Dental work demand: Ministry of Social Development grants near $15m in first three months of policy

Demand for dental work has skyrocketed since the Government rose the grant cap from $300 to $1000 for people on low incomes and benefits, with nearly $15 million paid out in three months.

Dental experts say it is great to see more people accessing dental care but that it 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.

The Greens are also calling for there to be no cap on dental care grants, with still nearly 8000 people since December needing to take out loans for dental care above $1000, adding another $6.3m in debt to the Ministry of Social Development, which now totals well over $2 billion.

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 recently revealed annual dental loans had 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.

Figures released to the Herald show between December 1 last year and the end of February, the amount of non-recoverable assistance jumped to $14.7m - up from $2.8m in the same period in 2021/22.

This amounts to more than $14.6 million worth of support for dental care that may have otherwise placed people into debt.

The number of recoverable grants needed to support those whose dental work costs exceeded the new dental special needs limit dropped by almost 1000.

Due to the policy change 27.4 per cent of clients needed this extra support since December, compared to 46.7 per cent during the same period a year earlier, said MSD general manager Jo Herewini.

But this still meant 7860 people in those three months had to take out loans from MSD for dental work costing over $1000, at a total cost of $6.3m, compared to $6.9m.

In total, over those three months, MSD spent $20.9m in grants and loans, compared to $9.8m the year prior.

Herewini said the high uptake suggested the change was having a positive effect for many people, particularly in low-income households, who were now getting the dental treatment they needed.

The latest figures showed if demand continued at the current rate the initial budget of $95m could be surpassed in less than two years.

The policy is part of a broader work programme, led by Social Development Minister Carmel Sepuloni, focused on reducing the impact of problem government debt for people in hardship.

This was also one of the 42 recommendations that came out of the Welfare Expert Advisory Group’s report on reforming the welfare system in 2019.

Sepuloni told the Herald it was pleasing to see the policy change had a “significant impact” already.

As part of its review of debt to MSD, Sepuloni said the Government was also looking into raising hardship grants, which hadn’t been raised in nearly 20 years, and on which Civil Defence payments are based.

Research from the New Zealand Dental Association, published in 2019, found that Kiwis in the most deprived communities have poorer oral health and get dental care less frequently.

Just 34.6 per cent of people living in the most deprived communities visited dental care in the previous 12 months, compared with 56.7 per cent of Kiwis in the least deprived areas. More than half - 51.5 per cent - avoided dental care in the previous 12 months due to cost, compared with 35.2 per cent in the least deprived areas.

New Zealand Dental Association spokesman Dr Rob Beaglehole said it was “awesome” to see more people in need accessing dental care under the new policy.

Part of the policy change was also expanding the criteria from emergency work to immediate and essential dental treatment. In the past, it mostly covered major work like extractions whereas now it covered most treatment including fillings.

“I think it’s a good step and in the right direction.”

But Beaglehole said the huge uptake highlighted the level of need in the community.

The NZDA has been advocating for expanding universal dental care overall, currently seeking to increase the age limit from 18 to 25 for free dental care and to cover anybody with a Community Services card.

“This policy has been really positive but others and the Dental Association are very concerned about the unnecessary pain and suffering of New Zealanders.

“This helps, but it needs to go further.”

Beaglehole said people had likely been delaying getting care due to the cost.

“We see people coming in at the end of the road, needing one or more multiple teeth taken out.

“Hopefully now that will go a long way into making sure that they have good oral health moving into the future.”

Beaglehole said they also wanted the Government to seriously look into the causes and prevention, including regulating sugary drinks.

Green Party spokesman for social development and employment Ricardo Menéndez March said raising the grant cap was a step in the right direction but people still would be accumulating debt, meaning repayments would be eating away at their benefits.

He pointed to the nearly 8000 people needing to go into debt for care over the $1000 cap.

“That has repercussions day to day as it eats away at their benefits. These are people who are already at the poverty line. They should not be going into debt to receive oral healthcare, it is a political decision.”

The Greens want all assistance for oral health to people on low incomes and beneficiaries to be non-recoverable.

“I’ve seen first-hand the realities of people putting off going to the dentist as they cannot afford it, with painful, rotten teeth. That has an impact on their physical health and their mental health.”