Looking Back Looking Forward - Oral health in Victoria and Australia 1970 to 2022 and beyond

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John Rogers (Specialist in Public Health Dentistry with more than 45 years' experience in management and policy development) and Jamie Robertson AM (over 40 years in private dental practice, extensive public governance and practice experience, and noted historian of the dental profession) look back on 50 years of public dental health in Victoria and Australia. They make a forensic examination of changes in oral health, shifts in government policy, professional practice, technological advancements and public expectations. With a lens focussed firmly on health equity, they ask how good oral health for all Australians can be achieved. While often taken for granted, good oral health is fundamental to good mental and physical health. Poor oral health precipitates and perpetuates low self-esteem and adversely affects a person's ability to eat a nutritious diet, find employment, and engage socially without embarrassment. Oral diseases cause pain and suffering. And yet, despite the well-meaning policy initiatives of some governments over the last half century, dental care remains out of the reach of many Australians and dental health inequality is increasing. While there are many reasons for poor oral health, it is often a clear sign of social disadvantage. Australia's public dental system is a tattered safety net failing Australians on lower incomes, forcing them to face long years waiting for general care. Dental care remains mostly excluded from Medicare. The mouth has been left out of the body. We urgently need a national conversation about how this situation can be remedied. In this unique history, the authors show how we have arrived at the current state of affairs. They trace oral health and disease alongside the complex interaction of social, political and economic factors over the past five decades. Drawing on the latest WHO Global Strategy for oral health, they delve into the past to chart a future in which better oral health is achievable for all. While there is a particular focus on Victoria, the issues are common across Australia and indeed the world.