Healthy Smile Squad

Media item: coverage of children's oral health outreach

This page records the media item. Third-party content is the property of its publisher and is not reproduced here.

What follows is general information on how children in Australia actually get dental care — the public pathways, the school-based programmes, and what to do when cost is the obstacle. It is written because tooth decay remains the most common chronic disease of Australian childhood, and most of it is preventable. Children's Dentistry is the service page.

The scale of the problem

Dental conditions are among the leading causes of preventable hospital admission for Australian children, and general anaesthetic for the removal of decayed teeth in very young children remains distressingly common. The disease is concentrated — a minority of children carry the majority of the decay, and that minority correlates strongly with household income, remoteness and access to fluoridated water. The stages of dental decay and Protecting your child from dental disease describe what is being prevented.

This is not primarily a brushing problem. It is an access and exposure problem.

School dental programmes

Victoria's Smile Squad is the state government's free school dental programme, delivered by public dental services to students at government primary and secondary schools. Broadly, it provides an examination, preventive treatment such as fluoride varnish and fissure sealants, and referral for treatment where needed — with parental consent, and at no cost to families.

Other states and territories run their own school dental services, structured differently. Check your state or territory health department for what applies where you live, as arrangements and eligibility change.

Why school-based programmes work: they reach children who would otherwise never present, they require no appointment-making by a parent, and they normalise dental examination. The single biggest predictor of a child receiving dental care is whether an adult books it, and school programmes remove that step. See When should a child first visit the dentist?

The public system

Victoria's public dental services, delivered through community dental agencies and the Royal Dental Hospital of Melbourne:

All children under 13 are eligible for public dental care in Victoria.
Children and young people up to 18 are eligible if they, or their family, hold a healthcare card or pensioner concession card, and this extends to those in care.
Emergency care is prioritised — see Children's dental emergencies — while general care operates on a waiting list, and waits can be long.
Care is free or low-cost for eligible children.

Contact your local community dental agency, or the Royal Dental Hospital of Melbourne, for current eligibility and waiting times.

The Child Dental Benefits Schedule

A Commonwealth scheme, and the one families most often do not know exists. The detail is at Child Dental Benefit Schedule and How does the Child Dental Benefits Schedule operate?

It provides a capped benefit for basic dental services over a two-calendar-year period for eligible children.
Eligibility depends on age and on the family receiving a qualifying government payment, most commonly Family Tax Benefit Part A.
It covers examinations, radiographs, cleaning, fissure sealants, fillings, root canals and extractions. It does not cover orthodontics or cosmetic work, and it does not cover treatment in hospital. For orthodontics see Children's braces and Invisalign and When should I take my child to see an orthodontist?
It can be used in private practice as well as public, which is what makes it valuable.
The cap is indexed and the amount changes. Confirm the current cap, your child's eligibility and your remaining balance with Services Australia, through myGov or by calling them — and ask any practice whether they bulk bill it, because whether you pay a gap depends on the practice.

What actually prevents decay

The evidence here is strong and unglamorous.

Fluoridated tap water. The most effective population measure there is, and free — The benefits of fluoride.
Brushing twice daily with fluoride toothpaste, supervised until around age eight because young children cannot yet brush effectively. Spit, do not rinse — rinsing washes the fluoride away. See Kids' teeth cleaning tips and How to encourage your child to brush their teeth.
Age-appropriate toothpaste strength, following current national guidance and your dentist's advice for your child's age and risk — Choosing the right toothpaste.
The form, frequency, timing and amount of sugar all matter, which is why grazing and sipping are treated as a separate problem from the total eaten — How does sugar affect your dental health?, Dental Health Week: protect your kids from the Sugar Bandits and Parents warned to limit children's sugar consumption during Halloween.
No bottle in bed, ever, with anything but water.
Fissure sealants on permanent molars for children at risk — Who is a suitable candidate for dental sealants?
First dental visit by the first birthday, or when the first tooth appears — far earlier than most families assume, and the visit is mostly about the parent, not the child. See Your child's first visit to the dentist.

If cost is the barrier

Say so, plainly, at any practice. Options exist and they are not embarrassing:

Public dental services, for eligible children and concession-card holders.
The Child Dental Benefits Schedule, checked through Services Australia.
Emergency public care, which does not require you to be on the general waiting list.
Dental schools and teaching clinics, which offer treatment at reduced cost under supervision.
Staged treatment, dealing with what hurts and what is urgent first — the price guide and Understanding Your Treatment show how a plan is set out here.
The National Debt Helpline — 1800 007 007 — free, independent financial counselling if dental cost is part of a wider problem.

Do not let a child's dental pain go untreated because of cost. Untreated decay in children affects sleep, eating, speech development, school attendance and the developing permanent teeth beneath.

