Introduction by Croakey: The Victorian Labor Party’s election promise to open 10 free public dental clinics across the state, with three to be located in regional areas, has put a long-overdue political spotlight on oral health.
New research suggests that if the Federal Government wants to improve its disappointing record on oral health, one way would be to introduce a tax on sugary drinks.
The measure would prevent many dental health problems and also bring significant benefits for health equity, say the researchers.
“People with the highest burden of untreated oral disease are often those who face the greatest barriers to dental care, and tax revenue could help reduce that gap,” they say.
The article below is by Dr Mishel Shahid, Professor Lennert Veerman, Professor Karen G Peres, Professor Santosh Kumar Tadakamadla, Dr Mary Wanjau, Dr Ankur Singh and Professor Marco A Peres.
Mishel Shahid, Lennert Veerman, Karen G Peres and colleagues write:
Health organisations in Australia have long called for a tax on sugary drinks to combat obesity, diabetes and heart disease. Our new modelling study, published, estimates the benefits for a part of the body that is often left out of the conversation: the mouth.
A 20 percent tax on sugar-sweetened beverages is projected to generate around half a million health-adjusted life years (HALYs) for the 2019 Australian adult population over their lifetime, through improvements in oral health and reductions in weight-related illness.
Around a quarter of that total projected health benefit comes from oral health alone. Over the first 25 years after the tax is introduced, we estimate it could prevent 3.7 million cases of dental caries, 191,000 cases of periodontitis, and about 115,000 cases of edentulism (complete tooth loss).
To the best of our knowledge, this is the first study to estimate this avoidable burden across dental caries, periodontitis and edentulism.
Policy blind spot
Oral disease is often treated as a lower-priority health issue, despite its clear impact on health and wellbeing. Oral diseases are among the most prevalent diseases globally and Australia is no exception.
Poor oral health, mainly dental caries, periodontitis and tooth loss contributed 4.2 percent of Australia’s non-fatal disease burden in 2024. If left untreated, both dental caries and periodontitis can lead to tooth loss.
Sugary drinks also contribute indirectly as they can promote weight gain, which increases the risk of diabetes, a known risk factor for periodontitis. Sugary drinks are also linked to a higher diabetes risk independently of weight gain.
In Australia, the burden falls hardest on people who can least afford dental care. Medicare does not cover routine dental treatment, and almost one-third of adults have untreated decay, largely because of cost.
This access gap contributes to widening health inequities and it will not be fixed by asking individuals to make better choices on their own. If we are serious about improving health and wellbeing, we need system-level legislative action.
Several such proposals, including a Seniors Dental Benefits Scheme, the AMA’s proposed sugar levy and the Parliamentary Budget Office’s costing of a 20 percent sugar-sweetened beverages tax, are yet to be taken up.
Our modelling adds to this debate by showing the health consequences of continued inaction. Revenue from a tax could also be one way to help fund dental care for Australians who currently go without it.
We also modelled what might happen if manufacturers responded to a tax by cutting the sugar content of their drinks instead of passing the cost on to consumers, testing scenarios of a 50 percent and a 100 percent cut in sugar content. Under a 100 percent reduction, the health benefits could be up to five times larger than with no reformulation and up to three times larger under a 50 percent reduction.
A future sugar-sweetened beverages tax could charge a single rate regardless of sugar content or it could be a tiered levy, like the United Kingdom’s Soft Drinks Industry Levy, where drinks with more sugar are taxed at a higher rate. A tiered approach gives manufacturers a stronger incentive to reformulate.
International evidence
Australia would not be the first country to see oral health gains from a sugar-sweetened beverages tax.
An interrupted time series analysis of the UK’s Soft Drinks Industry Levy found fewer hospital admissions for carious tooth extractions in children after the levy was introduced.
In the United States, an analysis of the Philadelphia beverage tax found reductions in tooth decay measures among lower-income adults and children, who often carry a higher burden of oral disease.
These taxes were not introduced primarily to improve oral health, but the benefits for teeth and gums are clear. Australia’s debate about sugar-sweetened beverages taxes should give oral health more attention.
What the modelling says
Like all modelling studies, our estimates show what could plausibly happen under a set of assumptions. They are not a prediction of exactly what will happen.
A sugary drinks tax would not, on its own, solve excessive sugar consumption or Australia’s barriers to dental care. But it could be a useful policy lever, particularly when combined with measures such as water fluoridation, restrictions on marketing to children, and better access to affordable dental care.
The study also shows why oral health should be part of the wider prevention conversation.
Dental caries, periodontitis and complete tooth loss affect health, wellbeing and quality of life. Reducing these conditions could lower treatment costs and help people avoid pain, time away from work or study, and longer-term impacts such as difficulty eating, chronic pain, or reduced confidence in social situations.
