 For most Australians, Medicare doesn't cover dental work, so millions of people can't afford to look after their teeth properly. A report issued today by the Brotherhood of St Lawrence finds underinvestment in oral health means 17% of the nation's poorest citizens don't have any teeth. 730 understands a confidential report to the government recommends spending an extra $6 billion over four years to extend dental care to the most disadvantaged. But as political editor Chris Yulman reports, the push to return to budget surplus means the government will struggle to find the money. Teeth are like governments. You usually don't think about them unless they're bad. But when they're bad, it's hard to think about anything else. I've had many sleepless nights, just rolling around in pain, literally banging my head up against the wall. Perth truck driver Alan Lee is 39. Only two of his teeth don't have cavities and all of his back teeth have fallen out. I've had quotes for dentistry to be done and it's just way too expensive, you know. So my next option is just to basically go in to the chemist, get painkillers. Government involvement in dental health has been mixed for a long time, driven by competing ideologies. In 1993, the Keating government set up the Commonwealth Dental Health Programme for emergency and basic dental care for health card holders. The Howard government shut it down in 1997. As waiting times for public dental health services have now been reduced, funding for the Commonwealth Dental Programme will cease from 1 January and the states will be responsible for these services. Order. A decade later, the Howard government set up a limited chronic disease dental scheme available through Medicare and estimated to cost $377 million over four years. The cost blew out. One and a half billion has been spent so far and it's forecast to cost another $1.6 billion this year. Labor has never liked the scheme and wants to close it. Years ago there used to be this thing called the Commonwealth Dental Health Care Programme. And so what we're looking towards today is an announcement about its re-establishment if we form the next government. But the contribution of all governments to dental health is small. In 2009-10, the National Dental Health Bill ran to $7.7 billion. Individuals picked up the tab for $4.6 billion and their health funds paid another $1.2 billion. The total contribution from all governments was $1.9 billion. People have to pay for at least 60% of those costs out of pocket. Now, to separate the mouth from the rest of the body makes no sense from a health perspective. It's a historical accident. With individuals picking up most of the bill, the poor suffer. Research commissioned by the Brotherhood of St Lawrence shows millions of Australians can't afford to properly care for their teeth. One of the most shocking findings was that people in the lower income groups have a much higher likelihood of having no teeth at all. They're 60 times more likely to have no teeth. Whereas in the higher income groups, people... ...indentulousness or toothlessness almost doesn't exist. Almost everyone agrees the government has to carry more of the weight of dental health. For a wealthy country, the state of dental health in this nation is deplorable. It needs urgent attention and it's really imperative that we invest in a significant way in the next year's budget and hopefully building on that towards a universal scheme into the future. When Labor cobbled together minority government, one of its commitments to the Greens was to invest in oral health. That was a significant part of our reason to support the government. That resulted in the establishment of a National Dental Advisory Council. That council was made up of a range of experts from different disciplines in oral health and their role was to provide recommendations to government about how to spend the money most effectively in the coming budget. The government has received the report but won't release it. This is a government that entered into a pact with the Greens to deliver a universal health scheme and one of two things is going to happen here. Either the government is going to have egg on their face or the Greens will. 730 understands the council's report says that all its members believe the long-term goal should be universal and equitable access to dental care. Although it notes that one of its members believes that should be through targeted schemes. It suggests expanding the existing chronic disease dental scheme to the most disadvantaged at a cost of $11.5 billion. That's a significant increase on the money invested now. It's clear that if you move towards a universal scheme there will be a substantial cost involved. Up front it may be in the order of $6 billion but that number will come down over time as the huge demand that currently exists begins to be met. Setting up a universal dental care system would probably mean an increase in the Medicare levy. The government says it will consider the council's advice but won't provide a running commentary on media speculations. I think the chronic scheme that Tony Abbott implemented when he was in government can be built on and I suspect that that recommendations in the report as well and part of the reason that Julia Gillard's only given the report to Bob Brown is that it does say that Tony Abbott's scheme was good and that it should be built on into the future. Labor's determined to bring its budget back to surplus so it will struggle to find any significant money to expand the ailing dental health system. That means Alan Lee's long, painful wait will continue. I've got permanent swelling on this side. I can only eat on one side and now that side's obviously starting to decay. It's very uncomfortable. Paul Black, political editor, Chris Yeoman with that story. There are just a few...