Who lives in Australia and how they access dental care is set to undergo significant change by 2030. What must dentists do to ensure the profession remains relevant and profitable into the future? By Angela Tufvesson
By 2030, Australia’s population is set to exceed 30 million, and one in five people will be aged over 60. University graduates will jump from one in four to eventually number one in two, but wealth will be distributed less equally.
So, what does this mean for the future of dentistry? Are practices likely to have a larger, more affluent client base? Will the growing older cohort add to demand for dental services? And what of the impact of technological development and continued oversupply of dental graduates on the profession?
Much has been written about Australia’s ageing population, and the 2016 census reveals the trend is set to continue. By 2030, as many Australians will be aged over 60 as under 20 and the older cohort will be more active than ever, says Mark McCrindle, head of social research firm McCrindle.
“Someone in their mid-60s can expect to live into their late 80s, and not only are there more people in the older age category but they are more active in those older years,” he says. “People are moving into aged care support later in life, people are independent longer and they are active as consumers later.”
Dr Joanna Gray, a coach and trainer from dental practice consultancy Momentum Management, says this means demand for quality dental care and cosmetic dentistry later in life will increase. Crucially, she says, practices that work with clients to develop clinical and financial plans for the future are well-placed to retain and benefit from older clientele.
“One of the big opportunities for dental practices is what I call retirement planning for the teeth,” she says. “And it’s not just the teeth—it’s the financial side of it as well. Smart practices have started to talk to their roughly 60-year-old patients about how they want their teeth to be when they’re older and looked at how to plan for that now, clinically and financially.”
Haves and have-nots
Most Australians fancy themselves as middle-class folk on average incomes, but the reality is wealth inequality is on the rise. Our Gini coefficient—a global measure of income spread—is now at its highest level ever, and the wealthiest 20 per cent of Australians own 71 times that of the poorest 20 per cent.
“With the oversupply of dentists in Australia you will see a push-down in wages and the reality is that makes it a more competitive market.”—Dr Hugo Sachs, president, ADA
“We’ve got a rising standard of living, full-time annual earnings are around $80,000 and net wealth is higher than ever,” says McCrindle. “But at the same time, we have a rising cost of living, rising utility bills and a bigger gap between the wealth categories. There’s a fragmentation of spend categories now and into the future compared with what we’ve seen in the past.”
Dr Hugo Sachs, president of the Australian Dental Association, says in the dental industry this phenomenon is best illustrated using a model of thirds. “There are many surveys that show us that a third of people have a regular dental check-up every two to three years, a third only turn up for required needs and there is another third that will never turn up,” he says.
Encouraging those who never go to the dentist to make an appointment for required care and those who only show up for required care to have a regular check-up would help to fill dentists’ appointment books, but Dr Gray says growing wealth inequality will likely prohibit a significant proportion of the population from accessing private dental care.
“The problem that we’ve got in Australia is there’s still a significant portion of the population that isn’t going to private practices,” she says. “Some are managing to get into the public system but some aren’t seeing dentists at all.”
And for patients who have private health insurance, cost of living pressures mean many may continue to prefer to attend practices where fees are fully covered by their health insurer. “The dental population is being segmented into a high-end, full-fee service for wealthier people, while the majority of people are happy to go to a health fund clinic where they pay nothing or next to nothing,” says Dr Phillip Palmer, chairman of dental practice management company Prime Practice.
Too many cooks
Despite Australia’s growing population—and even if dental practices are able to attract older clientele with the means to access the private system—an oversupply of dentists means many practices will continue to struggle and university graduates face increasing competition for jobs.
“A lot of the skills that I have, in 20 years’ time, those skills will be redundant and you’ll find computerisation has come to the fore.”—Dr Hugo Sachs, president, ADA
“In terms of the number of eligible patients, the type of patients who are going to go to a private practice, we’re probably at saturation point and on the verge of being oversupplied with dentists,” says Dr Gray. “And the current market is absolutely saturated in most places with dental practices. A lot of practices are opening up that are surprisingly quiet.”
Dr Sachs says Australia graduates approximately 1,200 new dentists each year but only about 550 dentists retire in the same period. “There is pretty stiff competition for jobs out there,” he says. “We have evidence of young graduates not obtaining full-time employment, or to gain full-time employment they need two or three jobs. With the oversupply of dentists in Australia you will see a push-down in wages and the reality is that makes it a more competitive market.”
Service and technology matter
Thankfully, however, many industry commentators agree the quality of service provided by dentists will continue to be the main determinant of success for both salaried employees and practice owners, especially given the future impact of technology.
A report published this year by The Foundation for Young Australians predicts that by 2030 there will be a reduction in the need for workers to complete routine, manual tasks and an increase in the time workers spend focusing on people and gaining value from technology.
“In order to keep a recurring practice stream of check-ups and cleans, dentists need to add value rather than lose the patient to a free clinic,” says Dr Palmer. “It’s going to have to be on a service and communication level. I don’t believe dentists have to add value from extra services but on the way their services are given.”
Indeed, Dr Sachs says dentists must keep up with changes in technology or risk falling victim to outdated skill sets. “The whole of dentistry is becoming revolutionised in the way in which it’s provided. A lot of the skills that I have, in 20 years’ time, will be redundant and you’ll find computerisation has come to the fore.”