.1 Oral health care delivery system in Australia_final recording 2_slides.pdf#page=18|L1.1 Oral health care delivery system in Australia final recording 2 slides, p.18]]