Fewer dentists, spread over a large area, where people have lower incomes.
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These are among the reasons that people living in outer-regional, remote and very remote areas see dentists less frequently according to Professor of Oral Health at LaTrobe University Bendigo, Mark Gussy.
About 44 percent of people living in outer regional, remote and very remote areas had seen a dentists in 2017-2018, compared to 52 percent of those living in major cities, according to the Australian Institute of Health and Welfare.
Just 40 percent of people living in the areas of most socio-economic disadvantage had seen a dentist in the previous financial year, compared to 61 percent of people living in the areas of highest socio-economic advantage.
Maryborough dentist Simon Sheed said recruiting and retention were the problems in regional areas, such as Maryborough.
Dr Sheed said practising alone could be a scary prospect for dental and medical professionals, especially recent graduates.
Maryborough was well supplied with private dentists but those who could not afford private care had trouble accessing a public dentist, Dr Sheed said.
The Maryborough District Health Service had a 22 month wait time for general dental care in 2017/2018.
More than 1,700 people were on the waiting list for general care.
The clinic had 0.2 full time equivalent dentist on staff for the financial year.
Rochester oral health therapist Ketki Shenai said availability of dentists could be a factor which kept people from dental care in the area.
The clinic draws patients from as far away as Lockington, Tongala and Elmore.
"I know when we go down to Melbourne there's a dental clinic every few kilometres," Mrs Shenai said.
"In this sort of area, Rochester and Echuca, we've only got about four dental practices. Then in Elmore they have maybe a visiting dentist once a week."
Professor Gussy said that Bendigo was very well supplied for dentists, but that rural towns like Maryborough, Elmore, Castlemaine and Echuca would likely have a similar pattern to elsewhere.
Professor Gussy said the burden of cost for dental care is greater for those in rural areas.
While there might be a similar ratio of dentists per thousand population in rural areas to major cities, often people have to travel further to access dental services, he said.
Incomes are generally lower in rural areas, while travel, lost work hours and childcare, make it actually more expensive, Professor Gussy said.
"The income of people living in those areas is much lower than it would be in metropolitan Melbourne, so the burden of the cost of a visit is much greater," Professor Gussy said.
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