Could adult dentistry be free?

The cost of visiting the dentist is enough to wipe the smile off many people’s faces, yet the implications of deferring treatment can be long-lasting.

Children receive free basic oral health services until their 18th birthday, yet most adults can access dental services only through the private system.

As Health Minister David Clark acknowledged the ‘‘huge unmet need’’ in adult dental care, is it now time the Government subsidised treatment?

University of Otago associate professor Dr Jonathan Broadbent said the system should be improved to help those unable to pay. ‘‘There remains a serious unmet need for care among those who cannot afford it . . . we need to ensure our safety net means that anyone who is in pain can receive prompt and affordable care.’’

At present, some adults do receive government-funded dental treatment, including people with complex medical conditions and disabilities, like cleft palate and some cardiac patients, armed forces’ personnel, and those with Community Services Cards.

However, New Zealand Dental Association (NZDA) president Dr Bill O’Connor said the cost of expanding care to a fully-funded system would be astronomical.

‘‘Universal dental care would likely cost more than the entire annual budget of large district health boards like Auckland and Waikato ...

‘‘In some ways, making dental treatment free may not necessarily reduce the level of disease because of complex socio-economic factors,’’ O’Connor said.

The Ministry of Health said there was no fixed fee structure for private dentists, which meant the cost of procedures could vary.

Factors included the practice’s location, whether it was a specialist or general dental surgery, and the type of equipment and techniques being used.

While it doesn’t make price recommendations, NZDA’s fee survey 2018 revealed the average dental examination was $76, while a panoramic X-ray cost $91.

A half-hour visit to the hygienist cost an average of $110, a composite crown was $408 and a onesurface amalgam filling was $153, while a root filling for a molar with three roots was $1155.

Dentistry was a highly regulated industry, and complying with those regulations was expensive, O’Connor said.

‘‘Materials and equipment costs are high. Wages are high. Rents have to be paid . . . you cannot deliver low-priced dentistry in New Zealand unless someone else is paying for it i.e. taxpayers or insurance companies.’’

Broadbent agreed the cost of setting up a surgery was significant. Otago University’s new 32-chair clinical dentistry unit in Auckland cost $28 million to build – nearly $1m per chair.

British residents had access to an almost fully-funded dental programme but ‘‘have worse decay rates and statistics than New Zealand’’, O’Connor said.

In a statement, Clark indicated his desire to see ‘‘more affordable access’’ for adults but said ‘‘it’s unlikely we’ll get significant change over the line’’ this term.