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Disparities in care access for health conditions where physiotherapy can play a major role are abetting health inequities. Spatial analyses can contribute to illuminating inequities in health yet the geographic accessibility to physiotherapy care across New Zealand has not been examined. This population-based study evaluated the accessibility of the New Zealand physiotherapy workforce relative to the population at a local scale. The locations of 5,582 physiotherapists were geocoded and integrated with 2018 Census data to generate 'accessibility scores' for each Statistical Area 2 using the newer 3-step floating catchment area method. For examining the spatial distribution and mapping, accessibility scores were categorized into seven levels, centered around 0.5 SD above and below the mean. New Zealand has an above-average physiotherapy-to-population ratio compared with other OECD countries; however, this workforce is maldistributed. This study identified areas (and locations) where geographic accessibility to physiotherapy care is relatively low., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Objectives: To investigate the oral care habits and assess the determinants of oral care behaviour among people with diabetes in the Republic of Mauritius., Methods: The present study draws on data collected from 589 dentate persons with diabetes by means of a close-ended questionnaire. Multivariate logistic regression analyses were used to estimate the association of different demographic and clinical factors with recommended dental hygiene practices., Results: The majority of the participants brushed at least twice daily (84.2%), never flossed (88.6%), attended dental clinics on need only (87.1%), and did not monitor their blood glucose levels regularly (69.9%). Neither awareness about the increased risk of periodontal disease and xerostomia nor receiving advice from diabetes care providers was found to be associated with good oral hygiene or increased service utilisation. The experience of oral diseases did not encourage recommended oral health practice, with participants without experience with periodontal disease being 3 times more likely to floss (odds ratio [OR], 2.9; P = .045). Regular dental visits were strongly associated with self-reported type 1 diabetes (OR, 7.8; P = .025). Participants from urban areas were more than twice as likely to visit their dental care provider at least once annually (OR, 2.3; P = .006). Regular dental attendance (OR, 3.7; P = .011) and flossing (OR, 4.5; P = .012) were strongly associated with one another., Conclusion: There is widespread noncompliance with regular flossing and dental service utilisation. Our findings highlight the need for an emphasis on preventive care through the provision of integrated medical and dental interventions to high-risk individuals suffering from both diabetes and chronic periodontitis., Competing Interests: Conflict of interest None disclosed., (Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Persistent hyperglycaemia in patients with uncontrolled or poorly controlled diabetes may cause serious oral and systemic complications. Persons with diabetes are mostly unaware of their increased risk of oral complications., Objective: This study investigated awareness about the association of diabetes with other diseases and knowledge about the systemic and oral complications of diabetes among patients with diabetes in the Republic of Mauritius., Methods: Data were collected from 720 patients with diabetes using an anonymous closed-end questionnaire. Descriptive statistics and multivariate logistic regression analyses were used to report the results and to identify factors associated with awareness about the link between diabetes and other diseases and knowledge about oral and systemic complications., Results: The majority of the study participants were aware of the association between diabetes and other diseases. However, knowledge about oral complications of diabetes was limited (caries [29%], periodontal disease [37%], and xerostomia [52%]). Education and the number of years since diagnosis of diabetes were the most significant predictors of awareness about complications. The experience of xerostomia and periodontal disease were associated with knowledge about their respective increased risk. Receiving advice from diabetes care providers increased awareness about caries and periodontal disease. Age and type of diabetes were associated with knowledge about systemic complications., Conclusion: Awareness about the oral complications of diabetes was limited and was mainly linked with the experience of disease. This indicates a need for increased health promotion with customised educational programs to inform patients with diabetes of their increased risk of developing complications., Competing Interests: Conflict of interest None disclosed., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

