Currently, dental care is provided free of charge for individuals under 18 years of age. Those who are on low incomes or governmental benefits can apply for grants intended for urgent or essential dental procedures, yet these grants do not cover routine cleanings or regular check-ups. (File image)
Photo: 123RF
A recent report has revealed that New Zealand’s dental care system is incurring costs that amount to billions each year, primarily through lost productivity and significant social implications.
This report serves as a crucial wake-up call advocating for the universal provision of free dental care. Activists assert that the financial burden of inaction is far greater than the cost associated with integrating dental care into the public healthcare system.
However, the government has approached this issue with hesitation thus far.
On average, the cost of a dentist visit in New Zealand stands at approximately $353. Alarmingly, it is estimated that around 40 percent of the population is unable to afford necessary dental care.
Hugh Trengrove, a public health dentist based in Auckland, remarked that the negative effects resulting from dental issues on productivity are evident to anyone who has encountered such problems firsthand.
“Dental pain affects numerous aspects of life including sleep, eating, and daily functioning, inevitably impacting overall productivity,” Trengrove stated.
He elaborated, “Even a mild toothache can impair your work capacity and harm social interactions, particularly in collaborative work environments where attention and focus are paramount.”
Dental for All, an alliance of healthcare professionals, labor unions, and anti-poverty advocates, has commissioned an extensive report examining the social, economic, and fiscal ramifications stemming from New Zealand’s current dental practices.
Utilizing Treasury’s cost-benefit analysis tool CBAx along with existing studies from both New Zealand and abroad, consultancy firm FrankAdvice has calculated that the inefficiencies of the current system lead to a staggering $2.5 billion loss in productivity annually, complemented by $3.1 billion in diminished life satisfaction and quality of life.
The financial impact of sick days alone amounts to an estimated $103 million each year.
Dentist Hugh Trengrove.
Photo: RNZ / Nick Monro
The primary barrier hindering universal dental care has consistently been the high associated costs, which could potentially reach up to $2 billion.
Max Harris, a campaigner with ActionStation and Dental for All, emphasized that the conversation should revolve around the economic ramifications of not implementing dental care solutions rather than merely the costs of action.
“The stigma and shame linked with dental issues inhibit social participation and self-esteem; furthermore, the report underscores that bypassing dental inclusion in public health is a loss to our economy,” Harris articulated.
He explicated, “Poor oral health can lead to missed job interviews and have broader negative effects on workforce capacity, particularly relevant as we work toward economic revitalization.”
Significantly, the report did not account for the costs or benefits for individuals who can afford private dental care and identified several societal impacts lacking an estimated monetary value.
As a result, Harris indicated that the financial estimates may be understated. “Excluding dental from public health provisions could incur even greater costs than those reflected in our report, yet in our efforts to provide responsible estimates, we arrive at these figures.” he asserted.
He also pointed out that some social outcomes could not be financially quantified, suggesting that this is a conservative assessment of the hidden costs of neglecting to incorporate dental care into the health system.
Labour leader Chris Hipkins receives a check-up at a Tasman Dental Centre in 2023, accompanied by Nelson MP Rachel Boyack.
Photo: RNZ / Nathan Mckinnon
As it stands, dental care remains free for those under 18 years old, and grants are available for those of low income, particularly for urgent dental care rather than for regular maintenance.
Trengrove, who is also an active member of Dental for All, noted a rising demand for urgent care, predominantly resulting in extractions, due to widespread neglect.
He expresses an ideal vision where no one necessitates dental interventions, stating, “If we had a robust public health framework focused on prevention and education, tooth decay could be eliminated. However, we, as a nation, have opted to underfund adult oral health, leading to significant consequences.”
Calls for the expansion of free dental care resurface with every election cycle, with the 2023 elections featuring various proposals. The Green Party advocated for universally free dental care funded by a wealth tax, while Te Pāti Māori suggested free dental services for families earning less than $60,000.
Labour proposed extending free dental care to individuals under the age of 30, with plans to broaden this coverage progressively over time.
“There is no rational justification for halting free healthcare at dental services,” asserted Dr. Ayesha Verrall, Labour’s health spokesperson, underscoring the necessity of extending such care.
