Rural and Remote Oral Health, Problems and Models for Improvement: A Western Australian Perspective

Abstract

Oral healthcare in rural communities shares many of the dilemmas faced by medicine in providing services to large geographical areas with dispersed populations. This study examined the population data and service provision data relevant to the geographical distribution of oral health care in Western Australia (WA). Of the 1.7 million people resident in WA, 72% were resident in the five major urban centres with only 13% in rural and remote regions. Of the 320 postcode regions, 186 had a population of less than 2500, 31 had a population from 2500 to 5000, 42 from 5000 to 10,000, 37 from 10,000 to 20,000, and 24 had a population greater that 20,000. Almost 80% of postcode regions with a population less than 2500 are in non-urban regions. Of the total of 690 dentists who were analysed in this study, it was found that the vast majority (greater than 85%) worked in practices in postcode regions within metropolitan Perth or the major urban centres. A total of 43 postcode regions did not have a dental practice within their bounds. In order to address this disparity in service availability, strategies including the development of training for medical practitioners and auxiliaries, the use of modern technology, school-based programs and the development of interdisciplinary links should be implemented. These strategies would also facilitate the development of closer links between medical and dental practitioners and the development of skills within the medical fraternity that would facilitate improved oral health in rural and remote communities.

Disparities in dental health of rural Australians: hospitalisation rates and utilisation of public dental services in three communities in North Queensland

“…A national survey of oral health highlighted the disparity in oral disease by remoteness, with people living in Australian cities less likely to suffer from dental caries/loss, more frequently able to visit the dentist, and having access to higher rates of employed dentists when compared to people living in remote areas 6 . A number of factors can contribute to poor oral health for rural communities including access to and availability of adequate oral health services 7,8 , retention of the oral health workforce in rural areas 9 and reduced access to preventative measures such as fluoridated water 10 . In addition, the social determinants of ill health -poverty, low levels of education, smoking and poor access to nutritious food at reasonable prices -are all more prevalent in rural and remote areas [11][12][13] .…”

Oral status of residents of long-term care facilities in Kentucky.

“…Similar to demographic data concerning elders in most industrialized countries, (Steele, Pacza, & Tennant, 2000;Sjogren & Nordstrom, 2000;Isaksson & Soderfeldt, 2007) the life span of Norwegians is increasing. As noted in other studies (Sjogren & Nordstrom, 2000), the elderly in need oflong-term care often have diseases that affect oral health.…”

Dental health in rural Victoria: the Crossroads Household Survey

“…23 Previous studies have usually been qualitative in nature and determined the frequency of phobia-related or socio-economic related psychosocial barriers. 14,24 Our study used qualitative and quantitative methods to investigate a wide range of barriers to care in a rural setting, combined with measures of dental health and access to dental health services. For analytical purposes, many of the barriers were amalgamated to more clearly identify population differences.…”

“…In addition, previous data indicate that dentist to population ratios in rural areas are significantly lower than in urban areas. 14,15 This study compared the prevalence of self-reported edentulism (i.e., none of their own teeth), partial edentulous residents (with some of their own teeth) and associations with access and perceived barriers to care in a regional centre and outlying towns in an area of rural Victoria.…”