Aim: To address deficits in human resources for oral health data (HROH) in rural and remote areas in Wales, Scotland and Northern Ireland by spatially profiling and modelling the distribution pattern of dental practices according to Health Boards., Methods: National Health Service (NHS) dental practices were located and mapped against population and rural-urban classifications of Scotland, Wales and Northern Ireland, using Geographic Information System (GIS) tools. All data collected were at the smallest geographical statistical hierarchy level in each country, and population data were retrieved from the 2011 census., Results: A total of 1,695 NHS dental practices were mapped against 27 Health Board regions. In Scotland, Northern Ireland and Wales, 18.3%, 18.7% and 7.7%, respectively, of the population living in the most remote areas resided within 2.5 km of a dental practice. In each country, the Health Boards with the largest proportion of the population living more than 10 km from a dental practice were the Western Isles (Scotland), Western Health and Social Care Trust (HSCT) (Northern Ireland) and Hywel Dda University Health Board (UHB) (Wales). In each country, the highest practice-to-population (PtP) ratios were found in Forth Valley (1:7,194) (Scotland), Southern HSCT (1:5,115) (Northern Ireland) and Hywel Dda UHB (Wales) (1:7,907)., Conclusion: Dental services are distributed unequally between urban and rural areas. PtP ratios coupled with GIS analysis are important tools to improve HROH distribution., (© 2020 FDI World Dental Federation.)

Objectives: Dentists are independent prescribers that can prescribe subsidised medicines under the Australian Pharmaceutical Benefits Scheme (PBS). It is hypothesised that increased dental prescribing can partly be accounted for by the growth in both the Australian population and the number of practising dentists. This pharmacoepidemiological study aims to determine the dispensing patterns of medications amongst dentists and to identify trends over time., Materials and Methods: Data on dental medications under PBS from 2006 to 2018 were accessed. All the dentist-prescribed concessional medicines dispensed at pharmacies in 2018 were included for time trend analysis. Cumulative dispensing counts and defined daily dose (DDD) per 1,000 concessional population days (DPD) were analysed for time trend analysis., Results: Out of the 56 medications within the dental PBS schedule, the top 20 medicines had a total cumulative dispensing count of 5,058,556, which accounts for 97.4% of the total dispensing count. Eleven out of 20 medicines were antibiotics. Overall, increases were observed for seven out of 20 medicines (amoxicillin + clavulanic acid, clindamycin, ibuprofen, diazepam, oxycodone, tramadol, naproxen) in both dispensing count and trend, as expressed per DPD., Conclusion: This study highlights the increasing dispensing pattern and trends of dentist-prescribed antibiotics, opioids and benzodiazepines. Further investigation may be required to determine whether the medicine use is appropriate. In the future, this could provide new educational opportunities on the appropriate use of medicines for dentists., (© 2020 FDI World Dental Federation.)

Objective: As the population ages, dentists are likely to encounter medical emergencies due to metabolic factors and polypharmacy. To date, there have been no documented studies in Australia that have analysed the prescription rate of Pharmaceutical Benefits Scheme (PBS)-funded emergency medicines for dentists. Therefore, this pharmacoepidemiology study aims to describe the dispensing patterns of emergency medicines as prescribed by dental practitioners, related to medicines covered by the Australian PBS system., Methods: Data on dental medications used for emergencies, under the PBS, from 1992 to 2018, were accessed. Cumulative dispensing counts were calculated. Data on medications that were not utilised were also collected in the form of the crude cumulative count., Results: Out of the 56 medications on the dental PBS schedule, eight were utilised for medical emergencies, with a total of 432 prescriptions on a national level, over 27 years. The commonly utilised lifesaving medicines of adrenaline, glucagon, as well as glyceryl trinitrate, had a total prescription count of 147, 88 and 27 respectively. Medicines used for opiate overdose; naloxone, had a total prescription count of one. Only one medicine (benztropine injection) for medical emergencies had a prescription count of 0., Conclusion: This study highlights the dispensing patterns of medicines prescribed by dentists for emergency scenarios. Although this study did not assess the appropriateness of use of the emergency medicines, further investigation may be required to ensure the future safety of patients when encountering emergency scenarios., (© 2020 FDI World Dental Federation.)

