Pharmacists are stepping in as frontline providers of oral healthcare advice in rural Victorian towns without dental practitioners, offering oral hygiene advice, managing dental pain inquiries and promoting preventative care, according to a new study by La Trobe University.
Eleven rural pharmacists shouldering health responsibilities far beyond traditional dispensing roles participated in the study, which calls for targeted training, increased collaboration and clearer guidelines to help them deliver oral health advice safely and effectively.
One pharmacist said there was “nothing in town other than us”, highlighting the essential role pharmacies play in areas where the nearest dental clinic is more than 20 minutes away.
Data from a 2021 National Pharmacy Survey revealed Australians on average visit a community pharmacist 18 times a year, while only 48 per cent of the population consulted a dental practitioner in the last 12 months.
Pharmacists reported offering oral health advice up to three times a week, often in response to customer concerns and script presentations. Their support for long-term oral health extended to a variety of areas, such as encouraging twice-daily brushing with fluoridated tooth paste, using fluoridated mouthwash, smoking cessation and dietary advice.
“Generally, people come here for dental pain,” another pharmacist said.
Professor Joseph Tucci, Pharmacy Discipline Lead at La Trobe’s Rural Health School, said while pharmacists were eager to offer oral health advice, time constraints and operating as a single pharmacist limited their ability to do so.
“In regions where dentists are absent, pharmacists are often the first and only line of healthcare,” Professor Tucci said.
“With structured support, they can play a more confident and collaborative role in preventing and addressing oral health issues.”
Few participants felt confident conducting oral examinations due to inadequate equipment, limited privacy or consult areas and no formal training to deliver such services.
“There’s a need for it because dentists are a long way away but, being a small country pharmacy, we don’t have the staff to allocate time,” one pharmacist explained.
“Pharmacies don’t really have that facility and we don’t have those tools,” another said.
Enhanced training and resources were the most discussed facilitators for pharmacists to be comfortable in performing limited oral examinations. Others suggested online training modules that could count towards continuing professional development requirements.
“Where we are located, there’s no point, for instance, in having face-to-face training that’s three hours’ drive away,” one participant said.
The study also highlighted a lack of collaboration with dental professionals, largely due to the absence of dentists in rural towns and no established referral pathways.
“We don’t have a dentist in town, so we don’t have much of a relationship with any of the dentists in bigger towns,” a participant said. “I don’t think it’s as good as it can be.”
Professor Santosh Tadakamadla, Dentistry and Oral Health Discipline Lead, said there was room for growth within the delivery of a community pharmacist’s oral health advice, as study results indicated advice provision was largely perceived as reactive.
“If pharmacists were more proactive in these discussions, some oral health conditions could be largely preventable,” Professor Tadakamadla said.
“With many rural areas not having access to fluoridated water, it is important that pharmacists are educated on the benefits of fluoridated products and how to successfully incorporate this as part of their oral health advice delivery.”
This study was the result of an Honours research project by Erica Stelfox.
- https://doi.org/10.1111/ajr.70059
- Rural pharmacist case study available on request.
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