Common questions

When should a child first see a dentist, and when does toothpaste start?

Earlier than most families expect, and the two dates are different. The Australian Dental Association's public guidance says first dental visits are recommended when the first teeth appear in the mouth, and its NSW branch puts an outside limit on it: the first visit should occur when the first baby tooth comes through or by one year of age and at least every 12 months.

The teething timetable gives you the cue. Baby teeth often start to appear around 9 months old, with a normal range of 3 to 12 months, and all 20 baby teeth usually arrive by age 3 — but if your child does not have any teeth by 12 months of age, it is best to have a check-up with a dentist. Brushing starts before toothpaste does: start using a toothbrush around 6 months of age or when your baby gets their first tooth, while you do not need to use toothpaste for your child until they are 18 months old. Flossing starts once your child has two teeth touching side by side, often around 2 years of age. Sources: Teeth.org.au (ADA), Baby and Toddler Oral Health; ADA NSW, Oral health information for children.

Until what age do I have to do the brushing for them?

Age eight, on the Australian Dental Association NSW guidance, which states that parents should assist with brushing children's teeth until age eight years of age. The same source starts the clock early: as soon as a child's first tooth appears (around 6 – 12 months), they should be cleaned twice a day with a soft toothbrush, with children encouraged to drink tap water and sugary foods and drinks limited.

How much toothpaste is a separate question with a specific answer. NHMRC's fluoridation guidance records that low fluoride toothpaste for children is actively promoted along with public health messages and guidelines about the appropriate use of these products — namely to use only a small pea-sized amount and to encourage children not to swallow toothpaste. It notes that dental fluorosis has declined in Australia even as fluoridation expanded, which it links to reduced fluoride exposure from other sources including toothpaste. Sources: ADA NSW; NHMRC, Water Fluoridation and Human Health in Australia: Questions and Answers.

How much difference does fluoridated tap water actually make?

A measured amount, and NHMRC publishes the figures. Its review found that water fluoridation reduces tooth decay by 26 to 44% in children and adolescents, and by about 27% in adults. The longer-run comparison is starker: compared to their parents' generation, Australians born after 1970 (when the majority of water fluoridation programs commenced in Australia) have about half the level of tooth decay.

Two points matter for a page about access. First, NHMRC supports Australian states and territories fluoridating their drinking water supplies within the range of 0.6 to 1.1 milligrams of fluoride per litre, so this is a specified dose rather than an open tap. Second, it is the measure that does not depend on anyone booking anything: NHMRC states that fluoridated water helps reduce tooth decay in all members of society, at all stages of life, including those who have less access to dental care and other measures that protect the teeth from decay. Its 2016 review also concluded there is no reliable evidence that water fluoridation at current Australian levels causes health problems. Source: NHMRC.

Is it how much sugar, or how often?

Both, and the Australian Dental Association's policy statement lists four variables rather than one: the form, frequency, timing and total amount of sugar intake are significant in the initiation of the caries process. Its public-education position asks for special emphasis on exactly those four, particularly snacking on sugary-beverages and/or sugar-rich foods that have limited nutritional value, and it singles out sipping drinks, other than water, during interrupted sleep. For children and young adults it says frequent consumption of drinks and foods with high sugar and/or acid content should be discouraged.

The World Health Organization puts a figure on the amount: limiting the intake of free sugars to less than 10% of total energy intake – and ideally to less than 5% – minimizes the risk of dental caries throughout the life course, where free sugars means all sugars added to foods and beverages by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and fruit juices. WHO also frames decay as three failures together, not one: a continued high intake of free sugars, inadequate exposure to fluoride and a lack of removal of plaque by toothbrushing with fluoride toothpaste. Sources: ADA policy statement on sugar; WHO, Sugars and dental caries.

Practical details

Smile Solutions, Level 1, 220 Collins Street, Manchester Unity Building, Melbourne VIC 3000. Phone 13 13 96, or theteam@smilesolutions.com.au. Monday–Friday 8.00am–6.00pm, Saturday 8.30am–1.30pm, Sunday by appointment. Directions are on Location; enquiries go through Contact Us.

Every practitioner's registration can be verified free on the AHPRA public register at ahpra.gov.au.

This page records a media item; third-party content is not reproduced and no child is identified. The material above is general information, not clinical advice. Ages, amounts and percentages are quoted from the Australian Dental Association, NHMRC and the World Health Organization as cited, and general guidance is not a substitute for advice for your own child — toothpaste strength in particular depends on age and individual risk. Eligibility rules, benefit caps and programme availability change and vary by state — Services Australia, the Victorian Department of Health and your local community dental agency are authoritative. Payment plan terms are set by the credit provider and change; confirm current terms directly before you commit.

Smile Solutions trades under ABN 28 193 514 103.