Objectives: While complementary and alternative medicine (CAM) is used by more than half of Australians, its role in dentistry is rarely covered in the curricula of Australian dental schools. This study aimed to investigate dental students' knowledge of and attitudes towards CAM., Design: Australian dental students in the final two years of their study were invited to undertake a survey. These questions consisted of five clinically relevant case vignettes, for which there was only one correct answer amongst four possible options and seven self-reported perspective-based questions. Results were analysed using descriptive statistics., Results: Of the 185 students that participated, the mean correct response rate for the five clinical scenarios was 3.46 ± 0.95 (range: 0-5 out of 5). Of 185 students, 157 (85 %) answered more than half of the questions correctly. All five questions were answered correctly by 19 (10 %) students. Most (74 %) students self-reported to have little to no knowledge. More than two-thirds of dental students reported an interest in and belief in the effectiveness of CAM. A similar proportion expressed a desire for the integration of CAM content into their undergraduate curriculum., Conclusions: Despite approximately three out of four of dental students in this study having little to no knowledge on CAM, attitudes towards CAM therapies, and the need to integrate them into the dental curriculum, were generally positive. Future research into identifying specific knowledge gaps could help to redesign improved dental curricula., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Objectives: To investigate the distribution of groundwater fluoride levels in Sri Lanka in relation to its population distribution to determine the population at risk for dental caries or dental fluorosis., Methods: The study used the most upgraded spatial distribution map of groundwater fluoride levels in Sri Lanka, and it was overlaid with a census of population data of the country., Results: The results indicated that 12% of children aged <12 years were at risk for dental fluorosis, while 81.4% of those who lived in low-fluoride zones were vulnerable for development of dental decay. Overall, 82.4% of the country's population lived in low-fluoride zones and 11.2% were at risk of potential health hazards posed by ingestion of excessive fluoride., Conclusion: The spatial approach provides a useful decision-support tool for developing an oral health strategy of safe fluoride use based on predicted oral health risks in communities., (© 2019 FDI World Dental Federation.)

Objective: The aim of this study was to analyse, in detail, the distribution of primary dental clinics in relation to the Malaysian population and relative population wealth, to test the hypothesis that an uneven distribution of dental services exists in Malaysia., Method: This 2016 study located every dental practice in Malaysia (private and public) and mapped these practices against population, using Geographic Information Systems (GIS) tools. Population clusters within 5, 10 and 20 km of a dental clinic were identified, and clinic-to-population ratios were ascertained. Population data were obtained from the Population and Housing Census of Malaysia 2010. Population relative wealth was obtained from the 2014 Report on Household Income and Basic Amenities Survey for Malaysia. The physical address for each dental practice in Malaysia was gathered from the Official Portal of Ministry of Health Malaysia. All data for analysis were extracted from the integrated database in Quantum GIS (QGIS) into Microsoft Excel., Result: The population of Malaysia (24.9 million) was distributed across 127 districts, with 119 (94%) having at least one dental clinic. Sixty-four districts had fewer than 10 dental clinics, and 11.3% of Malaysians did not reside in the catchment of 20 km from any dental clinic. The total dental clinic-to-population ratio was 1:9,000: for public dental clinics it was 1:38,000 and for private clinics it was 1:13,000., Conclusion: Dental services were distributed relative to high population density, were unevenly distributed across Malaysia and the majority of people with the highest inaccessibility to a dental service resided in Malaysian Borneo., (© 2018 FDI World Dental Federation.)

Objective: To estimate the scale of resource transfer that could be achieved by screening low-risk schoolchildren using teledentistry rather than using traditional visual dental examination., Methods: This study was based on a previous cost-minimisation study that compared the costs of two dental-screening approaches (visual and teledentistry). The data for the population of children 5-14 years of age was obtained from the Australian Bureau of Statistics and was divided across Australia according to statistical local area (SA2). The cost models (for teledentistry and visual screening) for each SA2 relative to the state, Remoteness Area (RA) and Socio-Economic Index for Area (SEIFA) indexes were estimated. The geographical information system was used to superimpose modelled cost data on the geographical map to provide a visual presentation of the data. Resource transfer scenarios, based on risk minimisation, were then developed and analysed., Results: This study demonstrated a suboptimal allocation of dental-care resources, such that children living in high socio-economic areas (major cities) with low disease burdens consuming half of the estimated resources of a universal visual dental screening system. The findings suggest that utilising teledentistry screening for low-risk children has the potential to free up $40 million per annum. Such resources can be reallocated to increase care access and improve the quality of dental services for vulnerable children., Conclusion: To reduce inequalities in dental health within a community, scarce health-care resources should be targeted at the population at most risk. These findings can be used to inform policymakers, guide the appropriate distribution of scarce resources and target dental services to benefit high-need children., (© 2018 FDI World Dental Federation.)

