Tooth erosion occurs when acid dissolves the outer layer of the tooth enamel. The damage is irreversible, and can lead to greater tooth sensitivity.

Erosion is caused by heightened levels of acid in the mouth. This can be the result of acidic foods and drinks, some prescription medications that reduce the flow of saliva, and acid reflux and vomiting.

Avoiding tooth erosion:

• Limit your intake of acidic drinks, including alcohol, caffeine, soft drinks and sports drinks
• Drink water regularly throughout the day, particularly after eating
• If you have consumed acidic food or liquid, wait 30 minutes before brushing your teeth

More information on how to protect your teeth from tooth erosion is available at the Australian Dental Association's Dental Health Week website.

Rushworth Kindergarten and six other Campaspe pre-schools have met the requirements of the state-wide Smiles 4 Miles oral health promotion program, with children and their families learning about how to keep good oral health by eating well, drinking well and brushing well.

In presenting the award Chief Executive of DHSV, Mr Felix Pintado, congratulated the kindergarten on its commitment to children’s health. “You have done a terrific job in setting these kids up for a healthy life.”

Smiles 4 Miles is a health promotion program developed by DHSV running in 31 sites across Victoria. In the Echuca region it is coordinated by the Echuca Regional Health Service.

Under the program, participating kindergartens and childcare centres develop healthy nutrition and water policies, and run oral health education activities with children and their parents.

Echuca Regional Health Service joined the program in 2009, and all seven participating kindergartens in the Campaspe region have now met the tooth-friendly criteria.

Ms Joanne Warnecke, Health Promotion and Community Nursing Coordinator at Echuca Regional Health, said that a total of 500 Campaspe children are participating in the Smiles 4 Miles program.

“We have found that our local kindergartens have been very keen to provide a pre-school experience that is good for children’s teeth and overall health,” said Ms Warnecke.

Director of Rushworth Kindergarten, Ms Marg Howard, thanked the parents and children at the kindergarten for their willingness to adopt new habits. “Parents tell us stories of their children reminding them in the supermarket what foods and drinks are OK to bring to kinder,” she said.

Approximately half of all Australian children have had tooth decay by the time they start school. The Smiles 4 Miles program is designed to instil healthy habits early. All children aged 12 years and under are eligible for priority access to Victorian public dental clinics.

Campaspe district’s Smiles 4 Miles kindergartens:

• Echuca Central Kindergarten
• Gunbower and District Pre-School
• Lockington Pre-School
• Unwin Street Pre-school and Occasional Care Kyabram
• Rushworth Kindergarten and Childcare
• Girgarre Kindergarten
• Colbinabbin Kindergarten

Forty-five year 5 and 6 students participated in the project under the guidance of DHSV staff members Jacqui Bunting, Amanda Perry and Meagan Chiuchiarelli with the assistance of CGPS teachers Kay Markiewicz and Jane Wu.

The students painted ceramic tiles inspired by the theme - 120 Years of Smiles. The tiles will be used to create a feature wall in the Level 2 waiting room of the Hospital.

The students produced some fantastic work and enjoyed participating in the project.

“The students were very fortunate to have such a golden opportunity to participate in a very significant event. They will surely appreciate viewing their work in the near and distant future. I ask them to imagine taking their own children to see their work on the wall at the Dental Hospital one day.” said teacher Kay Markiewicz.

The 120 Years of Smiles community art project was one of a series of events planned this year to celebrate 120 years of caring for the oral health of the community.

For further information about the feature wall, please contact Jacqui Bunting x1361.

Left to right: Amanda Perry, Kay Markiewicz, Jane Wu, Meagan Chiuchiarelli and Jacqui Bunting

Read the full article 'Dental as anything'  [PDF, 1.85MB]

“Most people know that smoking causes cancer, stroke and heart disease, but I don’t think many people realise that it can also cause your teeth to fall out,” said Dental Hospital patient Ms Eril Riley.

Periodontitis is a bacterial infection caused by a build-up of plaque on the tooth root below the gum-line. The disease is difficult to diagnose until it is at an advanced stage, and if left untreated, can destroy the gum tissue and bone that support the teeth, until teeth become loose and eventually fall out.

Evidence shows that smoking is a major risk factor for periodontitis. Smokers have been found to be more than four times more likely to have advanced periodontitis than non-smokers, and it is estimated that half of periodontitis cases in the United States are caused by smoking . Research shows that smokers lose more teeth than non-smokers do: in one US study, 20% of people over the age of 65 who had never smoked had lost all their teeth, compared with 41% of people over 65 who were daily smokers.