Because a sugar tax is a population-level measure, it does not rely only on individuals changing their behaviour. By making sugary drinks relatively more expensive at the point of purchase, it nudges consumption down across the whole population without relying on individual choices.
That is particularly important if prevention strategies are to reach the whole population and reduce health inequities.
Next steps
Based on the evidence from this study, we propose the following next steps:
- Policymakers should recognise oral health as a central part of the case for a sugar-sweetened beverages tax.
- Health and dental peak bodies should make the equity case clearly. People with the highest burden of untreated oral disease are often those who face the greatest barriers to dental care and tax revenue could help reduce that gap.
- Policymakers should legislate a well-designed sugar-sweetened beverages tax, after consultation with representative health organisations.
• Authors’ declaration: Our study was funded by a Griffith University internal seed grant, which had no role in the study aims or findings. None of the authors has received funding from the food or beverage industry. AI tools were used to support editing of this article.
Author details
Dr Mishel Shahid is the Manager, Systems Science and Research at The Australian Prevention Partnership Centre and an Adjunct Research Fellow at Griffith University. Mishel holds a PhD in public health and epidemiology from Griffith University and a master’s in dental public health from the University of Dundee, UK. She has experience in evidence synthesis using systems thinking approaches, health economic modelling for policy-approved interventions and causal modelling for health service assessment.
Professor Lennert Veerman is Professor of Public Health at Griffith University, School of Medicine and Dentistry, where he leads the Public Health & Economics Modelling group. A Dutch-trained public health physician with a passion for healthy physical, economic, social and natural environments, he has published on a broad range of topics in public health. The scope of his work includes health economics, and he now has a strong profile in epidemiological modelling, burden of disease studies, non-communicable disease control and the cost-effectiveness of prevention. He is the discipline lead for public health research in the School.
Professor Karen Peres is a dentist, epidemiologist and internationally recognised researcher in child oral health and oral epidemiology. She holds two master’s degrees, in Paediatric Dentistry and Public Health, and a PhD in Epidemiology. After 15 years in Brazilian universities, she moved to Australia in 2012 to join the University of Adelaide’s Australian Research Centre for Population Oral Health. She later held senior academic roles at Griffith University before joining the National Dental Centre Singapore in 2020, where she is appointed as Associate Professor at Duke-NUS Medical School.
Professor Santosh Kumar Tadakamadla is Professor of Dentistry and Oral Health at La Trobe Rural Health School, where he leads the Oral Health theme of the Violet Vines Marshman Centre for Rural Health Research. A dental public health specialist and Senior Fellow of the Higher Education Academy, he has published more than 170 peer-reviewed papers. His research focuses on health promotion, health inequalities, oral epidemiology, oral-systemic links and quality of life. His honours include an NHMRC Early Career Fellowship, the 2025 IADR Distinguished Scientist Young Investigator Award and the 2020 Centennial Emerging Leader Award for the Asia-Pacific region.
Dr Mary Wanjau is a Senior Research Fellow at Griffith University’s Public Health & Economics Modelling Team. Her research assesses the health and economic impacts and cost-effectiveness of policies addressing chronic disease risks such as physical inactivity, unhealthy diet, obesity, and alcohol. She has led modelling of the impact of sugar-sweetened beverage taxes for Kenya, Kyrgyzstan, and Estonia, and contributed to similar modelling for Australia, Egypt, Nigeria and Mongolia. Her modelling has informed enacted sugar-sweetened beverage tax legislation in Mongolia and Estonia.
Dr Ankur Singh is Chair of Lifespan Oral Health at the University of Sydney and an Australian Research Council DECRA Fellow. A public health researcher and social epidemiologist, he leads interdisciplinary research using population datasets and advanced epidemiological methods to assess interventions, reduce disease burden and address oral health inequalities across the lifespan. His expertise includes intervention simulation, multilevel and Markov-based modelling, health inequality measurement and evidence synthesis. He also holds leadership and editorial roles with international oral health and social epidemiology organisations.
Professor Marco A Peres is Deputy CEO for Research and Education, Director of the National Dental Research Institute Singapore, and a senior academic at Duke-NUS Medical School, Singapore. His research focuses on global health, health policy effectiveness, health services research, health inequalities, life course epidemiology, and the links between oral and general health. He has been recognised among the top 2% of scientists worldwide, received the 2017 IADR Distinguished Scientist Award for Global Oral Health Research, and was awarded the 2023 NMRC Singapore Translational Research Award.
See also this ABC News story: Sugar tax on drinks may improve oral health in Australia, study suggests
See Croakey’s archive of articles on oral health
Add Comment