Dental health in a world of pain

I HAVEN'T been to Kathmandu since 1981, but it was in my mind this week as the federal government released a report recommending a Medicare-style system for dental health.

Given the report had been in government hands since December, releasing it the day the ALP resolved its self-imposed leadership headache seemed odd. They wouldn't be wanting to bury it, would they?

Health Minister Tanya Plibersek was quoted as welcoming the document, adding that implementing the plan would have to be ''managed in a fiscally responsible way'' - code for saying the report was not particularly welcome, because they didn't want to spend the money.

The dental health problem is important. Big and increasing numbers of lower-income Australians face finding themselves just plain toothless. The cost of private dental care in this country is a reason. The report found 34 per cent of the population avoided visiting the dentist because of the cost, and there were about 400,000 on the waiting list for public dental care, a wait of up to five years.

Unlike the government, I did not have a headache during the week of Kevin Rudd's attempt at a prime ministerial second coming. But I did have toothache - blinding pain from an abscess behind an apparently dead tooth.

To solve it I was offered two options and two levels of pain - both financial. The first would have extracted the tooth and cost about $250. The second would keep the tooth via a root canal procedure costing $1600, topped off with a crown costing something similar. In other words, keep the tooth and extract the wallet.

Given the tooth is a premolar, my dentist said a gap caused by an extraction would not show. That is what a great deal of modern dentistry has become - smile management.

I don't dismiss the importance of smiles. As employment opportunities are increasingly located in the so-called service industries, a good set of teeth and the willingness to show them are a proven advantage. I am particularly fascinated by commercial television news presenters, who have an amazing ability to recount disaster and tragedy with their incisors and canines locked rigidly on display. Rudd showed a similar talent after his hammering.

My issue was not related to my smile. I was concerned about a more basic tooth function - eating. Given I had had a molar removed when I was 12, causing many adjacent tooth problems,

I opted for the root canal job.

The procedure took place during the exact hour the Labor caucus was giving Rudd that hammering. But while I was on my back, mouth jammed open and finely ground particles of the tooth I had eaten with since six were sucked down the drain, my thoughts were not in Canberra, they were in Kathmandu.

Flashing through my mind was the ghoulish sight of secondhand dentures on display in shop windows. From travellers' photos I gather the practice still continues. Poor Nepalese with bad teeth have them all extracted and then chew on dentures that had once been masticating for someone else.

These days there is a new clientele in the city for dentures and all forms of dentistry: Westerners avoiding the crippling costs at home.

I was also thinking this week how on earth an average retiree in Australia could afford what was going in my mouth.

There are 32 teeth in most people's mouths. What if half of those teeth need what my dead tooth needed this week? Many so-called average Australians have a superannuation nest egg of about $100,000, so that's half of it gone on just dentistry.

It is unlikely that such people would be able to afford overseas dental treatment, but a number of my friends have, with good results. Before our dentists start expressing outrage at losing work to overseas counterparts, it's worth reflecting on this: in my dental surgery car park this week, not one car apart from mine was Australian-made. Most of them were German. Are dentist jobs any different to those of our automotive workers, the bank employees or any others whose management find it better value to get the work done overseas?

So in this spirit, I suggest to a government worried about the cost of universal dental care, a simple solution: provide free air tickets to Bangkok, Singapore or even Kathmandu for anyone with a toothache.

Geoff Strong is a senior writer.