Is anyone surprised by the lack of funding for adult dental services in the Government's new Wellbeing Budget?
Last I checked, my teeth were vital to wellbeing. If they hurt, I hurt. If they're unhealthy, so am I.
Surveys show nearly half of Kiwi adults don't go to the dentist - 44 per cent or 1.6 million people - many because they can't afford to. Yet dentists tell us even parents whose minor children are eligible for free treatment sometimes skip appointments.
Looking after our teeth, and those of our children, is a necessity, not a luxury. No child should be admitted to hospital for tooth decay, but it happens every day. Those admissions cost taxpayers tens of millions of dollars each year.
Providing dental care for all adults is estimated to cost $1 billion. Spending even half that could yield results. Imagine $500 million spread across the population. For simplicity's sake, let's say 3.7 million adults (out of a total population of nearly five million) live in New Zealand.
Providing everyone 18 and over with a voucher for $135 worth of dental work could at least get them a cleaning.
But you must shop around for even the most basic services. It's frustrating as a consumer to see prices all over the map - if you can find them at all.
A scan of Tauranga dentists' websites shows most do not offer even a whiff of what you might pay for services. A Facebook user in Mount Maunganui recently asked how much her friends paid for a cleaning.
Some said their hygienist charged $120, while others forked out more than $200. Need a filling? A tiny crack repair might cost $100, while more extensive work runs $250 and up.
The NZ Dental Association (NZDA) says adults have experienced dramatic improvements in oral health since the 1980s and the lifetime experience of dental decay has almost halved in people aged 20 to 24 and 35 to 44. Yet we hear stories of people pulling their own teeth, of faces swollen with infection, of hospitalisations - because folks can't afford treatment.
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Let's do what many advocates suggest and remove GST on dental services and increase the age young people can get free dental care to 20 or 21.
NZDA says low-income adults should be able to access health care services through public funding and recommends users fund some of the costs. Having the user pay even a small portion holds them accountable.
Government money is available for dentistry via Work and Income, to holders of Community Service Cards and through ACC. But it's mostly for emergencies, not because you haven't seen a dentist in five years and need six fillings. NZDA also says we need "continued advocacy of water fluoridation".
I disagree with this last point. We don't need advocacy of water fluoridation; we need actual fluoride in the public water system. Science (real science, not the pseudo stuff) is clear: fluoridated water saves teeth and money.
The Ministry of Health website says, "Over 60 years of international and New Zealand research tells us that water fluoridation is effective and safe in reducing tooth decay."
Scientists say while too much fluoride (naturally-occurring or introduced), can cause illness, the amount of fluoride required to promote oral health is tiny - and safe. Too much of anything can kill you, including drinking too much (non-fluoridated) water.
Special snowflakes hate this logic because they're all allergic to fluoride the same way my 13-year-old is allergic to food he doesn't like. What do dentists know, anyways? They wasted five years at university, plus several more years of study when they could've become a subject specialist for free by reading articles online.
My parents grew up in Ohio, US, before water was fluoridated. They have mouthfuls of fillings. I had fluoridated water from birth and grew up cavity-free. I didn't hear a dentist's drill until I was 36 years old.
In New Zealand, where most of the population relies on the public health system, we need a simple, proven way to keep children's teeth from rotting because their parents fail to brush baby and toddler teeth with fluoride paste or forget to teach older children how to floss and brush.
Those kids start life at a disadvantage - getting fillings and root canals - an oral health history they'll swallow their whole lives.
A study out of Auckland last year showed children in the poorest neighbourhoods were 12 times more likely to have worse oral health compared to children from affluent areas.
Water fluoridation could help level this playing field.
Or we can continue segregating ourselves into neighbourhoods of shiny white teeth versus mouths filled with decay and flaming gums.
While we're at it, let's take another page from the Dental Association's book and tax sugary drinks. New research shows sugary drink sales dropped 38 per cent in Philadelphia one year after the introduction of a levy on soft drinks and other sweetened beverages. NZDA says the study in the Journal of the American Medical Association adds to international evidence showing sugary drink consumption can be decreased via targeted levies.
NZDA says reducing sugary drink consumption will improve the country's overall dental health. So will water-only policies for schools and local councils.
I'm not holding out for a dental voucher, but I am hopeful central and regional governments will take steps to improve oral health. Money spent now could save hundreds of millions of dollars in the future and spare countless teeth.
Dawn Picken also writes for the Bay of Plenty Times Weekend and tutors at Toi Ohomai. She is a former TV journalist and marketing director who lives in Pa¯pa¯moa with her family