Accomplishments

Box 3.1 Dr Shanahan on putting the mouth back into the body

I'm here today to advocate on behalf of the 11.6 million Australians with chronic disease. This is a longstanding gap that affects them and the health system. It is the exclusion of oral health from primary health care.

Infection is infection irrespective of its location, and it's generally caused by pathogenic bacteria. The consequences are usually evident clinically but often the cause is not evident because bacteria are not visible and chronic infection is symptomless. So, besides clinical examination, investigation often requires radiography and microbiology, which are available to medical practitioners under Medicare but are not available to oral health providers.

Pathogenic oral bacteria have no boundaries. They can escape from the mouth and cause problems outside it, so this is a medical, not a dental, issue. Medical practitioners are responsible for healthcare outcomes. As soon as bacteria cause health problems, the priority is infection control. Medically necessary care is essential health care and is covered by Medicare legislation, but this is not. It is arbitrarily treated as dental and personal care and therefore excluded from Medicare legislation and health policies.^[9]

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