The $2 dollar per day dental budget

Prepare for a cash extraction!
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Prepare for a cash extraction!

Families should be budgeting around $2 per adult per day for dentistry.

Children get "standard" dentistry for free (braces not included), so they can be left out of the budget until they turn 18.

Two dollars a day adds up to just shy of $1500 for a couple.

There was no saving this tooth.
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There was no saving this tooth.

It's a lot of money, but Andy Tapper managing director of Lumino, the largest dental practice chain in the country with a  market share of around 13 per cent, says the average spent by each Lumino customer in a 12-month period was around $750.

Averages are always a little deceptive.

Over half of us only head to the dentist when we have a problem. They will be dragging up the average because they'll be paying for more than the check-up and clean regular goers generally face.

The routine stuff can be had for $300 a year.

Tapper says Lumino's Auckland Proudmouth mega dental surgery is trialling a "care plan" which costs $300 a year. It gives the patient two cleans with the dental hygienist, and one check up. If people need any extra work done, and there's more to pay.

Tapper says so far just over 2000 people have signed up for the plan, but it's a pilot that has yet to be rolled out to other Lumino dentists.

Directly pre-funding dental care like this isn't something Kiwis are in the habit of, though many people use hospital and surgical health insurance to pick up most of the tab for the really big stuff, like dental surgery and the extraction of impacted wisdom teeth.

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But there is a rise in people using the "everyday" health plans from NIB and Southern Cross to part pre-fund standard dental care like check-ups and minor fillings. These are often bought to top-up the hospital and surgical covers.

These everyday plans allow people to claim back some of the costs of some preventative dental treatments, though dental is only part of what they cover. Depending on the level of cover, these plans cost roughly $5-$10.50 a week, but the excesses policyholders pay mean that they still have to foot part of the bill

NIB's Everyday basic cover costs $4.95 a week and pays up to $500 for dental treatments a year, but only 60 per cent of each treatment cost, and it does not cover all treatments. Wisdom tooth extractions are not covered, for example.

NIB's Everyday Mid cover costs $9.55 a week, and has a dental claims limit of $750 a year, and includes wisdom teeth extractions.

The proportion of dental work paid by health insurers is quite low though.

In Australia, it is about 20 per cent, Tapper says. "In New Zealand, we are not sure what the statistic is because it has always been so low. It hasn't really been measured. It would be less than 5 per cent."

For those who do not pre-fund their dental care, interest-free loans from the likes of Q Card are becoming an increasingly popular option.

Lumino has done a deal with Q Card for 30 month interest-free finance.

Tapper said that between 10 and 30 per cent of treatments depending on the surgery are being funded this way.

Q Card payments tend to be for higher value treatments, he said, saying it was cheaper than people using their credit cards. At some dental practices around half of payments are made with credit cards.

Given that a decent set of chompers is important for health, happiness, and career advancement, the failure of many people to regularly go needs explaining.

There's no shortage of dentists. Tapper says there are around 2200 dentists at work in the country, and most have spare capacity to take on new patients.

And tooth extraction figures indicate there's the need for preventative care is high.

Southern Cross Healthcare has researched the issue.

A survey of over 2000 people it commissioned found 68 per cent gave affordability as the reason for not going regularly.

Even income-rich households bringing in $100,000 or more a year cited affordability as being the number one barrier.

Fear does play a part, but only 19 per cent claimed fear of dentists kept them from going for routine check-ups.

Tapper says dentists believe many people just aren't prioritising dental care over spending on other things.

"People should be saying I should be investing some money in my oral health, but so many people don't place enough value in it. People automatically conclude that it is expensive," Tapper says.

Lumino's per customer average spend indicated how much people should be setting aside for dentistry.

While the dental problem is a tough one to crack, there are signs of progress on one front.

Under 18s get free routine dental treatment. The mystery has been why such a high proportion of kids weren't accessing this free care.

In 2006/07, a quarter of kids weren't seeing a dentist each year. That's down to just 16 per cent in 2013/14.

READ MORE: Kids getting rotten baby teeth pulled out

The other big way Kiwis fund dental work in New Zealand is through Work and Income (See Ministry of Pain), though ACC covers costs after an accident, and some charitable dental work being done.

An example is the free dental care being provided to up to 1500 low income adults through Smile New Zealand, which is a charitable partnership between Southern Cross Health Trust and the New Zealand Dental Association.

Terry Moore, chief executive of Southern Cross Health Trust, says: "We know from our research that there are a lot of New Zealanders cannot afford even basic dental care – as unlike the majority of health, dentistry isn't a subsidised service. Many people in our communities struggle to pay for day-to-day basics so seeking dental care even when they are in pain simply isn't within their budget."

THE MINISTRY OF PAIN

The Ministry of Social Development through Work and Income will pay for emergency dental work for beneficiaries.

Sometimes it makes grants, sometimes loans that have to be paid back.

That it does so recognises that a benefit isn't enough to pay for unexpected dental costs.

The maximum "Special Needs Grant" for dental work is $300 within any 52 week period, though the ministry says: "Where exceptional circumstances apply, this amount may be exceeded or more than one payment may be made."

If there are no exceptional circumstances, or where people aren't poor enough to qualify for the grant, they may qualify for an "Advance Payment" of benefit to pay for dental work.

This has to be paid back, usually as a deduction from future benefit payments.

Not all dental treatments are covered. Those that are include root treatment, tooth extraction, tooth restoration and the treatment of acute infection, the ministry said. Each year the ministry pays out on around 26,000 treatments, with grants of between $12m-$13m, and advance payments of $9.5m-$11.5m.

OH, NO, WE WON'T GO

The annual New Zealand Health Survey shows how many of us do not routinely go to the dentist. The latest survey for the 2013/14 year showed a clear link between people's income and the frequency of visits.

  • 49.7 per cent had visited a dentist in the past 12 months.
  • Nearly a quarter of a million people had a tooth pulled.
  • 53 per cent said they only went to the dentist when they had a problem.
  • Men were less likely to have gone than women. Maori were less likely to have gone than Pakeha. Pacific Island people were even less likely to have gone. Asians were less likely to have gone than Pacific Islanders.
  • 76 per cent of people who live in "high-deprivation" areas only visit dentists in emergencies.
  • 84 per cent of children aged 14 or younger visited the dentist.

 - Stuff

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