21 Aug 2017

Tooth wisdom: Dentists suggest preventive focus for poor

8:02 am on 21 August 2017

Tens of millions of dollars are being spent each year on emergency dental treatment for the poor, and dentists are calling for a better system which can get people seen before they need expensive work.

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Photo: 123rf.com

Figures from the Ministry of Social Development show Work and Income has given out 400,000 emergency grants over the past six years, costing more than $140 million.

People over the age of 18 have to pay for their dental visits, but those on benefits or low incomes can access emergency dental grants of up to $300 a year through the scheme.

If the treatment costs more than that, they will have to pay back the difference.

Lynn, who lives in Auckland and is on a benefit, has used the grant twice over the last couple of years.

The first time, she needed three of her wisdom teeth out and a filling - a total cost of $1300. She got the grant and the rest she paid back to Work and Income at $7 a week.

Then she needed some more work done, which was likely to cost $1700.

"I had to get my [other] wisdom tooth removed and my molar, because there was a hole in my gums where food was getting trapped and it was giving me an abscess, so it was an emergency to have to get it removed."

Scott Waghorn runs six dental practices in Auckland, including Dental Care West, New Zealand's largest.

For $300, you could usually get two teeth removed, or a couple of fillings, he said, but that could be avoided altogether if the problems were caught earlier.

"It's just a small decay that's left for a long time and then a longer time and then even more time. That little decay nibbles into the tooth, causes a huge amount of pain and infection, then they go Work and Income and get the grant."

Dr Waghorn said the root causes of poor oral health also needed a closer look.

"The government needs to focus on what is causing this, as opposed to the 'ambulance at the bottom of the cliff' scenario.

"We know the two major things that cause this are diet and deprivation, certainly some work is being done, but a lot more needs to be done so we can save money at the other end."

Wellington's Simply Dental general manager Rachel Bridgeman said tooth decay was easily avoided and given the wider health benefits in terms of reducing obesity and diabetes, there should be a greater focus on prevention.

She said some patients had teeth so decayed that they could not be saved and there was no option other than to remove them.

Making dental check-ups more affordable, and therefore more regular, would be a better use of money, she said.

"It's actually more expensive - not just on an economic level, but on a social impact level it's more expensive - for people to be suffering from a disease that is preventable.

"People missing out on jobs because their teeth don't quite look the part, or taking time off work."

Dental Association chief executive David Crum said that approach would not be cheaper, however.

"You would have to put a vastly bigger sum in to prevent this sort of disease pattern," he said.

"The important thing around this issue, for me anyway, is that it really is important to keep this safety net in place so people who need treatment immediately, but cannot afford it, can still access it."

Lynn thought all dentists should be offering affordable payment plans for everyone, but that the government had a part to play as well by partially subsidising dental visits and treatment in the same way as doctors' visits and prescription medication.

"It just makes things a lot easier for not just beneficiaries but for every New Zealander to go in and get their teeth done," she said.

According to the figures from the Ministry of Social Development, about $24m is spent making around 68,000 grants each year.

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