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The Dental Prosthetist and their Future Role in Oral Health P5

Here’s the percentages which that graph is based from these are the ones that are known, not projections, these are the actual data from the national oral health survey. What i want you to look at is the trend here. So in 1979  across the encore  Australian population 15.4% roughly 1 in  7 people were  fully adentalist and by  2005 that  had dropped to 5.2 % air in 1 in 20 . Think about what happen to the population of Australian between 1979 and 2005.  You only need to go on the road in the [Inaudible] or any capitals in austral and to get the answer to that question. The answer is the population now is much, much arranger and so if the population has increased, has doubled in that time then 5 % would have been 10 % of the same number of you had kept the denominator constant.

I know it’s after lunch but hopefully you can keep the lower proportions at the back your mind. If i we look internationally we are actually doing very similar to Canada, and to the US in terms of the actual adentalist rates. So there is nothing funny happening in Australia. These are the trends that are being seen in the developed countries. Nothing unusual, that’s good to know. This is the modelling into the future. If we look at this graph at where we are not which is 2010 or 2011 just over her to 2029 what t you can see is that the h rate of reduction is actually slowing. If you look at the intervals and you look at the amount of the reduction from here to here and so on it so actually per annum beginning to slow up.

That’s the first thing, it’s not going in a proportional rate. This is a bit like what we saw in terms of the carriage reduction, it actually flattened out in 2004 and then it began to rise again. This is my most important slide to remember of the afternoon slide for you. This will bring cheer to your hearts. Look at the number of head count, head count of peopled who are fully adentalist in 2005 which i told you there is a 1.05 million people and in 2020 its still 904, 000. It’s only reduced a little bit over a period of 15 years. So straight away that gives you a li bit of an incline and those arte people who are decentralist. I’m not eve talking about the partially decentralist patient.

This is that actual head count data and oust people don’t even think about it in such a simple way. In your practise you’ve got a couple thousand of patients on your books. In 2020 you will still have a couple thousand patients on your books the same basic demand in communities is actually sitting out there. That’s just for four dentures. Complete tooth loss is not distributed equally around Australia. It is different between capital cities and outside capitals by almost too times. So you are twice as likely to have some of these fully dentures outside of capital century. If you are 75 years and over once again you can see this difference in distribution and if you look at annoying who has less than 21 teeth you also see as discrepancy. This morning when Andrew was giving you that great plug for the northern territory, he said it kind of appears there’s a lot of work, it’s a nice place to live. In terms of disease there is more missing teeth in areas of   Australia that are remote and rural per head of population than there is the major cities. Yes that’s where the workforce is mainly distributed. If people feel they are not busy enough then that might be something to have a think bout. If you are looking at this one over here this is capital virus non capital city complete adentalism in different j age groups. Well ignore the 15 – 34 bit look at tithe 55 -74. Its about 40-% and the over 70s is still high and overall it’s nearly double.

So in terms of where people who are fully adentiollious are they’re more likely to be an outside a capital city, in terms of post code analysis. A little lesson for you there. If you got to rural end and remote versus urban you can also see that there is some little differences even though there aren’t   quite so marked over here. This is urban, rural and remote.  The problem with this particular  study worthies The National Telephone survey is that it  under represented  a lot of the groups in ritual  and remote areas  because ethos past codes h are list  well populated . So there is little bit of an issue there.

What about card status and missing teeth. Well as i mentioned to you earlier if you are eligible for health care card then in any age group the dark gay bars you are going to have roughly twice the likelihood. So if you think about public sector, health services delivery then public sector delivery outside of capital city is where a lot of denture work is going to be done. In the moment  81% of  procedures in Australia and therefore as a snap shot about  40% of you are sitting in this room then 80 % of you into room  will probably work  largely in the private sector and probably in the  a larger centre but the   dentuurelisnm is  slightly off to the side . Depending on the catchment of your practise.

There is some pretty big qualities. Here is some more analysis of some recent data for you. This is looking at the 55  and over so in turns of  percent adentalist the card  holders are about  2 and a  half times  higher, less than 21 teeth  about   two and half times  higher and untreated decay about  40%  higher so card holders  have the drivers  for a lot of the need into the future. I think that would be a fair comment to make.

