Background: People who have difficulty in accessing dental services may present to hospital emergency departments (EDs), medical practices for treatment of their dental problems or seek treatment and advice from pharmacists. However, it is suggested that these services are only used for temporary relief of pain and do not provide definitive treatment. Rural communities are served by a range of health care professionals. Such practitioners provide a network of heath care professionals serving rural communities. Stronger links and cooperation between rural health care practitioners and dental health practitioners may improve service provision such that interventions are both timely, effective and result in appropriate follow-up or referral.

Aim: To describe strategies that can be used by primary care practitioners to improve the provision of oral health services to rural and remote communities.  

Methods: Case studies with semi-structured interviews were employed. The chief dental officer of QLD was approached to identify communities which met the study criteria. The managers of the General Practice, Pharmacy and hospital/multi-purpose centre in the identified communities were invited to participate in the study. Seventeen interviews were conducted with 35 primary care providers (GPs, Nurses, Pharmacists, Receptionists and Practice managers) in 4 rural/remote communities in QLD. Interview data were analysed using descriptive statistics and thematic analysis with the assistance of SPSS 20 and Nvivo 10. 

Preliminary Findings: the number of people presenting to primary care providers with oral health problems varied from practice to practice and community to community. GP practices reported seeing people with oral health problems from “everyday” to “one per month”, hospitals from “very common” to “4 in a month”, pharmacies from “10-15 per week” to “1 a month”.  Common presenting problems were toothache (70.6%), abscess (58.8%), oral/gum infections (47.1%), sore mouth (17.6%), trauma (11.8%) and dental care product advice (11.8%). Over 80% of primary care providers advised patients to see a dentist, 64.7% provide short-term pain relief, 47.1% see a doctor and 53% provide prescriptions for antibiotics. Primary care providers were not always confident in providing oral health care advice with 23.5% sometimes not confident enough and 11.8% not confident. Over 70% of primary health providers did not consult any other health professionals when they needed to solve an oral health problem for their patients.  Most were aware of the nearest dental practice from their community but the majority never contacted that practice for advice. Only one third arranged emergency appointment with a dentist for their patients but never received feedback for the patients they referred.

Conclusions: People in rural and remote communities do present to primary care providers with oral health problems. There appears a few links between dental practitioners to rural primary care networks in solving oral health problems for these communities.