Objectives: Brazil is one of the largest countries in the world, in terms of geography and population. Most Brazilians reside in the south and south-eastern regions, with notable numbers in the regions' megacities, such as São Paulo city. Healthcare provision in such a complex environment is difficult. Thus, a clear understanding of the distribution - or rather, the maldistribution - of these services is fundamental for optimising the allocation of human and financial resources to areas of greatest privation. The present study aimed to determine the distribution of primary dental clinics in São Paulo city., Methods: A total of 4,101 primary dental clinics in São Paulo city were identified and geocoded. Clinic locations were integrated with the city's 19,128 constituent census tracts - each containing sociodemographic data for the 11,252,204 residents - using Geographic Information Systems (GIS)., Results: Approximately two-thirds (64.8%) of the population resided within 0.5 km of a primary dental clinic, and a further 23.9% were within 1 km. Populations more than 1 km out were typically characterised as sociodemographically disadvantaged. Primary dental clinics were also more sparsely distributed in the city's peripheral census tracts than central census tracts., Conclusion: Primary dental clinics are maldistributed in São Paulo city, with disadvantaged populations having less spatial access than their advantaged counterparts., (© 2017 FDI World Dental Federation.)

Different non-invasive methods have been proposed for dental age estimation in adults, with the Kvaal et al. method as one of the more frequently tested in different populations. The purpose of this study was to apply the Kvaal et al. method for dental age estimation on modern volumetric data from 3D digital systems. To this end, 101 CBCT images from a Malaysian population were used. Fifty-five per cent were female (n = 55), and forty-five percent were male (n = 46), with a median age of 31 years for both sexes. As tomographs allow the observer to obtain a sagittal and coronal view of the teeth, the Kvaal pulp/root width measurements and ratios were calculated in the bucco-lingual and mesio-distal aspects of the tooth. From these data different linear regression models and formulae were built. The most accurate models for estimating age were obtained from a diverse combination of measurements (SEE ±10.58 years), and for the mesio-distal measurements of the central incisor at level A (SEE ±12.84 years). This accuracy, however is outside an acceptable range in for forensic application (SEE ±10.00 years), and is also more time consuming than the original approach based on dental radiographs., (Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Despite great progress in oral health over the past three decades, the rates of caries remain high in Australia, particularly among underserved populations. The reasons for poor oral health amongst underserved populations are multiple, but rests with socio-economic determinants of health. The present review considers international workforce models that have been created to enhance the recruitment and retention of dental providers in rural areas. Several strategies have been developed to address care access problems in rural areas, including the use of telemedicine and mid-level dental providers (MLDPs). Despite ongoing opposition from dentistry organisations, the Alaska and Minnesota workforce models have proven that developing and deploying dental therapists from rural communities has the potential to address the unmet needs of underserved populations. It is more efficient and cost-effective for MLDPs to perform triage and treat simple cases and for dentists to treat complicated cases. The use of MLDPs is intended to increase the capacity of the dental workforce in areas that are too isolated to entice dentists. Telemedicine has emerged as one solution to address limited access to health care, particularly in locations where there is a lack of providers. Telemedicine not only provides access to care, but also offers support, consultations and access to continuing education for practicing dental providers in rural areas. This strategy has the potential to free up resources to increase care access and reduce oral health disparities, thereby contributing to closing the rural-urban oral health gap., (© 2016 FDI World Dental Federation.)

Measuring various items (evidence) at the scene of an investigation, exposed to the elements, is an instrumental part of systematic forensic science. The key to these measurements often rest on rulers, and a knowledge of their limitations is vital to their appropriate application. The aim of this study was to test forensic ruler accuracy and photographic distortion under conditions that simulate common use to provide a foundational basis for baseline accuracy of their use. A series of ABFO rulers from 2 anonymous manufactures were tested against gold standards for accuracy at various temperatures (-14, 0, 25 and 40 °C). At the same time a series of rulers were photographed at different angulations to test reproducibility and angular distortion. At room temperature a variation of 0.28% in the dimensions of the rulers were found with larger distortions at colder temperatures. Photographs taken with the camera above the rulers suffered the least distortion (approximately 6-10°) and there was no difference over time, nor with ruler background colour. The results from this study show that further investigation is required into preventing angular distortion, and show the need for increased training to those who would be in a situation requiring them to document the scene of a crime., (Copyright © 2016 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)

