Oral health disease in New Zealand is in a state of crisis. How do we navigate our way forward?
Oral health in New Zealand encompasses a variety of conditions, including dental caries, periodontal disease, oral cancer, oro-facial trauma, and congenital anomalies like cleft lip and palate. According to the 2009 New Zealand Oral Health Survey, while 90% of adults have some or all of their natural teeth, one-third suffer from untreated tooth decay and a similar number show early signs of gum disease. Additionally, 40% of adults reported a history of dental trauma, and the 2008 Accident Compensation Corporation data recorded 32,110 oro-facial injuries. In 2020, the New Zealand Cancer Registry reported 547 cases of cancers affecting the lip, oral cavity, and pharynx. These chronic and cumulative conditions highlight the necessity for ongoing oral healthcare.
The impact of oral diseases extends beyond discomfort and appearance, affecting self-esteem, social interaction, and overall health. Serious complications can include severe pain, dental abscesses, and life-threatening infections. Oral health outcomes are influenced by a complex interplay of socioeconomic, environmental, and biological factors, disproportionately affecting Māori and Pacific peoples.
Current funding mechanisms for adult oral health services in New Zealand are insufficient, creating significant barriers to care. Nearly 40% of adults avoided dental visits due to cost concerns, as reported in 2020/21. This issue is particularly acute among middle and low-income earners who often defer essential dental care due to financial constraints. Even though children and adolescents have access to publicly funded oral health services until their 18th birthday, adults face considerable challenges in accessing affordable dental care.
To address these disparities, the New Zealand Dental Association (NZDA) proposes a strategic roadmap aimed at achieving equitable access to oral health services. This plan includes immediate, actionable steps and intermediate strategies, progressing towards long-term goals. The strategy encompasses broad systemic changes. These include integrating oral health into comprehensive primary and community healthcare frameworks, building and developing a culturally and clinically safe workforce of oral health professionals, extending services to rural and remote communities, enhancing public health measures like fluoridation, and supporting kaupapa Māori oral health services.
Financial assistance is also available through Work and Income New Zealand, which offers up to $1,000 per year for immediate and essential dental treatments, accessible to all residents, not limited to those on benefits. This support is crucial in mitigating the cost barrier, yet a more comprehensive approach is necessary to ensure sustainable and equitable oral health outcomes.