The new report includes 10 case studies of people who have struggled to afford dental care at different times in their lives. Illustration / Paul Slater
Nancy* knew something was wrong.
Her tooth had turned blue, and it was becoming harder to eat.
“I’m in pain all the time. I can’t eat on that side of my mouth and have stopped eating in public altogether, as I feel uncomfortable,” she said.
Unable to afford a visit to the dentist, and just over the income threshold for welfare support, Nancy pulled her rotten tooth out at home.
Nancy’s story is one of 10 included in a new report, released today, commissioned by campaign group, Dental for All.
The group, which includes Action Station and Auckland City Mission, has persistently called for universal dental care, saying high private care costs create impossible barriers.
Almost half of New Zealanders struggle to afford dental care, according to the Tooth Be Told report that predates New Zealand’s most recent cost-of-living crisis.
Adult dental care is not included in New Zealand’s public health system. The average cost of a dental examination in 2023 was $89, an extraction was $291, and a crown was $1624, according to a dental fee survey.
The target (expected) hourly rate for a dentist was $541.
The report’s researcher, Kayli Taylor, is part of Dental for All. She says the status quo is not working, often leading to people making “impossible decisions” between different health needs.
“It is causing anxiety, stress and pain.”
Those whose stories are included in the report are referred to only by aliases.
Health Minister Simeon Brown acknowledged there were barriers to accessing healthcare, particularly dental care. He said the Government provided targeted relief to those in need.
“Agencies such as Health New Zealand, the Ministry of Social Development, and ACC have targeted subsidies and support packages for low-income Kiwis who are in need, and those who have suffered injuries.”
Ellie went to the dentist with severe toothache. She was told she needed to get her wisdom teeth removed.
“They quoted $250 for the top wisdom tooth extraction and $3000 for the bottom teeth. I asked them if there was any way to make it cheaper and they said without anaesthetic it would be cheaper.
“I chose without anaesthetic — I couldn’t afford the pain relief.”
Ellie was given a sedative to sleep through the procedure. However, she woke up halfway through and the dentists rushed to finish it.
“As a result of the rush, they didn’t sew it up properly and it got infected.”
Moana woke up at 4am to join a queue at the hospital that was offering tooth extraction at a reduced cost.
“Now I have a gap in my mouth which I feel self-conscious about. But a false tooth is too expensive. It sucks, but you have to do whatever the last resort is.
For another tooth, she used a Q Card to cover an $1800 root canal treatment.
With interest of 30%, she paid an extra $1200.
“If the dentist was free, it would be life-changing for me.”
Getting into debt to cover dental care is a common theme in the report.
Leigh, who had a drug addiction for about 17 years, now has a full upper denture. Only seven of her own teeth remain.
She is in debt to the Ministry of Social Development (MSD) $25,000 for dental work. She pays off $25 a week.
Aroha is a survivor of domestic violence and struggled to find the confidence to go to the dentist, leading to decay. All her upper teeth have been replaced with dentures.
For this and other dental work, she is in debt to MSD for about $5400. She pays off some $5 a week.
“Getting dentures has brought my confidence back. Before, I felt insecure about my teeth and would struggle to do job interviews.
“I am anxious about the future. Dentures don’t last forever and need to be replaced. This comes with a huge cost I do not know how I will afford.”
Anaru can still remember dentist visits as a child. He says he was given a filling at 5 with no anaesthetic and patronised by the dentist when he cried.
“I have a lot of anxiety about going to the dentist and that was a pretty significant barrier to getting the care I needed when I was younger.”
In his early 20s, he ate ice cream to soothe the pain in his wisdom teeth and swelling in his jaw.
“Dental care was so expensive — it was better to suffer with the pain than deal with the cost.”
He said there was a misconception that people who did not go to the dentist did not care about their teeth. He was depressed about his poor teeth and felt too self-conscious to smile.
“To give you a sense of how bad it was, I was once driving on a learner’s licence with someone else in the car who didn’t have a licence. The car had no WOF or registration and I didn’t have my licence on me.
“I was stopped by a police officer. This is a lot of illegal stuff that would have easily got me several fines. Desperate to not have this, I showed the cop the side of my mouth and said I was on my way urgently to the dentist, and they let me go.
“But I wasn’t going to the dentist — I couldn’t afford to go.”
Anaru eventually sought care through the Dunedin Dental School, which quoted him $95 for scaling work across four visits, compared to $4000 at a private dentist.
He described the dentists at the school as “so kind and empathetic”.
“Now that I am able to get this work done, I feel a lot more confident. I experienced times in my life where I didn’t want to smile in public, would cover my mouth with my hand, and was constantly afraid of being judged.
“If I had been able to get the work I needed done when I needed it, it would have made a massive difference to my life.”
Julia Gabel is a Wellington-based political reporter. She joined the Herald in 2020 and has most recently focused on data journalism.
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