A boosted dental grant scheme is proving so successful dentists say it needs to be expanded with people finally able to afford to have their rotting teeth removed but unable to afford replacements, which the grant currently does not cover.
The Government has paid out over $30 million in dental fees in the first six months since raising the grant cap from $300 to $1000 for people on low incomes and benefits in December - five times the amount paid over the same period in 2022 before the cap was raised.
The flood of extra dental care is part of an extra $131m the Government paid out in hardship grants across the 2022/2023 financial year - nearly $740m in total - over what was budgeted, with nearly $70m of that predominantly in Civil Defence payments after the cyclones but also reflecting higher needs amid the rising cost of living.
Dental experts say the boost in grants has seen nearly $25m of dental care carried out that would otherwise not have occurred, but also highlights the “crisis” over oral healthcare in New Zealand, with the number of people accessing grants doubling to nearly 20,000 compared to the same period the year prior, indicating many had been putting off seeing a dentist due to the cost.
They are also concerned that the number of people needing to take out loans from the Government has not changed, with the reason likely that the non-recoverable grants do not cover teeth replacements.
“People who are accessing those funds now are likely to have had a lengthy history of neglected dental care,” said New Zealand Dental Association chief executive Mo Amso.
“Now that they’re accessing some care, a significant number are having extractions, that have deteriorated beyond repair. But they cannot afford to replace them, and so are taking out loans to do so.”
The Green Party is also calling for there to be no cap on dental care grants, with still nearly 8000 people since December needing to take out such loans for dental care out of the criteria and above $1000 - known as recoverable grants - adding another $6.3m in debt to the Ministry of Social Development, which now totals over $2.4 billion.
Treatment not covered by the non-recoverable grants include for dentures - such as tooth replacements and false teeth, cast restorations - such as crowns, and even regular check-ups. People can take out recoverable loans from MSD for these treatments.
The Herald has previously reported on the high costs of dental care and how desperate Kiwis had been resorting to their own “DIY dentistry”, including using power drills.
In December, the Government raised the amount people on low incomes and benefits could receive for dental treatment annually from $300 to $1000, fulfilling one of Labour’s manifesto commitments from 2017.
It was the first time the grant cap had been raised in 25 years. Prior to the grant cap rising, anything over $300 had to be paid back.
The Herald last year revealed annual dental loans had consequently doubled from just under $15m in 2017 to nearly $32m in 2021 and $27.2m in just the first nine months of last year.
By raising the cap to $1000, it was estimated the amount of client debt to MSD would reduce by $95m over four years, as more of the cost would be covered by the grant.
In just six months more than $24m has been paid out - moving at about twice the rate as predicted.
Amso said increasing the grant cap - for which the NZDA had long advocated - had already had a “huge impact” in addressing previously unmet needs.
But they were concerned that the number of people taking out recoverable loans from MSD for dental work had remained about the same - about 17,000 totalling $14.2m in the six months after the change compared to just under 20,000 at $16m in the same period a year before.
“We do know dentures remain the one thing that is not covered by the non-recoverable grants that people in New Zealand wish they were.”
Amso said it depended on how many teeth had been removed but could cost from a few hundred dollars up to a few thousand to replace.
Proper dental care had a huge impact on people’s lives, Amso said, and they had seen major positive changes since the grant cap was raised.
“For some people, if you saw a frown, it was a literal frown and metaphorical, because they couldn’t smile because of [their teeth].
“Patients I used to treat in the community used to struggle to get jobs because they had bad teeth. Allowing people to maintain their dignity by being able to access funding for their dental care is restoring their mana.”
Amso said they would also like to see the accessibility criteria expanded including raising the income threshold, which was currently just below minimum wage for a single person over 18, and including community services card holders.
They also called for political parties to commit to annual increases - such as pegging it to inflation - and carrying out a review to ensure recipients were being charged fairly, which they had also previously advocated for.
Social Development Minister Carmel Sepuloni said she was pleased to see the high uptake of grants since the cap was raised.
“Ensuring people on low incomes have access to and can afford dental procedures is important because having good dental hygiene helps people obtain work, and improves quality of life, people’s self-esteem and mental health too.”
She said they were currently reviewing wider hardship assistance and would not commit to any further increases nor expanding the criteria.
Expenditure for dental grants is not capped and so no more funding decisions were needed to accommodate the high uptake, she said.
MSD was also starting a post-implementation analysis of dental grants to understand if dental providers were charging clients more than the general public.
Green Party social development spokesman Ricardo Menendez March said nobody should get into debt because they needed to cover the cost of dental treatment.
“The increase in demand for emergency dental shows the high level of oral health deprivation in our communities.
“That the debt created remains the same despite the cap increase further demonstrates why we must overhaul dental support so it doesn’t create debt in the first place.
“That includes increasing access to regular dental check-ups so people can take care of their teeth before they need expensive emergency dental care.”
National Party social development and employment spokeswoman Louise Upston said National would retain the $1000 dental grant cap.
On expanding the criteria, such as covering dentures, she said they would consider on a case-by-case basis such as if having no teeth was a barrier to employment.
She said she agreed there needed to be a review of grants available but would not commit to annual increases linked to CPI.