Dental system costs New Zealand $2.5 billion a year in lost productivity and $103 million in sick days – report

The report says New Zealand’s dental system is costing billions of dollars a year in lost productivity and social impacts.

The report is another call to make free dental care universal, with campaigners saying the cost of inaction outweighs the cost of introducing dental care into the public health system.

But the government remains cautious for now.

A trip to the dentist costs an average of $353 per visit. An estimated 40 percent of New Zealanders cannot afford dental care.

Hugh Trengrove, an Auckland dentist, said the impact of dental problems on productivity is obvious to anyone who has experienced them.

“It affects your ability to sleep, eat, function on a daily basis and will certainly affect your productivity.

“If you have a toothache, even if it’s a passing background toothache, it will affect your ability to work and it will also affect your social interaction and your ability to interact with people. And if you’re in a work environment, of course there is an impact on productivity.”

Dental for All, a group of health professionals, trade unions and anti-poverty campaigners calling for dental services to be included in the public health system, commissioned a report into the social, economic and financial costs of New Zealand’s current dental facilities.

Using the Treasury’s cost-benefit analysis tool CBAx and existing New Zealand and overseas research, consultancy FrankAdvice found the current system costs New Zealand $2.5 billion a year in lost productivity and $3.1 billion in lost life satisfaction or quality of life.

It is also estimated that $103 million was spent on sick leave.

The barrier to universal dentistry has always been the cost, which can reach $2 billion.

ActionStation and Dental for All campaigner Max Harris said the question has always been how much it will cost the government to do something, when it should be how much it costs to do nothing.

“We know it causes shame, stigma, means people can’t participate in society, they can’t smile. But this report also shows that we lose a lot in the economy by keeping dental services out of the public health system.

“It’s actually leading to people not going to interviews, poor oral health is impacting the workforce and I think that’s really important as we look at economic recovery.”

The report did not take into account the costs and benefits for people who could afford private dental care, and found some impacts that did not have an estimated monetary value.

Many of the figures were also based on data up to 2022 and therefore could not take into account the impact of the expansion of dental grant eligibility extended by the previous government.

Therefore, according to Harris, the estimates were conservative.

“Removing dentistry from the public health system may cost even more than the numbers in this report, but because we tried to be responsible in these estimates, we ended up with the numbers we have now,” he said.

“I should add that there were some other results for which we were not able to provide costs. So this is really a minimum estimate of how much it costs our society not to integrate dentistry into the public health system.”

Dental care is currently free for those under 18 years of age. Low-income people or welfare recipients can apply for grants for immediate or necessary treatment, but not for periodic cleaning or check-ups.

Trengrove, who is also a member of Dentistry for All, said there had been an increased demand for emergency and emergency care, which had largely been limited to tooth extractions.

He said that in an ideal world, no one would need dental care.

“If we had effective public health measures and an effective and functioning system that improves access to education and preventive services, then tooth decay could become a thing of the past. And we’ve chosen not to do that as a nation, we’ve chosen not to invest in adult oral health, and that comes at a real cost.”

Expanding free dental care is an issue that comes up every election cycle.

In 2023, the Green Party campaigned for universal free dental care, paid for through a wealth tax.

Te Pati Māori proposed free dental care for families with incomes under $60,000, while Labor pushed to make it free for children under 30, with a view to gradually expanding it.

Labor’s health spokeswoman Dr Aisha Verrall said the party’s policy remains to expand access.

“There is no logical reason why free health care stops at your teeth,” she said.

But given the workforce and other infrastructure would need to be built up, Verrall said a gradual introduction was the only way to go.

“Preparing people for life with good dental care in early adulthood is a really important start that will keep them healthy throughout their lives. But I am quite confident that the creation of universal free dental care will go beyond one political term.”

Harris believed that the will for political change had never been stronger.

“It’s really just about closing a gap, correcting an anomaly, and we think that can be done across the board. Some politicians will want to be more cautious, but we urge those politicians to act quickly because, as this report shows, inaction is costing us dearly.”

Prime Minister Christopher Luxon told RNZ the health system as a whole needed to get itself in order first by focusing on the five health goals before moving on to dental care.

“I understand that there are real problems and concerns associated with dentistry. But at this point, our system that we’ve invested record amounts of money into, you know, it’s a system that we’ve invested an additional $17 billion into over the next three years, but we need to improve the system.”

But Trengrove said the problem could no longer be ignored.

“I think the situation is changing. I think people are concerned about this. When you consider the government to not fund dentistry, it is effectively shifting the cost of dentistry onto individuals, and often the most vulnerable,” he said.

“If you step back and look at it that way, I don’t think politicians have any choice. I think they really need to get up and do this.”

Trengrove acknowledged that the public health system in its current form would not be able to provide universal access. Instead, he proposed an integrated model that was publicly funded but used private practice to provide services.

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