Shagging the same sort of trend here. Once you ‘ve seen one of these graphs you can  work those out pretty  quickly, card holders  versus non card  holders in different  age groups are morel likely  to show complete  tooth loss. This is the 55 and overs. This is the 60s and over. Once again the card holders and the harbours and the non-card holders are the lower bars so it doesn’t matter which particular study y that you look from, there is a repeat in pattern that begins to emerge from this sort of hard numbers around Australia.

This one , percentage of people  who wear a denture , card  holders versus non chard holders arts  you expect the card  holders here in purple are going to be higher and that’s  true  but the number does not  match the proportion of those who have more  missing teeth . That  tells me that there is a larger  amount  of  untreated need  in the card holder population ,EG  , waiting list to have dentures  made in petrel who are missing teeth now . Any survey you do of the population will certainly reveal that to you. There is untreated need out there in the community, there is no doubts about that t whatsoever.  What if you look at indigenous communities? If you look at the DMFT it certainly is a bit high particularly in the  younger age group but  if you look hat the untreated carries you can see its almost doubled and the rate of being adentalist across the entire community is almost tripple . So again i you will find indigenous  patients  will tend to be over represented  in terms of  people who are going to be getting severe dental disease  and slosh  having missing  teeth and therefore needing some level of replacement .

So what does all that mean? If you package all that  together in terms of  simple , how busy is my appointment  book the answer is the projected  demand for services  for  these sorts of patients is going to go up . It’s been going up and it will continue to go up.

This is from an analysis that only came out a week ago. This is brand new, web ink data   for you. This is prosthetic treatment needs across all of Australia modelled according to patient age. This is the current data, this is storm 2008 / 2009. As you can see as someone age goes up the mean number of prosthetic services per patient increases particularly of the age of 45- 54 years which is sort of what you would expect. There is a demand that links to age and the age distribution. Remember the coffin comment i made, the age distribution is changing.

Let’s give you some hard numbers, if you turn into literally specific occasions of service the box in the red are i the services for removal prose. The row above is crown and bridge. If you look at those one over here this is in thousands s this is under 1.8 million in 2005 will rise to 2.7 million in 2020. That’s assuming that there is only half of the current rate of per capita growth. This is an extremely low projection. Even that shows think you would agree ire p pretty significant increase in terms of projected and demand for care.

By 2020 its certainly going to increase if you take the most conserving protection which s hack od the current per capita growth rate, It  will incease by  about  24 % and if you take it at a realistic rate which is the current rate of per capita demand  it will go up by nearly 40% .  There are patients in need. there is tooth loss in certain groups  and there is demand so all the things that  drive practise business are actually sitting there  and they’re fairly will described  in literature today . So  in this report which is the report  that just came out  on  predicted dental demand to  2020 the removal probe services were projected  to increase by 52% an did you think abbot heat that means in  practical terms that going to mean a  lot more partial because the  patent of  adentalist have changed from  fully adentalist-ness to more wards partially adentalist-ness . So more partials.

Then if you think about those  people who were are e going to be  getting partials can  we sort of  predict who those people are going to be ,chances are from the modelling that’s being down  they are more likely living outside the capital city , they are  moreleoluy to  be in a low SES group , indigenous and have a lower level of schooling . There are   patients who may be more likely to fall into a public sector service five they are in an eligible population group. So once again you can see it’s a question about the distribution of workforce that should match that. It should be quite interesting.

So having said all of that is this evenly distributed across the country?  If you look around Australia you can sees that, you loo at the 55 group which sis the light grey and the 75 which are the dark grey you can see that they are actually fairly consistent across the country. There is not not a lot of variations. Few little wobbles in South Australia but nothing of any great major distribution. So is people actlaluu being seen is the next question.  Well, return to my comment about card holders.  One in two adults age 55 currently is eligible for card. If you look across sasutsrali at sort of a big picture level. That means list of demand for public sector care and of course lots of waiting list and lot of hardship and postponing treatment for people who can’t affords it in the private executor. That’s just the reality of the world we like in today for a whole range of reasons.

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