“It appears that smoking creates an environment in the mouth that is conducive to bacterial growth,” said Dr Julie Fraser, periodontist at The Royal Dental Hospital of Melbourne. “The risk of developing periodontitis increases with increasing numbers of cigarettes per day and years of smoking.”

“The good news is that giving up smoking reduces the risk of periodontitis over time. If a person quits smoking today, over the next 10-11 years, their risk of developing periodontitis will reduce to that of a non-smoker. If a person already has periodontitis, we know that giving up smoking will slow the disease’s progression, and will improve the effectiveness of treatment,” said Dr Fraser.

With regular cleaning and treatment by a specialist periodontist, periodontitis can be controlled, and natural teeth can be protected, but it is very difficult to cure the disease. People with periodontitis often have to receive regular specialist treatment for the rest of their lives.

Related links:

The facts about periodontitis
General dental advice
Teeth tips and facts
 

The Dental Hospital first opened its doors in 1890 from rented rooms above Garton’s Horse and Carriage Bazaar in Lonsdale Street. It was staffed by volunteer dentists who provided free treatment for low-income people from 9.00-11.00am each weekday.

Today the Hospital has a purpose-built facility in Swanston Street that operates seven days a week with more than 400 people a day passing through its doors. Last year the hospital treated close to 50,000 patients from around Victoria.

Chief Executive of DHSV, Mr Felix Pintado, said that while facilities and dental practices had changed over the last 120 years, two important things had remained the same.

“The Dental Hospital has always provided free or subsidised treatment for people who probably couldn’t otherwise afford oral health care,” said Mr Pintado. “Those of us working at the Hospital today are continuing that tradition of care.”

“Also, since its establishment, the Dental Hospital has been an educational institution. Dental students, and now also oral health therapy students, gain clinical experience working at the Hospital at the same time as providing a much-needed service.”

“The Hospital’s relationship with the University of Melbourne and RMIT University continues to be crucial to meeting the demand for skilled oral health practitioners,” said Mr Pintado.

The Dental Hospital has a series of community and professional events planned this year to celebrate its 120 years of caring for the oral health of the community.

Felix Pintado, Chief Executive of DHSV (far right), with Princes Hill Secondary College music students.

The health industry and the dental profession are experiencing significant workforce and professional changes. This CPD event, initiated by the DHSV Specialists Leadership Forum, brought together the knowledge of expert presenters who explored the implications of key changes.

The speeches from the evening can be listened to by clicking on the links below:

1. Introduction by Dr Eryn Agnew, Dental Health Services Victoria
   
   The impact of change on workplaces and professions [MP3, 22MB - 40mins]
   Ms Deb Stewart, Senior Lecturer in Management and Organisation Change, Victoria University
    
2. Implications of the 'Melbourne Model' for the dental profession [MP3, 11.6MB - 24mins]
   Prof Eric Reynolds, Head of the Melbourne Dental School and CEO of Oral Health CRC
    
3. The new National Registration environment for dentists [MP3, 18.4 MB - 40mins]
   The new National Registration environment for dentists - presentation [PDF, 1MB]
   Dr Gerard Condon, Member, Dental Board of Australia

If you have trouble downloading and listening to these MP3 files, please contact web@dhsv.org.au.

Scientists are investigating the role that dental bacteria might play in heart disease. Studies show that people with greater exposure to the bacteria that cause periodontal (gum) disease are at increased risk of heart disease.

Professor Hanny Calache, Director of Clinical Leadership, Education and Research at Dental Health Services Victoria (DHSV), said there is also a known link between poor diet and heart disease.

“People who don’t have enough teeth to chew well, will avoid eating raw fruits and vegetables which reduces their intake of fibre and Vitamin C. Studies show that this increases the risk of cardiovascular disease,” said Hanny.

The good news is that eating a healthy and balanced diet of fresh fruit and vegetables, lean meat, fish and wholegrains, drinking plenty of tap water, and avoiding sugary foods is good for both your oral and heart health.

Useful Links

Teeth tips and facts
General dental advice
The Royal Dental Hospital of Melbourne

The group includes eight representatives from regional and metropolitan Aboriginal health services who are required to take into consideration not only the communities they represent but also other Aboriginal communities throughout Victoria.

The new Aboriginal Oral Health Reference Group will alert Dental Health Services Victoria to gaps in service delivery in Aboriginal communities, and will give advice on oral health awareness programs and materials.

Ms Colleen Marion, Chief Executive Officer at the Western Suburbs Indigenous Gathering Place welcomed the new group.

“We all talk about the problem of oral health in our communities and organisations all the time, but it has been difficult to find ways to address the problems. The new reference group gives us a pathway to better oral health for our people,” said Ms Marion.

