How to improve dental care for kids

Australia should move to a universal dental care scheme over the next 10 years, as we recommended in our recent report Filling the Gap. But even under existing policy, there is a funded dental scheme for children. The tragedy is that it does not deliver the care it could.

Most Australian children – about 57 per cent of them – are entitled to receive dental care subsidised under the Commonwealth Child Dental Benefits Schedule (CDBS). Children are eligible if their parents receive Family Tax Benefit Part A, or one of a range of other payments from the Commonwealth.

The CDBS pays for children to be treated by state public dental services or private dentists for preventive and primary dental care. But it has a woeful take-up rate. As the graph shows, when the scheme began, the Commonwealth set a target that 2.4 million children – around 80 per cent of those eligible – would use the service each year. In the event, fewer than 1.2 million children use it each year.

This is an astonishing public administration failure. Parliament passed legislation for the scheme in the expectation that it would be used as proposed – and allocated funds accordingly.
The dramatic under-performance of the CDBS must be confronted. This is an ideal opportunity to experiment and use behavioural economics techniques to improve public policy, and health care delivery.

We suggest:

  • State public dental providers brainstorm with the Commonwealth Department of Health on strategies to improve take-up rates. These might include sending revised letters to eligible families, social media and/or media campaigns, school dental vans as Victoria is introducing; and advertising in schools in low-income areas.
  • The states and the Commonwealth – in conjunction with a university – rigorously evaluate the success or otherwise of the various strategies used.
  • The states and the Commonwealth jointly fund the strategies and the evaluation.

Will this work? It’s hard to know. But what we do know is:

  • It doesn’t cost much to promote publicly funded dental care.
  • If we don’t do something, take-up rates will stay low.
  • If children don’t get the dental care they need, they are likely to develop oral health conditions that will be painful and more costly to treat when they become adults.

Let’s not wait for a universal dental scheme. Let’s give our kids the care they need now.