In the strange old world of television, its funny what generates a story. Kevin Milne makes an aside in his consumer advice column in Womens Weekly about bunking off your dentist bill (an option he does not recommend) and both our major current affairs shows climb into the cost of dentistry, off the back of an NZ Herald story. A month or so back Jim Anderton launches a fully researched and costed plan for universal access to dentistry, and while it gets some modest coverage, its ignored by TV.
Ah well, at least this is getting the issue debated. There is no doubt that the cost of visiting the dentist is a major issue for many people along with the other increasing costs of daily life, and the low cost options (such as hospital clinics) are unable to cope with demand.
One thing that is interesting to note in the Campbell Live story is that there are DHBs out there that are putting more resources in to make dentist visits more affordable. But the National led government has clearly signalled that they do not see oral/dental health as a priority. They got rid of dental health from the list of targets for DHBs, and the majority of DHBs have responded to that by putting resources into the other target areas. This is a big mistake from the current government in my view.
Labour did make significant advances in the last term of government with getting the mobile school dental clinics into our communities. Access for primary school children (which is still free) has improved. It is harder with teenagers, who are still free until 18. Many dentists do not think that the subsidy they get for treating teenagers under the Combined Dental Agreement is sufficient to meet the costs they face. Anecdotally we hear of practices turning away teenagers, and of course by this stage avoidance behaviour with the dentist is beginning.
It was no surprise in both the TV stories to hear dentists say they were concerned about so-called “socialised dentistry”. They are business people and the government wading into their sector scares them. But the truth is that our current model is not working as it should. 44% of Kiwis are not seeing a dentist annually. Dental problems are a gateway to other health issues, and the long term costs of dealing with those are huge, let alone the personal health impacts.
As ever in health, many of the answers in terms of good oral health lie with actually helping to keep teeth healthy in the first place. Supporting children and teenagers to stay in the habit of good dental care, which includes regular check-ups, oral health education for parents and children, an increased role for dental therapists to provide early intervention and,dare I say it, a wider take-up of fluoridation in our water supply.
But we can not get away from the need to make dental care more accessible, and that means more affordable. Jim’s plan, which he has handed over to Labour, is costly. Up to $1 billion per year when fully implemented. We are looking closely at what we can afford to do, and over how long a period of time. But it is an issue that we have to face up to.