Ms Christine Ingram, manager of the dental program at Victorian Aboriginal Health Service, describes it as the next step in improving oral health for Aboriginal people.

“We first held a roundtable meeting with Dental Health Services Victoria in 2006 and as a result of that meeting an Aboriginal community development worker was appointed at the dental hospital. The reference group is the next step to getting better services and oral health awareness out into communities,” said Ms Ingram.

VACCHO (Victorian Aboriginal Community Controlled Health Organisation) is also participating in the group. Timothy Moore, senior policy officer, welcomed its establishment. “There is a lot to be done in the area of Aboriginal oral health and VACCHO is looking forward to helping improve DHSV’s capacity to work with Aboriginal people.”

Aboriginal and Torres Strait Islander children have more than twice the amount of tooth decay experience when compared to the overall Australian population of similar age. Aboriginal and Torres Strait Islander adults have more missing teeth than the overall Australian adult population.

There is now growing evidence indicating that oral diseases, including tooth decay and gum disease, share common risk factors with other diseases, and that poor oral health occurs simultaneously with a range of chronic diseases.

“One of the first things we have to do is get the message out to our children and parents that good oral health is important to the rest of your health,” said Colleen Marion.

Jacqueline Watkins, Aboriginal Community Development Worker at DHSV, thanked the members of the group for their positive first meeting. “It is very exciting for me personally to see us get to this stage, and I think our first meeting was a sign that we will be able to do positive work together around improving oral health in our communities.”

Aboriginal and Torres Strait Islander people have priority access to public dental treatment and do not have to be placed on a waiting list to receive general, denture or specialist care.

The program, run by Dental Health Services Victoria, aims to encourage talented oral health graduates into the public dental sector, and foster their talent through mentoring and professional development.

Five new oral health therapists were selected into the program from Victoria’s most recent cohort of Bachelor of Oral Health graduates, and all five are now working in regional public dental clinics in Maryborough, Benalla and Wangaratta, Pakenham and Ballarat.

“This was a great result in our first year,” said program coordinator, Dr Elizabeth Milford.

“We will be working with the graduates over the next 12 months to ensure they have the capacity to bring high-level clinical and leadership skills to the public oral health sector.”

“The graduates are a dedicated group of young professionals, who not only impressed their university lecturers with their clinical results, but have also demonstrated a strong motivation to contribute to public health.”

Graduate Jodi Leversha was working in two private practices in Melbourne’s eastern suburbs when a vacancy came up at Maryborough District Health Service.

“I was keen to get public sector experience because it’s an excellent grounding and would give me the chance to use my full range of skills”, said Jodi.

Originally from Melbourne, Jodi did her degree at the Bendigo campus of La Trobe University and was open to the prospect of moving back to central Victoria.

“Because of my studies there, I was familiar with the district and have a lot of friends around the place. Being part of the graduate program gave me the confidence to take the plunge and commit to a rural community health service.”

Now six weeks into her new role, Jodi is enjoying using her training to bring much-needed dental care to Maryborough families.

Dr Milford said she and the graduates’ new employers will be working closely together to ensure the oral health therapists get a range of professional experiences at the same time as meeting the dental needs of their local communities.

The program will select its next round of graduates in June this year.

Hayley Worm, oral health therapist at Central Hume Dental Service
Photo courtesy of Steve Kelly, Wangratta Chronicle 

The survey found that between 40% and 57% of 12-15 year-olds have had some decay in their permanent teeth. On average, Australian 12 year-olds have slightly more than one decayed, missing or filled permanent teeth, and 15 year-olds have an average of two decayed, missing or filled permanent teeth.

The data for the report was collected in 2003-2004.

Principal Oral Health Advisor at Dental Health Services Victoria, Professor Mike Morgan, urged parents and young teenagers to be aware that children were at greater risk of dental decay as they entered their teen years.

“There a number of factors that increase decay risk for this age group. From a lifestyle point of view we know that young people in this age group are starting to experience some independence from their parents and this can have a negative impact on their oral hygiene habits and the quality of their diet,” says Professor Morgan.

“It is also possible that once they leave primary school, young teens are attending for oral health care less regularly, and this is something we need to keep an eye on.”

A number of initiatives have been introduced in Victoria in recent years to improve access to public dental services for teenagers:

• Priority access for all children up to 17 years of age, giving them access to the next available dental appointment at their local community health service or at The Royal Dental Hospital of Melbourne.
• Integration of the School Dental Service into community health services across Victoria so that people can receive dental care at the same location as they receive their other health care, whatever their age. Many health centres now offer family appointments for dental visits.
• Fluoridation of the water supply in a number of Victorian communities.
• Introduction of the Commonwealth Medicare Teen Dental Plan in 2008, providing free dental check-ups for teenagers.

