A Senate committee says the government should bite the bullet on public delivery of dental care and ways to boost the oral health workforce.
A challenge to chart a path to universal access to dental and oral health care has been laid at the feet of the federal government.
A Senate inquiry into dental services which reported on Thursday described the sector as a "system in decay".
The report called on the government to work with the states and territories to achieve universal access to dental and oral health care through Medicare or a similar scheme.
The committee implored the government to consider a seniors dental benefit scheme and a plan to expand access to the child dental benefits schedule to all children.
"The community has shared clearly that dental care is too expensive, people are waiting too long to access public dental care, if they're eligible at all, and we must do more to support our oral healthcare workforce," committee chair and Greens senator Jordon Steele-John said.
The overhaul should be led by a chief dental officer within the federal health department, the report said.
To boost the workforce, consideration should be given to setting up dental schools at regional universities and expanding medical student rural subsidy programs to dental and oral health students.
The committee found more than 85 per cent of dental care in Australia was delivered in private, for-profit dental clinics and Australians paid out-of-pocket for almost 60 per cent of all services received.
Public services were overstretched, understaffed and wait times for non-urgent care stood at 12 to 24 months.
As a result, 40 per cent of Australians avoided or delayed seeing a dentist.
An adult oral health study quoted in the report found one in three adults had untreated tooth decay, one in five regularly experienced toothache and one in 10 had severe tooth loss (less than 21 teeth).
The bipartisan committee noted a universal dental scheme would "come at a substantial cost, and with significant risks".
The Parliamentary Budget Office put the cost of an uncapped universal dental scheme at $25 billion over the next three years, while a seniors-only scheme could cost $4 billion.
"Public dental services are ill-equipped to handle an increase in patients, and many parts of Australia are currently under-serviced in terms of workforce capacity," the report said.
"Any new or expanded scheme would need to be introduced in stages, and the workforce would need to be gradually increased."
The report recommended allowing dental therapists to deliver basic diagnostic and preventative services, and boosting funding for preventative schemes.
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