Must we grin and bear the cost of dentistry?

We once owned a cat I nicknamed Port Douglas. Why? We were about to plan a much-needed holiday to Queensland when the cat got sick. The trip was postponed, and the airfares and a substantial amount of the accommodation money was instead spent on vet bills. That December, instead of the normal Christmas card from the vet, we were festooned with luxurious gifts. I pointed out to my delighted spouse that vets only send such gifts to certain ‘‘highly valued’’ customers.

When you own a pet, at least you know that sort of expense comes with the territory. But what about your dental health? If a filling falls out on Boxing Day or you’re flat broke and the dentist recommends a root canal, you must first visit a bank. I could rename three of my crowns Crown Range and my root canal Amsterdam after holidays forgone to pay for dental care.

We all know that poor people find the cost of dental care prohibitive, but even people defined as rich by the Government (annual income of $70,000 or over) can have problems paying the dentist.

Dentists know this. I love the way they sit you down and, in a very calming, grief-counsellor voice, talk you through the operation – financially. Once you have stopped shaking and you know about potential pain in your wallet, they move on to a brief discussion about the pain in your mouth.

Given that children get free dental care, why not have free, or at least subsidised, dental care for adults, too? If you have a Community Services Card you will have access to some state-funded dental treatment, but for just about everyone else, you must pay top dollar.

Health Minister David Clark accepts that there is a ‘‘huge unmet need’’ in adult dental care. But free dental care does not seem to be on the agenda this term. Labour went to the country promising no new taxes in the first three years. It also promised that the previous National government’s tax cuts for the wealthy and corporates would be set, if not in concrete, then in some very tough amalgam.

There’s no money sloshing around for dental care, which is a pity because our level of dental health – though better than the UK, which has a state-funded dental programme – is not so flash.

The New Zealand Dental Association reckons the cost of free adult dental care would be exorbitant, and it might not reduce the level of disease. I agree it would cost a bomb, and that no system is going to entirely eliminate dental problems, but isn’t there some middle ground?

If you’re not wealthy and need dental work, you either get a loan or grin and bear the pain. I suspect the number of workers who suffer intense tooth pain through not visiting a dentist is higher than we think. And what’s that doing to productivity?

Could the Government look at partly subsidised dental care, in the way doctors’ visits for some are partly paid for by the state? Could businesses be encouraged via tax breaks to make dental care part of employment packages? Could union health centres extend their reach to dentistry?

Some people think our dentists, knowing the system is a private monopoly, are taking advantage. At more than $1200 for a root canal and $160 for a filling, on average, you could be forgiven for thinking it’s a ripoff, but I’m not convinced.

A by-product of our user-pays tertiary education system introduced in the 1990s is that dentists and their staff are often paying back massive student loans, not to mention high rents, expensive equipment and other overheads.

We all know that prevention is better, and cheaper, than cure. Yes, more than $100 to visit a hygienist is relatively expensive. However, it is well worth it if they prevent a $1200 root canal further down the track.

Perhaps something the Government could look at is instigating a cheap, ‘‘no frills’’ level of primary adult dental care. Employing mainly hygienists and a few dentists, with emphasis on education and prevention, it could target low-income people who couldn’t afford private care. That wouldn’t help people who need urgent high-level dental care, but a sort of Kiwibank for teeth could improve adult dental health in the long term.

I can already hear the screams of pain from some private dentists about government getting involved in dental care but, given there are many people who don’t go to the dentist because of cost, it’s hardly going to hurt the private market.

In my experience, most dentists despair at our low level of dental health, despite it being good news for them financially. They would love to see more adults with healthy teeth and not having phobias about visiting a dentist – whether those phobias are to do with injections, drills or spending large sums of money.

I could rename three of my crowns Crown Range and my root canal Amsterdam after holidays forgone to pay for dental care.