In Victoria, public dental care is available to all children aged 12 years and under, and to teenagers aged between 12 and 17 years whose parents hold a health care or pensioner card.

Professor Morgan said that the latest report provides useful information on the oral health of young teenagers. “This is definitely a population group we need to monitor closely to ensure that they are accessing the oral health care they need.”

 Oral health tips for teens

• Brush teeth twice a day with a fluoride toothpaste.
• Limit the amount of sugary food you eat, especially between meals.
• Avoid fizzy and sports drinks - the acid in these can damage tooth enamel.
• Have a dental check-up every 1-2 years, even if your teeth and gums feel fine.

Links

• Dental health of Australia’s teenagers and pre-teen children: The Child Dental Health Survey, Australia 2003-2004, Australian Institute of Health and Welfare, published 18 January 2010, www.aihw.gov.au/publications/index.cfm/title/10778

• Who is eligible?
• Fees
• Advice for children
• Advice for young adults

The Totally Smoke Free status means that in addition to complying with the ban on smoking inside buildings, patients, visitors and staff will also need to comply with a “no smoking” rule in car parks, courtyards, entrances and footpaths surrounding the Hospital.

“The evidence on the links between second-hand smoke and a range of health problems, including respiratory illnesses, cardiovascular disease and breast and lung cancer, is well established. As health care providers, we are obliged to limit this risk to the community,” said Mr Felix Pintado, Chief Executive at The Royal Dental Hospital of Melbourne.

The Royal Dental Hospital of Melbourne is supporting staff who wish to quit smoking by subsidising the cost of nicotine replacement therapies and running a support program.

For further information, please contact the DHSV media unit.

Thirty-three coordinators shared success stories and experiences from across their various regions, and discussed new ways of engaging with families in a range of socio-economic circumstances.

A total of 367 pre-schools (22% of Victorian pre-schools) around Victoria are now participating in the Smiles 4 Miles program which is run by Dental Health Services Victoria in partnership with local governments and community health services.

Under the program, participating pre-schools promote good oral health by following tooth-friendly eating and drinking policies, and involving children and parents in oral health education activities. Pre-schools that have implemented all the requirements are recognised with a Smiles 4 Miles award.

An independent evaluation of the program, commissioned by the Department of Health, has recently commenced, with the findings expected to be available by mid-2010.

Mike answered questions from callers on a wide range of dental topics, including:

• fitting dentures properly
• dry-mouth conditions
• dental implants
• mouth ulcers
• oral hygiene habits
• links between oral health and some medical conditions
• gum recession
• using public dental services

Listen to the podcast of Mike and Dr Feelgood - Talking Health: 22 November 2009 (mp3 file can be played with Microsoft Media Player).

At a recent visit to The Royal Dental Hospital of Melbourne hosted by DHSV, the Federal Minister for Health and Ageing, The Hon Nicola Roxon, discussed the proposed reforms with oral health professionals and encouraged them to send through their comments and suggestions on how more affordable dental care can be provided to more people.

Dental Health Services Victoria (DHSV) supports the greater focus the report of the National Health and Hospitals Reform Commission brings to universal access to dental care and to early detection and prevention of oral disease.

Read the final report of the National Health and Hospitals Reform Commission (June 2009)
http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/Content/nhhrc-report-toc

Respond to the Commission’s recommendations
http://www.yourhealth.gov.au/internet/yourhealth/publishing.nsf/content/home

Mrs Roxon toured The Royal Dental Hospital of Melbourne in Carlton and met with dental professionals and health service managers to answer questions and take comments on the NHHRC's proposed Denticare scheme.

Chief Executive of Dental Health Services Victoria, Mr Felix Pintado, welcomed the opportunity to participate in a discussion about dental care reform, and was pleased that the Minister took up DHSV's offer to come and see public dentistry in action.

Image: Federal Minister for Health and Ageing, The Hon Nicola Roxon (photo courtesy of the Department of Health and Ageing)

Associate Professor Hanny Calache, Director Clinical Leadership, Education and Research at Dental Health Services Victoria, arranged the first workshop on the subject in September.

Clinical Caries Management in Community Dental Clinics – a new horizon in public dentistry was attended by 50 leaders in the oral health sector, including public health professionals, academics, professional associations, consumer representatives and members of the dental industry.

The group discussed how a new caries risk assessment tool and caries management protocols could be introduced across public dental programs. Most public dental programs are delivered by community and regional health services.

