Pinch Point: The vicious cycle of dental care

In the 'well-heeled' Porirua suburb of Whitby, patients visit the local dentist with swollen faces and "raging" infections leaving them on the brink of hospital admission - some because they did not have the money for a check-up.

As the cost of living bites, dental care is increasingly a luxury - and dentists are sounding the alarm that something must change.

Lauren Crimp reports as part of Pinch Point - an ongoing RNZ series about living with the cost of living.

In the Whitby Dental waiting room, Katharine was in for a root canal - the first of two. She had been in a lot of pain, but it was not just physical suffering.

"I think it's $600 or $800 [each] ... it's a lot of money," she said.

"When you have something like this, you have to just get it done, you can't ignore it, but for us it's a really big pinch on our finances."

Katharine counted herself lucky - while it was tough, she could put money aside to save for the work.

As she headed in for her appointment, Matt Wood walked out of his.

"I lost a bit of a tooth and a filling, so I had to have that fixed up, and it was also an annual check," he said.

It had set him back $250, which "could have been worse" - it was caught early, making the work slightly cheaper.

Wood and his family prioritised putting money aside for preventative dental care. He could not pay for it out of the weekly budget.

Dentist Dr Sophie McKenna said that was out of reach for many.

"I've done some root filling work on someone who had the most horrendous raging infection last week with a massively swollen face, nearly ended up in A&E, [it's] really worrying," she said.

"She's a classic example of someone who was going to end up on IV antibiotics, maybe in intensive care, if we didn't manage it."

The patient was shocked at how ill she had become.

McKenna said she saw patients in similar desperate states week in, week out.

"And in this suburb, you know, maybe you'd think Whitby is quite well-heeled, and we're still seeing it. In fact, I feel like we're going backwards."

It was a vicious cycle.

"They can't afford the regular care, so then the only time they come in is when it's a crisis, and by then they've got a raging infection, the tooth is so bad that it can't be saved.

"And then we're having to pull it out and then they have a miserable experience and it costs them heaps and then they bail for another four years until something else happens.

"It just seems crazy. How are we not doing better than that?"

Dentists push for change, politicians remain coy

Dentists were worried, McKenna said.

"I know the public see us as wealthy so-and-so's who just love charging dollars, but actually it's distressing to see ... most of what we're seeing is completely avoidable and preventable."

The Dental Association recently handed the government a report making a raft of recommendations to prevent poor oral health, and make care more accessible, including publicly funding it.

Matt Doocey, who was Acting Health Minister at the time, directed health officials to look into it.

There has long been calls for universal dental care, or at least subsidised treatment for adults.

A means-tested entitlement could also work, but right now the country did not have the dentists to deliver it, McKenna said.

A bipartisan approach to dental care was vital, she said, but there was no commitment for a system overhaul from Doocey.

"That's currently not our position, clearly," he said.

Doocey explained dental care was free for under-18s, and there was a grant available worth $1000 for people in hardship who could not afford essential treatment.

That grant cost taxpayers about $60 million annually.

Labour's Carmel Sepuloni would not be drawn on a fresh approach either, pointing to a policy prior to the last election.

"The intent at that point was to move towards universal dental care," she said. "We didn't get elected, and now, we haven't got to the point where we have policy on this."

With no concrete change planned, dentists worry more people will put off their check-ups.

Sign up for Ngā Pitopito Kōrero, a daily newsletter curated by our editors and delivered straight to your inbox every weekday.