Objectives: We sought to understand disparities in dental insurance coverage among hospitalised Western Australian children and associated factors., Methods: This study analysed the data obtained for 43,937 child patients under the age of 15 years hospitalised for an oral-health related condition, as determined by principal diagnosis (ICD-10AM). Primary place of residency, age, gender, Indigenous status and socioeconomic status were also analysed., Results: Of our sample, 47.3% reported lack of dental insurance coverage. Non-Indigenous children were more likely to have dental insurance than Indigenous children. When insurance status was considered, Indigenous children were less likely to be hospitalised for dental treatment. Rural children were more likely to be uninsured than urban children. Lack of health insurance coverage was strongly associated with children living in very remote areas. These disparities were exacerbated among rural indigenous children. Disparities in dental insurance coverage and dental care are also evident by socioeconomic status., Conclusions: Better understanding of disparities in access to care among children, socioeconomic divide in oral health insurance coverage and subsequent development of intervention programmes, will be critical to improving Australian children's oral health., (© 2014 FDI World Dental Federation.)

Dentistry in Australia has faced, and continues to face, significant workforce issues, in particular, a grossly distorted workforce distribution. In this study, an analysis of the consequences for the workforce that would occur under a series of reduced maldistribution scenarios is examined and reported. Three different scenarios were tested based on existing dental practice to population data at a national level. This study clearly highlights the very significant maldistribution of practices in Australia. However, more importantly, it highlights that to address this maldistribution requires something in the order of a tenfold increase in dental practice numbers (and the commensurate increase in workforce), which is not possible (or reasonable). As a nation, Australia has to look to other methods of achieving equity in access to good oral health. The application of modes of care delivery including, but not limited to visiting services needs to be examined and extended. Clearly, these new methodologies are going to rely on non-dental health professionals taking a far more significant role in leading oral health-care models as well as the expanded application of technology to bring unique skill bases to areas where these skilled individuals do not (and will not) reside., (© 2013 FDI World Dental Federation.)

Introduction: In this study, we evaluated the reliability and validity of 3 bite registrations in relation to condylar position in the glenoid fossae using magnetic resonance imaging in a symptom-free population., Methods: Nineteen subjects, 14 men and 5 women (ages, 20-39 years) without temporomandibular disorders were examined. Three bite registrations were taken and evaluated on each subject: centric occlusion, centric relation, and Roth power centric relation. The differences in condyle position among the 3 bite registrations were determined for the left and right condyles: centric occlusion-centric relation, centric occlusion-Roth power centric relation, and centric relation-Roth power centric relation for each plane of space., Results: The results indicated that (1) all measurements collected had large standard deviations and ranges with no statistical significance, and (2) of the 19 subjects and 38 condyles assessed, 33 condyles (87%) were concentric in an anteroposterior plane. In the transverse anatomic plane, all condyles were concentric., Conclusions: The clinical concept of positioning the condyles in specific positions in the fossae with various bite registrations as a preventive measure for temporomandibular disorders and as a diagnosis and treatment planning tool is not supported by this study., (Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.)

Australia is the sixth biggest (by area) country in the world, having a total area of about 7.5 million km(2) (3 million square miles). This study located every dental practice in the country (private and public) and mapped these practices against population. The total population of Australia (21.5 million) is distributed across 8,529 suburbs. On average about one-third of the population from each State lives in suburbs without practices and 46% live in suburbs with one to five dentists. Of those living within the study frameset, 86.6% live within 5 km of a private practice and 84.4% live within 10 km of a government practice. Australia's dental practices are distributed in a very uneven fashion across its vast area. Three-quarters of suburbs have no dental practice and over one-third of the population live in these suburbs. This research clearly identified that in a vast and uneven socio-geographically distributed country, service planning, if left to market forces, will end with a practice distribution that is fixed by economic drivers of scale and not that of disease burden. A more population health-driven approach to future design and construction of government safety net services is needed to address these disparities., (© 2013 FDI World Dental Federation.)

