The Medicare Chronic Disease Dental Scheme: Historical, Scientific, Socio-political Origins.

While evidence and expert opinion are the foundations of effective policy, the politics, economics, and timing of a proposal can affect outcome. Australian government involvement in the planning, funding and delivery of dental services has been minimal and inconsistent. Many believe that the hybrid dispersal model of shared constitutional power has intermittently led to poor administration of national health policy. Throughout the decade-long prelude to the introduction of the Chronic Disease Dental Scheme, a landmark health policy in Australia, Parliamentarians moved responsibility for public dental services of disadvantaged Australians into an impasse between the Federal, State, and Territorial Governments. Developments throughout the era confirm the influence of administrative intrigue, centralized authority, competing priorities, funding pressures, political strategy, public opinion, scientific evidence and the timing of a proposal on the formulation and implementation of oral health policy. Synchronized inter-governmental collaboration was also absent. Moreover, the impasse and its resolution immediately before a national election demonstrate the bipolar roles of centralized political authority and political resolve in either obstructing or implementing policy. The historical, scientific, and socio-political contexts undermining the preamble to the Chronic Disease Dental Scheme lend weight to concerns about the hybrid dispersal model of constitutional power.

The genesis and development of the Endodontic Study Club of Brisbane (1964-1970).

This narrative delineates the International, Australian and Queensland settings, between 1940 and 1970 that impeded the development of endodontology and evidence-based endodontic practice. It explores the genesis of the Endodontic Study Club of Brisbane between 1964 and 1970. Pioneers' contributions to endodontology in Australia, together with contemporaneous problems, are identified. The author used literature review and historic method. The historical and constitutional backgrounds contributed to the disjointed origins of the Australian Society of Endodontology, which were networked but autonomous study clubs that appeared in capital cities between 1960 and 1965. This was an era when dental education in Queensland was emerging from serious problems. Brown and Simpson liaised with Ehrmann and established the Endodontic Study Club of Brisbane. Members of the Endodontic Study Club of Brisbane were collegiate, disciplined, few, innovative, insular, isolated and visionary. Membership demanded a commitment to self-education, collective learning and peer review.

Diagnosis and management of a maxillary lateral incisor exhibiting dens invaginatus and dens evaginatus.

This case report, involving an indigenous Australian, presents the diagnosis and non-surgical endodontic management of a 22 with developmental abnormalities. They include a dens evaginatus and a dens invaginatus that extends to an apical burst in a second truncated root. Cone-beam computed tomography and endodontic microscopy were not available to the clinician. This case report focuses on ambiguities appearing in the literature relating to classification and terminology associated with the abovementioned developmental anomalies. It also demonstrates the need to methodically collect and cautiously interpret available information before initiating endodontic intervention. Axial inclination, distance perception, internal demarcation and spatial awareness, together with an understanding of dental anatomy, embryology and histology and associated physiology and pathology, allowed the clinician to accurately predict the point, the angle and the depth of coronal access. Sensibility of the dentino-pulpal complex was maintained. Critical thinking, experience, innovation, problem-solving and established principles can compensate for inaccessible technologies.

Twentieth century influences on Queensland dental practice: a tangential view.

Political scientists, historians and journalists intermittently suggest that, within the Australian context, public policy and its administration in Queensland are different. Significant evidence suggests that, from colonial times, distance and decentralization have influenced Queenslanders' demographic profiles and collective identity. Using historical analysis to qualify and quantify both the alleged difference and its social significance warrants caution. Nonetheless, some developments in public dental policy and the practice of dentistry across Queensland provide intriguing contrasts. This study, a literature review, uses historical method. The authors focus on pivotal proceedings that affected both the dental profession and dental practice in the twentieth century. These events embraced the genesis and evolution of dental education and influenced fluoride politics and policies controlling the delivery of public dental services. These developments reflected not only the contemporaneous social and political fabric but also the broader influences on Queensland history, namely: area, distance, decentralization, groundwater, isolation and topography. The events and observations in this report lend some support to hypotheses concerning a Queensland difference within the Australian context of public policy and its administration.

Fluoridation advocacy in Queensland: a long and winding road.

BACKGROUND: By 1977, all Australian states and mainland territories, with the exception of Queensland, had widely implemented adjusted water fluoridation. This disparity in public health policy persisted until 2008. METHODS: This study analyses the sociopolitical and socioeconomic backgrounds that underpinned the repeal of the Fluoridation of Public Water Supplies Act (1963) and its replacement with the Water Fluoridation Act (2008). The authors used a literature review and historic method. References are in the public domain. RESULTS: The devolution, without funding, of a discretionary local authority power to fluoridate contributed to the perennial low fluoridation status in Queensland. A window of opportunity for fluoridation advocates opened between 2003 and 2008. Now that 87% of Queenslanders have access to optimally fluoridated water, Queensland premier Anna Bligh has largely delivered on a promise made in 2007 to fluoridate water supplies across the state. CONCLUSIONS: The implementation of adjusted water fluoridation requires not only political stability and resolve, but also centralised authority. The last of these factors must embrace the decision, the funding and the indemnity. State control over water-related infrastructure and water treatment enhances prospects for fluoridation. The roles of opinion polls, internal advisers and departmental figures are also confirmed. Political repercussions were minimal.

Risk perception and water fluoridation support and opposition in Australia.

OBJECTIVES: A considerable body of evidence confirms that water fluoridation effectively reduces the community incidence of dental caries with minimal side effects. However, proposals to introduce this widely endorsed public-health measure are often perceived as controversial, and public opinion frequently plays a role in the outcome. Despite this, the public's perception of risk associated with water fluoridation has not been well researched and remains poorly understood. Our objectives were to determine whether risk perceptions reflecting various "outrage" factors are associated with water fluoridation support and opposition. METHODS: We conducted a cross-sectional questionnaire survey of a national sample of 517 Australian adults (response rate = 34.7 percent) aged 18-92 years. RESULTS: Approximately 70.5 percent of respondents supported water fluoridation, with 15.1 percent opposed and 14.3 percent neutral. Sixteen of the 20 assessed outrage factors were significantly associated with water fluoridation stance in the predicted direction, with greater outrage being related to increased water fluoridation opposition. An overall outrage index computed from the 16 significant outrage factors accounted for a statistically significant 58 percent of the variance in water fluoridation stance beyond the effects of age, gender, socioeconomic status, and age and presence of children. CONCLUSION: Outrage factors are important aspects of the public's perception of risk in relation to water fluoridation. Given that water fluoridation appears to be a low-risk, high-outrage controversy, efforts to mitigate the level of public outrage, rather than continuing to deny possible hazards, may offer a worthwhile strategy in gaining public acceptance for the extension of water fluoridation.