Australia’s millennial generation are usually on-message when it comes to health. They eat better, drink less and exercise more than previous generations.

But there is one area they are letting themselves down, and that is dental health.

The Australian Institute of Health and Welfare (AIHW) says while the number of regular dental visits across all ages remains steady, 25-35-year-olds go less frequently than any other group, and they are getting worse.

And it comes as no surprise that cost would appear to be the main barrier.

Lara*, 27, lives and works in Canberra. Growing up, she was always conscious about taking excellent care of her teeth, and even remembers in high school how impressed the dentist was with her “perfect teeth”.

But through university, when she was trying to financially support herself, Lara mostly skipped the dentist. She went a couple times for one-off pain but a tight budget meant she went without a regular check-up for five years.

“There were just some things that kind of needed to be dealt with more immediately, that had more pain implications than my teeth did at the time so I was like ‘okay, we will prioritise that now and teeth will come later’,” she said.

But when later came Lara was told that she had periodontitis or gum disease. Not only that, but her dentist told her it looked like she had the gums of a 60-year-old.

Lara was stunned how much had gone wrong in the five years she skipped her check-ups. She now must have her teeth professionally cleaned at least twice a year – and possibly more often – if things get any worse.

Dr Carmelo Bonanno is a dentist with 33 years’ experience and has just completed a two-year stint as the President of the Australian Dental Association. He said gum disease is often not recognised until too late.

“The main thing is that dental disease is usually the silent disease,” he said. “It means that if something is going on you won’t know about it until it is too late.

“Once it becomes painful, you’re going to have some serious dental problems to deal with.”

The Australian Dental Association put together a statistical picture of Australians’ oral health earlier this year, and the results were grim.

Not only are we not being as diligent with our check-ups, but only half of Australians are managing to brush their teeth every day.

“Some people are not looking after their teeth as well as they did or could have been, people get busy,” Dr Bonanno said. “I think that in all generations we are seeing a slip but especially in the younger groups.”

“If you don’t attend (a dentist) when you first become aware of a problem it can become far more costly to address, and even the consequences of not addressing could be even more costly in terms of tooth loss and the cost of tooth replacement. So again, it depends on your circumstances.”

While the consequences of avoiding the dentist are clear, it can be over-ridden by the cost. Dental work costs us more out-of-pocket than any other annual healthcare item including pharmacy, physiotherapy and treatment by specialists.

The cost issue might mean there will be no real improvement in the oral health of many Australians unless it becomes more affordable.

Professor Hal Swerissen, a public health policy expert and fellow at the Grattan Institute, says that situation highlights the need for universal dental care in Australia.

“The reality is that oral health is the sort of thing that is expensive at the moment,” Professor Swerissen said.

“Most people go and see a health professional when they have a problem. But often in the world of oral health that will mean it is too late.”

Dental healthcare is not covered under Medicare, but there are some federal and state schemes for children and those in low-income situations.

But Professor Swerissen says that states and territories only have the budget to be able to support 20 to 30 percent of those that are eligible, leaving the rest to fend for themselves.

He says implementing a Medicare-style system for dental care would cost the federal government $6 billion per year, and they are not yet willing to make that investment.

“When Medicare was put in place by the Hawke Government in the eighties, oral health wasn’t included because it was a pretty significant cost.

“It’s often been seen as a state government responsibility to provide public dentistry to people on low income, so we’ve seen some shifting between the Commonwealth and the states over who is responsible for many years,” he said.

And while that tug-of-war is going on, it’s the teeth of Australians that are suffering.

*Not her real name