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Those who have spent years advocating for oral health services to be properly funded from the public purse to allow equitable access must wonder if that day will ever come.
In the last couple of years, momentum seemed to have gathered for some changes in this area. In 2018, the Labour Party adopted a policy for free dental visits for adults.
What has followed has been less impressive. Options for improvement in a Ministry of Health briefing on adult dental care and oral health issues, sought by then Health Minister David Clark in 2018, have gone nowhere. These included increasing publicly funded dental care from 18 years to the time of a young person’s 27th birthday, dental care for socio-economically deprived pregnant women and low-income parents and caregivers of children under 5, increasing Work and Income assistance for urgent dental treatment, and the possibility of free dental checks and some subsidised dental treatment for superannuitants. All of these ideas needed further work, but none was commissioned. This information has recently come to light because releasing the briefing was resisted and only happened after Newshub sought the intervention of the Ombudsman.
The National Party is also not inclined to push for improved access for adults at this time, although its proposal to put an extra $30 million into childhood dental services if it leads the next government has been welcomed by the New Zealand Dental Association. Part of that funding would go to providing children with free toothbrushes and toothpaste and supervised daily brushing sessions (modelled on a successful Scottish programme which decreased tooth decay).
We hope adequate consideration has been given to the practicalities around such a school programme. For instance, will schools have sufficient basins and areas for safe storage of toothbrushes, and other measures to prevent the scheme unwittingly contributing to the spread of illness? In Scotland, post-Covid-19 changes have been made to the programme, including moving to a dry brushing model where pupils, rather than use a sink, spit excess toothpaste into a tissue, paper towel or disposable paper cup which is then binned. Close supervision of all aspects will be required, regardless of the model used.
Neither major party seems interested in seriously addressing the issue of sugary drinks and high-sugar foods or placing a health tax on products that cause oral disease to both lower consumption and help fund dental services.
For too long dental care has been treated by governments as if our teeth, should we be lucky enough to have any, exist separately from our other bodily parts, are divorced from other aspects of our health, and somehow become less important once we reach 18.
Both major parties are using the spending on the Covid-19 aftermath as an excuse not to do more for adult oral health, but we wonder if that is a false economy. As we have said previously, will we soon get to a point where the cost of not addressing our national dental crisis is outweighed by the value of introducing universal care?
We already know that less than half of adults regularly go to the dentist mainly because of the cost, and that last year more than 6000 people sought dental treatment at hospital emergency departments when most of them should have gone to a dentist.
With higher unemployment and many people likely to have a dip in their income, access to dental treatment will be even more limited.
Any move to universal care would have to be well planned and delivered in stages to address those with the highest needs first and ensure that facilities and staffing were sufficient to cope with the increased demand.
If this is not the right time to commit to developing such a programme, when will be?