A shortage of dental services across the Northern Territory is placing a significant cost burden on health services, and has led to many basic infections becoming life threatening according to a leading Darwin surgeon.
Mr Mahiban Thomas, a head and neck surgeon and also Chair of the NT Regional Committee of the Royal Australasian College of Surgeons (RACS), presented his research findings to the RACS SA, WA and NT Annual Scientific Meeting held in Alice Springs.
His five-month study focussed on patients with deep space neck infections, who presented to Royal Darwin Hospital. It found that in most cases emergency medical treatment could have been avoided had dental treatment been administered earlier.
"Most of the infections that we see could have been treated as simple dental infections at one point in time, but by the time they get to us they have become life threatening. For example, a patient might not be able to breathe properly.
"Surprisingly head and neck infections occur in typically younger patients with a median age under 30, and more likely in males. These problems are far more common in people that overuse alcohol ortobacco, and Aboriginal and Torres Strait Islander patients were significantly overrepresented in our numbers."
Dr Thomas believes that the lack of funding for dental services in the NT Health system is partly to blame for the problem, and he believes that greater resourcing will lead to reduced costs over time.
"In our study we calculated that the cost of treating these patients in hospital was almost $390,000, which would equate to approximately $935,000 over a one-year period. If we spent this money on clinical dentists instead we could halve these costs and relieve pressure on hospital beds."
"In the NT unless you have a health card or a pension card you are reliant on private dental cover, which is a significant barrier to those who can't afford it. Most other jurisdictions have greater public access to dental services, for example there are dental schools where patients can get care for free or for very little. Unfortunately we don't have anything like that here.
"The infections can be very complex, but they can be handled very simply when we have the resources to stamp them out early. Therefore, we need to invest to save.
"Many of the patients that we see end up having to spend long periods of time in the intensive care unit ICU). It is often not just a single procedure that needs to be performed, and returns to theatre are quite common.
"Between April and September 2017 at the Top End Health Service we saw 42 patients who stayed in hospital for two days, 17 whose length of stay was greater than three days, nine who stayed over five days, and four who stayed longer than a week."
"It makes sense for the NT government to change its strategy and to invest in senior dentists within the hospital system who will help to work with these clients, and to defuse the situation before it goes too far. Ultimately this will save money, save bed spaces, and reduce the surgical workload allowing us to focus our attention on other areas of need."