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There’s consensus on the urgent need for a dental benefits scheme for older Australians, and now a recent pilot project is offering real hope that a viable solution is closer than ever. By Tracey Porter.
To aid its push for a government-funded oral health scheme for seniors, the Australian Dental Association (ADA) was recently involved in a proof-of-concept pilot project that ran from November 2024 to March 2025, which produced more than encouraging results.
It included free individualised dental plans as part of a GP-provided healthcare program, marking the first time oral healthcare has been included in formal health management frameworks.The initiative saw dentists provide free dental treatment to 70 seniors, alongside bespoke advice and information designed to improve oral health and reduce the risk of dental disease.
ADA president Dr Chris Sanzaro has thrown the weight of the ADA behind the project, stating, “The results… show that this scheme is a valuable blueprint for similar pilots to be rolled out around the country and inform the construction of a SDBS (Senior Dental Benefits Schedule) down the track.”
Dr Sanzaro says with this hurdle jumped, it is now time to progress the project to the next stage.
Driven by affordability issues, extensive waiting times, as well as what the ADA has called the “under-funding and under-resourcing” of the nation’s public health clinics, hospitalisation for potentially preventable dental conditions for seniors is growing at over seven per cent per year.
The dire state of oral health among Australian seniors was laid bare in a recent ADA survey published in April, which showed many of those in the 65-plus age bracket have compromised oral health and high levels of oral disease.
It revealed that in the past 12 months, 55 per cent of all over-65s delayed seeking dental treatment, citing affordability as the main barrier.
The same survey found that 16,000 seniors were admitted to hospital for treatment of painful dental issues in 2022/23, with that figure expected to rise to 22,630 by 2027/28.
These and other worrying statistics have prompted the ADA to ramp up its efforts this year to make a SDBS a reality in the near future.
The ADA has been lobbying successive governments for a SDBS since senior Australians were identified as a priority group in the 2015-2024 National Oral Health Plan.
The Parliamentary Budget Office has calculated the cost of such a scheme to be around $1.14 billion a year in 2025/26 for the 2.8 million eligible seniors. This would rise to $1.26 billion in 2026/27.
The results… show that this scheme is a valuable blueprint for similar pilots to be rolled out around the country and inform the construction of a SDBS down the track.
Dr Chris Sanzaro, president, ADA
While a SDBS was recommended in both the aged care royal commission and the 2023 Senate inquiry into dental care, the Maroubra project isn’t the first time moves have been made to improve the standard of oral health care for older Australians.
Other projects have successfully improved access to affordable and comprehensive dental care for this cohort. These include the University of Newcastle’s Senior Smiles program which provides oral health services and referral pathways to support those living in residential aged care facilities and the Hunter New England Local Health District oral health service’s ResiDENTAL program that provides portable dental equipment for onsite use.
Dr Sanzaro says there are several points of difference between the Maroubra scheme and previous programs that make the former a more palatable and realistic proposition. “There were differences from the ADA’s proposed SDBS in terms of the eligibility of those recruited—it was targeted to those with underlying medical conditions—and this allowed the scheme to operate effectively in that location where there are doctors to treat other medical conditions.”
Another difference was that the Maroubra pilot was not restricted in terms of volume or cost of treatment that each patient could receive, Dr Sanzaro explains. This means it offered more information demonstrating the level of unmet need, and the range and scope of treatment required.
Patients reported better-fitting dentures, improved confidence and a greater understanding of oral hygiene practices. In addition, all untreated tooth decay was successfully managed and prevented from advancing.
While there are many compelling reasons to back a SDBS, Dr Sanzaro believes the government will be focused on an affordable, sustainable scheme with proven benefits.
Next steps are likely to involve further pilot studies in other regions—metro, regional and rural. Each will need to demonstrate a reduction in acute care episodes for vulnerable older Australians, as well as improved oral health, life quality and avoidable hospitalisations, he says.
“Although the SDBS concept is solid, the exact detail of the scheme needs refinement—eligibility, potential extra funding for subsets of the eligible groups, sub-limits or caps for treatments, and extra funding for some procedures—for example, removable prosthodontics—that might otherwise exceed any caps.”
Technically, an SDBS could be introduced quite quickly, with the legislative framework already in existence thanks to the existing Child Dental Benefits Schedule (CDBS), Dr Sanzaro explains.
Conceding approval of a SDBS is subject to a variety of factors including the appetite of government, the speed of policy making, eligibility criteria and funding arrangements. The ADA will work with the government, stakeholders, and media to push for improved funding for all priority groups, Dr Sanzaro says.
He remains confident the individual stories that emerged from the first pilot will be repeated in future pilots and is hopeful it will be looked upon favourably by future decision-makers.
“The lead-up to the last election demonstrated that there is strong community demand for improved dental funding and the government’s language changed over the campaign,” Dr Sanzaro says.
“Although the government and ADA’s long-term vision for dentistry funding are not aligned, the ADA looks forward to working with the government on implementing sensible short- to medium-term solutions where we do align.”