Drawing upon evidence and practices developed by international cariology experts, including Dr John Featherstone of the University of California, the new protocols would see high-risk patients making regular dental visits and undergoing early detection screening.

“We face particular challenges in community oral health settings with some of the measures recommended for intensive caries management,” said Professor Calache.

“Demand on public dental services can be an obstacle to offering three and six-month re-call appointments to high-risk patients. Another challenge is the high cost, of diagnostic measures and protective therapies such as antibacterial and remineralisation treatments, for community dental services and their patients.”

Professor Calache said that the overall cost of public oral health care was likely to be reduced by targeting more intense treatment to those identified as ‘high’ or ‘extreme’ risk, and reducing the number of restorations (fillings) required by public dental patients.

“We need to re-orient our community dental programs so that we are set up for early detection, increased prevention and less surgical intervention, using the best evidence and most effective caries management technologies available,” said Professor Calache.

 With scientific research giving clinicians a better understanding of dental caries, Prof Calache said that it is time for public dental services to align their practices with the scientific evidence.

“We now understand that caries is actually an infectious disease and its cause needs to be managed. Fillings and extractions can treat the symptoms but they don’t cure the disease. Earlier detection of dental caries will give us the opportunity to repair early caries lesions and reduce a patient’s risk of future caries episodes,” said Prof Calache.

A Welcome to Country ceremony took place at the Hospital in Carlton, and was formalised with a smoking ceremony and the unveiling of a plaque by Senior Wurundjeri Elder Doreen Garvey-Wandin. Activities concluded with a dance performance by Koori Youth Will Shake Spears.

The event date was chosen by Aunty Doreen for its proximity to NAIDOC Week and was endorsed by DHSV’s Diversity Group and Community Advisory Committee.

DHSV Chief Executive, Felix Pintado, said his organisation celebrates this occasion as an important sign of respect to the traditional owners of the land.

The formal acknowledgement of the land’s traditional custodians has been organised by DHSV’s recently appointed full-time Aboriginal Community Development Officer, Jacqueline Watkins.

“DHSV is committed to Aboriginal health care initiatives to help Victorians in need,” said Felix.

“We actively promote good oral health in Aboriginal communities, with priority access and assistance for patients to arrange and attend appointments. These initiatives are likely to expand as the range of programs for Aboriginal and Torres Strait Islander people increase at DHSV.”

The ceremony was attended by Aboriginal Elders, Aboriginal patients of The Royal Dental Hospital of Melbourne, representatives from Victorian Aboriginal Health Services, DHSV Board Directors, Executive and staff.

As Victoria’s leading public oral health agency, DHSV supports the plan to train a staff member from all 2,830 nursing homes in dental hygiene by next year (2010).

Professor Mike Morgan, Dental Health Service Victoria’s Principal Oral Health Adviser, commented:

“Training aged care workers to assist with residents’ oral health is a significant step towards preventing illness related to oral health and reducing pain and discomfort for older Australians, particularly those in nursing homes.”

“Educating aged care workers also reduces the gap in the number of clinicians available to address the oral health care needs identified in the Victorian government's strategic plan for public dental health services and oral health.”

DHSV has been operating a domiciliary dental unit for over 25 years, providing treatment to people in aged care homes and others who are homebound due to medical, physical or mental conditions.

DHSV is experienced in and committed to providing care to residents of nursing homes and welcomes this positive step towards recognising and prioritising the oral health of older Australians. DHSV is available for consultation on this proposal and other public oral health matters.

DHSV welcomes the National Health and Hospitals Reform Commission’s draft report proposing an increase in Federal spending on oral health and the development of a system to ensure universal access to prevention, diagnosis and restorative care for oral health.

The draft report highlights the urgent need to improve oral health promotion, and preventative, diagnostic and restorative care. While some Australians have excellent oral health, the report shows that poor oral health has negative social and health consequences for at least one in four Australians. Oral health problems are particularly acute for indigenous Australians, refugees, pensioners and others on low incomes, and people living in rural areas.

Professor Mike Morgan, Dental Health Service Victoria’s Principal Oral Health Adviser, commented:

“Integrating oral health into broader health promotion, and ensuring universal access to preventive, diagnostic and restorative dental services, will increase Australians’ health and well-being and reduce the burden of disease and need for emergency dental care.

There are a number of issues requiring ongoing discussion including the need for an appropriate oral health workforce, particularly in rural and remote regions and in the public dental sector. Government support for the education and training of oral health care providers is important to ensure that this bold new proposal is successful.”

DHSV encourages ongoing discussion of oral health initiatives that work towards providing appropriate oral care access and improved oral health outcomes to all Australians.