This study developed a Monte Carlo simulation approach to examining the prevalence and incidence of dental decay using Australian children as a test environment. Monte Carlo simulation has been used for a half a century in particle physics (and elsewhere); put simply, it is the probability for various population-level outcomes seeded randomly to drive the production of individual level data. A total of five runs of the simulation model for all 275,000 12-year-olds in Australia were completed based on 2005-2006 data. Measured on average decayed/missing/filled teeth (DMFT) and DMFT of highest 10% of sample (Sic10) the runs did not differ from each other by more than 2% and the outcome was within 5% of the reported sampled population data. The simulations rested on the population probabilities that are known to be strongly linked to dental decay, namely, socio-economic status and Indigenous heritage. Testing the simulated population found DMFT of all cases where DMFT<>0 was 2.3 (n = 128,609) and DMFT for Indigenous cases only was 1.9 (n = 13,749). In the simulation population the Sic25 was 3.3 (n = 68,750). Monte Carlo simulations were created in particle physics as a computational mathematical approach to unknown individual-level effects by resting a simulation on known population-level probabilities. In this study a Monte Carlo simulation approach to childhood dental decay was built, tested and validated., (© 2013 FDI World Dental Federation.)

Objectives: New Zealand is a country with a relatively small population (4 million people) distributed unevenly over a relatively large land area. Adult oral health services in New Zealand are almost all delivered through a market-driven, private practice model and are funded directly by patient payments. Little attention has been given to the distribution of these services. This study reports the findings of a high-acuity examination of the distribution of private dental practices in New Zealand, using modern geographic information system (GIS) tools., Methods: A total of 1,045 private dental practices in New Zealand were geocoded. These dental practices overlaid 1,909 area units., Results: The highest practice: adult population ratios found in this study reflected the areas with the highest population densities of Maori and Pacific Islander people., Conclusions: Oral health has a substantial impact on health-related quality of life and the utilisation of dental care services can contribute to its improvement. As such, it is expected that access to care should be focused on the population groups with the highest degree of need. However, in a market-driven, mostly private practice model, such as that in New Zealand, available care is concentrated largely in areas of high socioeconomic status and in populations with lower levels of oral disease., (© 2012 FDI World Dental Federation.)

Aims: This study aimed to assess the temporal and spatial changes in the demand for general anaesthesia, relative to disease incidence, in 0-19-year-olds., Methods: Hospitalisation data were obtained from the Western Australian Morbidity Data System for the financial years 1999/2000 to 2004/2005, and principal diagnosis was obtained from every patient discharged from a public or private hospital. Hospitalisation data was correlated with socioeconomic status and the geographical location of primary residence., Results: In the public hospital sector, there were greater rates of people residing in Statistical Local Areas (SLAs) with decreasing accessibility to healthcare services utilising the option of treatment of dental caries under general anaesthetic (GA) compared to people living within highly accessible areas. In the private sector, children who resided in SLAs with the greatest access to healthcare facilities had a greater rate of being hospitalised for the treatment of dental caries under GA., Conclusions: The results demonstrated distinct patterns of trends in demand for general anaesthetic care among different SES groups and geographical location of primary residence. There was an overall emerging trend of increasing demand placed on public sector both among dental care users among high and low SES. Moreover, the results demonstrated the potential application of geographic modelling as a service planning tool for estimating the future demand for GA care for dental caries in addition to the timely need for focused attention on preventive services for early identification, prevention and control of dental caries among children.

In line with findings throughout Australia, rural, remote and Indigenous Western Australians suffer from a higher burden of oral disease and have less access to dental practitioners and care than their urban and non-Indigenous counterparts. With workforce projections indicating an increase in the shortage of dental practitioners, especially in rural and remote areas, the Centre for Rural and Remote Oral Health (CRROH) in Western Australia set out to establish a sustainable programme to service such increasingly disadvantaged populations. Via the vertical integration of education, service and research CRROH pioneered a sustainable model to deliver much needed oral health services to some of Western Australia's most remote areas, while primarily focused on addressing the oral health needs of Indigenous Australians. One of the key lessons from the programme has been the development of a strong clinical governance framework and a support network to sustain services in remote locations. This study offers one way to provide and sustain dental care for those most in need, yet largely left out.