In a study focusing on oral health in rural communities, 11 rural pharmacists who shoulder responsibilities far beyond traditional prescription medicine participated in the survey, calling for targeted training, strengthened interprofessional collaboration and clearer guidelines to improve the safety and effectiveness of oral health services.
One pharmacist admitted: “There are almost no other medical resources in our town except the pharmacy.” This reality highlights the key medical role that pharmacies play in remote areas where the nearest dental clinic is more than 20 minutes away by car.
According to the 2021 Australian National Pharmacy Survey, Australian residents visit community pharmacists an average of 18 times a year, but only 48% of the population have consulted a dentist in the past year.
Pharmacists said they usually provide oral health advice three times a week, mainly targeting customer concerns and prescription guidance. These suggestions cover a wide range of oral health care content, such as encouraging brushing twice a day with fluoride toothpaste, using fluoride mouthwash, quitting smoking and eating a healthy diet.
“Generally speaking, people come here to relieve toothache,” said another pharmacist.
Professor Joseph Tucci, head of the pharmacy discipline at the School of Rural Health at La Trobe University, pointed out that although pharmacists are willing to provide oral health support, time and manpower constraints are their main obstacles.
“In rural areas where there is a shortage of dentists, pharmacists are often the first or even the only medical staff that residents contact,” Professor Tucci emphasized. “If they can be given structured support, they will play a more confident and collaborative role in oral health prevention and problem solving.”
However, due to insufficient equipment, lack of private consultation space and lack of professional training, few participants were confident in conducting oral examinations.
One pharmacist admitted: “Although dentists are far away and we do need help, as a small rural pharmacy, we have limited staff and it is difficult to allocate time.”
Another said: “Pharmacies have limited facilities and lack necessary inspection tools.”
Interviewees generally believe that strengthening training and resource allocation is crucial, especially incorporating continuing professional development (CPD) through online training modules to help pharmacists improve their oral examination skills.
“In some places, driving three hours to attend offline training is actually not very realistic,” one participant pointed out.
The study also revealed that the cooperation between rural pharmacists and dental professionals is weak, mainly due to the lack of local dentists and the lack of a sound referral system.
“There is no dentist in our town, and we have little contact with dentists in big cities,” a pharmacist admitted, “The situation is really not optimistic.”
Professor Santosh Tadakamadla, head of the Department of Dentistry and Oral Health, said that community pharmacists still have room for improvement in providing oral health advice, and the current service is more of a passive response.
“If pharmacists can be more proactive in oral health promotion, many problems could have been prevented,” Professor Tadakamadla emphasized, “especially in the absence of fluoridated drinking water in many rural areas, pharmacists’ knowledge of fluoridated products and their use are particularly important and should be part of oral health advice.”