Election 2023: Labour's free dental care promise 'good step' but has 'some challenges'

12:44 pm on 4 September 2023
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Labour launched its election campaign with a promise to extend free dental care to all those under 30. Photo: 123RF

More dentists and a renegotiated funding model would be needed for Labour's pledge on free dental care to come into effect, the New Zealand Dental Association president says.

Labour launched its election campaign with a promise to extend free dental care to all those under 30.

Free dental care would cover annual check-ups, teeth cleaning, basic fillings and extractions; the government would prioritise 18 to 23 year olds from July 2025, and then to those under 30 the following year. At the moment free dental is available to those under 18.

The cap on places for dental training would be increased by 50 percent.

Leader Chris Hipkins said in its first 100 days a Labour government would also launch a campaign to recruit more dental workers from overseas.

New Zealand Dental Association president Amanda Johnston said she was delighted with the pledge to make dental care accessible to more people though there would be workforce challenges.

The workforce was stretched particularly in rural and provincial area, she said.

"We'll need to increase the workforce significantly because there'll be more uptake if dental care is free for that much greater number of people."

There would usually be 60 new graduates from the University of Otago dental school each year.

About the same number of dentists would generally come in overseas but that didn't happen during the Covid-19 border closures "so we're a bit behind", she said.

Johnston said that was based on the current funding model for under 18s so was "probably not realistic", and the figure could potentially be double.

The Combined Dental Agreement which covers treatment of children up to 18 would have to be renegotiated and would be need to be higher, she said.

"[Labour has] promised to review the Combined Dental Agreement, which is the funding model that they'll use, but it will mean that it will be lifted significantly for dentists to take it up.

"Dentists tend treat adolescents in the community almost as a community service. We make a loss on that - it's a patient service that we offer - so it's not going to be sustainable to treat more of the population with that funding model."

Another factor affecting cost was the number of people who would take up free dental care and that was difficult to assess, she said.

There were barriers to going to the dentist other than cost, such as distance or it not being a priority, and only 60-70 percent of adolescents up to the age of 18 went to the dentist, she said.

Johnston said the policy misses an opportunity for introducing co-payments which prompted people to be committed to carry on the treatment.

Auckland Te Whatu Ora dentist Hugh Trengrove.

Dr Hugh Trengrove. Photo: RNZ / Nick Monro

Dr Hugh Trengrove, clinical director for hospital and specialist dentistry in Auckland, said he was seeing an increased demand for people requiring care who wouldn't need hospital treatment if comprehensive care was provided in the community.

"We've got several thousand children waiting for care with us and we have equal numbers and growing numbers of adults as well."

"Dental care in New Zealand is not fit for purpose on the current model and we need to re-look at this."

He said it was a good step forward to have discussion on oral health become part of the political landscape.

Free dentistry would make a big difference, but a prevention-based approach is also needed.

"One of the elephants in the room with the recent policy announcements is there's no discussion around the management of sugar and we need to address that."

Making it financially viable for dentists, as small businesses, to see the patients would make a big difference.

In Auckland, hospital-based oral health therapists were not leaving the system because they weren't paid enough he said.

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