Reflections on Long-Term Dental Outreach: Insights From Stakeholders in Rural Australia

The Profile of Tara

Since the COVID pandemic, the population in Tara has doubled in size due to lower living costs (LP4). However, the majority of residents have low socioeconomic status, with most relying on welfare: “There's a lot of very poor people living in Tara, it is not a wealthy town and in fact nearly 80% of the town my patients are on welfare recipients of one kind or another” (LP4). These situations, coupled with the lack of job opportunities, are perceived to contribute to drug issues and poor self-care and parenting: “People just don't look after themselves … I try and just do the best I can with my own children. But if they don't know how to look after their own teeth, how are they going to teach their children?” (SR13). Participants also described Tara as a neglected town: “It looks small but it's big, because it's a small town like this gets neglected very easily” (SR6). They observed this was due to a lack of access to healthcare. As of 2024, there is no resident dentist in town, making dental services inaccessible: “That's (travel to neighbouring town for dental appointments) only four-hour round trip. But I can't do that. That is an enormous round trip in one day” (SR11).

Program Development and Perceived Impact Over Time

Since 2007, the program has reached capacity to provide services to “10% of the population in one weekend” (LP4). Although the population in Tara differs, ranging from 1980 (Google ¹¹ ) and 3851 in 2021 (census data ¹² ) to 5300 active patient records (from the local clinic), this sentiment indicates that this program has reached a significant population throughout the years. Additionally, the number of volunteers increased from 20 to 30 people to 140 volunteers (VT31). Most participants gave positive feedback about the program: “I’d never heard of any great, wonderful people coming here to do this” (SR21). Key enablers included the quality of treatment: “This experience is much softer with your mouth” (SR9) and the welcoming atmosphere: “They're so welcoming … they were there to listen and to hear what we had to say. There was no judgement” (SR11). Additionally, VTs mentioned the positive impact on oral health outcomes: “We hear less and less of that (complex and serious oral health conditions). So I do feel that we have brought a change to people's lives here” (VT31).

Impact Beyond Oral Health Outcomes

Importantly, the interviews revealed that this program improved patients’ self-esteem: “It (denture) was never really a bit of plastic in my mouth. It was part of my identity” (SR6): “Once a patient gets the dental treatment completed, this gets rid of any pain and discomfort that they have in mouth. They're much more aware and also likely to gain to healthier habits” (LP35). These observations are supported by the previous findings, ¹³ which show that dental disorders affect an individual's self-esteem.

Participants also shared that they felt valued and were attending the event even to meet the volunteers. The respondents who experienced a recent bushfire emphasised that the program not only provides dental services but also focuses on emotional support:

Their house was destroyed, absolutely destroyed … You guys are a godsend (the bushfire relief aid and medical services that Tzu Chi provides during the 2024 outreach program). And I mean that in the most polite way. People think that they'll never get the help out (in Tara) (SR27).

These nondental improvements suggest that this outreach may be addressing broader community issues. Evidence^14,15 shows that improved self-esteem and social network are significantly associated with better oral health outcomes, indicating that this outreach could be positively influencing patients’ attitudes toward oral health.

Continuity and Cycle of Positivity

Participants also expressed that both SRs and VTs share positivity:

“They might be having a bad day … It just cheers him (SR) up, just a little bit. And then maybe the next person might be the same and it's just rubs off just being nice, and that's what you guys are doing. It's not just about teeth and sticking needles” (SR6): “[Tzu Chi] people are very polite and you can see the way they speak, very soft … (I) get angry, you know. So I come here, I see people, even though in a very explosive environment, still very calm.” (VT19)

In the Australian context, the limited government resources for primary healthcare in the dental sector is pronounced, particularly in resource-constrained regional areas. ¹⁶ Prioritising curative care rather than prevention is a common trend in dental outreach programs.^17,18 However, study participants have highlighted the nondental benefits, including enhanced mental health and broader access to other health services. This program builds relationships between healthcare providers and underserved communities while promoting preventive care awareness and providing strong justification for continued investment in these initiatives. These findings highlighted the importance of continuity and trust in effectively engaging the community, which can inform the design of similar programs in other settings.

It can further contribute to the development and implementation of the national oral health plans for individuals in regional and remote areas, those who have experienced domestic violence, and those with mental health and medical complexities.