The whole tooth: pliers, shame and the biting cost of dental care in New Zealand
Rotten teeth don’t always come out easily.
When Carl took his with a pair of pliers, he was surprised at how hard it was to rip the rotten things out of his swollen gums.
Two quickly died out, but the other two held on as he twirled the clamp back and forth, agony cutting off the numbing effects of a bottle of whiskey.
Eventually his cousin took over and the job was done. Carl, a self-confessed tough bastard, cried tears of pain and relief. Cold and shivering, he thinks he must have been in shock.
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“I was never able to drink whiskey again because it brings back those memories.”
Auckland’s dad talks about his experience on the condition that his last name is not used. Walking around with a mouth full of rotten teeth was shameful enough and resorting to pulling them out yourself is almost as bad, he says.
He had been quoted over $3,000 to fix them; the kind of money Carl said was impossible to find.
“I had gone to the hospital for help, I had gone to WINZ…in the end there was no other choice, I just had to do it.”
Carl is just one of millions of New Zealanders who are going without dental care due to high prices and a nationwide shortage of dentists.
A new report, produced by the Association of Salaried Medical Specialists (ASMS), calls for a series of changes in the industry, saying dental care is prohibitively expensive, undersupplied and directly fuels global health inequalities. Eventually, he wants free care for all Kiwis.
“In 2020, it was estimated that over 1.5 million or 40% of adults had an unmet need for dental care due to cost. Among Maori and Pasifika adults, this figure is over 50%,” the report said.
The concept of free dental care for all is not new. Long debated by various governments, initiatives were launched and then abandoned and while free basic care for children has been in place for decades, which ends at the age of 17, leaving charities to fill gaps.
In 2018, the Ministry of Health estimated that it would cost $148 million extending free dental care to everyone up to their 27th birthday; low-income pregnant women; low-income parents and caregivers and a one-time dental exam for everyone who is 6 years old.
The Tooth Be Told report states that each year around 250,000 adults and one in 10 children have their teeth pulled due to cavities, and Aotearoa recorded the highest unmet need for adult dental care among 11 comparable countries in 2020.
Our workforce of dentists and dental specialists is one of the lowest per capita in the OECD and continues to decline, he continued.
The report also revealed that New Zealanders spend $2.45 million a day at eftpos dental practices and, although this does not include credit card or Afterpay spending, this amounts to $896 million per day. last year.
The average transaction was $353 per swipe, which is about 50% of a minimum wage adult’s weekly income.
“Compared to national average rents in New Zealand, an average dental visit is $120 more than the median weekly rent for a bedroom in an apartment,” says ASMS.
The shortage of dentists adds to the problem, as pointed out by Hawke’s Bay, where the 9,000 residents of Wairoa have been without dental service since the beginning of 2020.
South Canterbury dentist Fraser Dunbar says adults often come to the emergency room after taking tools from their own teeth.
“The pliers are used every day; it has almost become the norm. Anyone can pull a tooth, and these poor buggers do it without anesthesia. It must be extremely painful.
Dunbar says there has been a heartbreaking increase in the number of people in their twenties who need all their teeth because they cannot afford treatment.
“The beneficiaries are not so badly paid, they are the working poor. Without a community service card, discretionary dental spending is out the door and the number of these people seems to be on the rise.
Poor dental health makes life a misery, says Dunbar, and her job can be devastating at times.
“There used to be a joke about people pulling their teeth out as a wedding gift and we’re almost back to that. It’s not a joke anymore, it’s soul destroying.”
Pediatric waiting lists for general anesthesia in hospitals are skyrocketing, with a colleague in Auckland recently telling him he had seen 800 cases this year.
“The thing is, there are 1,300 kids on the list, so they’re already 500 behind.”
The report’s recommendations include fully subsidized dental care for everyone, suggesting this could be done gradually starting with low-income adults.
It also calls for a “dental workforce plan” ensuring services are fairly distributed nationwide; the localization of dental services alongside other primary providers and the implementation of a sugar tax.
In a statement, Health Minister Andrew Little said the government in this year’s budget allocated $125.8 million over four years to increase dental subsidies.
“This means that starting December 1, the grant will increase from $300 to $1,000 per year. It will also be available for preventive dental care and not just for emergencies, and it will be available for low-income workers as well as beneficiaries.”
These changes are expected to help some 50,000 people a year get the dental care they need, he said.