However, she mentioned that due to workforce demands and increasing infrastructure needs, a gradual implementation of this policy appears to be the only viable approach.
Labour’s health spokesperson Dr Ayesha Verrall.
Photo: RNZ / Samuel Rillstone
Dr. Verrall believes that establishing a solid foundation for good dental health early in adulthood is crucial for lifelong wellbeing. She indicated that achieving universal free dental care would likely surpass a single political term.
Harris maintained that there has never been a stronger political momentum for change in this sector.
“Our mission is to eliminate existing gaps in access; advocating for universal dental care is essential. Some politicians may prefer a cautious stance, but we urge them to act decisively, as the consequences of inaction are readily apparent,” he urged.
In response to RNZ, Prime Minister Christopher Luxon emphasized the need to prioritize overall health system improvements before addressing dental care specifics.
“I understand that dental issues are pressing, but the current focus remains on achieving our five health targets. We have allocated record funding—an additional $17 billion over the next three years—yet we must first see improvements across the entire health system,” Luxon articulated.
Despite this sentiment, Trengrove argued that the dental crisis can no longer be brushed aside.
“Public concern over dental care is escalating. Given that the government is not funding dental care, it shifts the financial burden onto individuals, especially the most vulnerable members of society,” he asserted.
“When viewed through this lens, it becomes imperative for politicians to prioritize this pressing issue,” he added.
Trengrove acknowledged that the current public health system lacks the capacity to deliver universal dental access; however, he proposed an integrative model that involves public funding alongside private service providers to enhance service outcomes.
**Interview with Hugh Trengrove – Public Health Dentist**
**Editor**: Good afternoon, Hugh! Thank you for joining us to discuss the recent report highlighting the urgent need for reform in New Zealand’s dental care system.
**Hugh Trengrove**: Thank you for having me. It’s a crucial issue that deserves attention.
**Editor**: The report indicates a staggering loss of $2.5 billion in productivity due to dental issues each year. What do you think are the main contributors to this statistic?
**Hugh Trengrove**: One major contributor is the prevalence of dental pain, which affects daily functioning. Many people with dental problems find it difficult to concentrate at work, impacting their overall productivity. Issues with sleep or discomfort while eating can divert attention from tasks at hand.
**Editor**: It sounds like a challenging cycle. Listening to patients, what common issues do you encounter related to dental access?
**Hugh Trengrove**: A significant issue is the lack of access to regular dental care for adults. Many individuals only seek help during emergencies, leading to more severe complications. The financial burden of routine check-ups and cleanings excludes a large portion of the population, creating what I refer to as a “crisis” in oral health.
**Editor**: Max Harris mentioned that we should be talking about the cost of inaction rather than just the costs associated with implementing solutions. How do you see this perspective?
**Hugh Trengrove**: Max is absolutely right. The costs of neglecting dental care can lead to reduced economic output, decreased quality of life, and increased healthcare expenses down the line. Investing in universal dental care may seem expensive initially, but it can save substantial sums over time by reducing emergency interventions and productivity losses.
**Editor**: You mentioned an ideal vision for a robust public health framework for prevention. What steps would you recommend to achieve this?
**Hugh Trengrove**: Education is key. We need to prioritize preventative measures and raise awareness about oral health from an early age. Also, reallocating funding towards preventive programs and routine care can make a significant difference in the long run. Ultimately, if we dedicate resources to prevention, we can significantly reduce the need for more costly interventions.
**Editor**: The political landscape has seen various proposals around expanding dental care coverage. Do you believe we will see meaningful change in the near future?
**Hugh Trengrove**: There is certainly momentum and an increasing recognition of the issue among political leaders. However, achieving universal dental care will take time and commitment. I hope that the upcoming discussions will result in actionable policies that reflect the importance of dental health in the overall healthcare system.
**Editor**: Thank you, Hugh, for your insights today. Your perspective on the intersection of dental health and overall productivity is especially compelling as we move forward with this crucial conversation.
**Hugh Trengrove**: Thank you for addressing this important issue. I hope that continued dialogue will lead to real change in our healthcare system.