Kiwis are neglecting their oral health because of the cost of visiting a dentist.
Fear of the bill, rather than the drill, is the motivating factor, with a Sunday Star-Times reader poll revealing 64 per cent of participants had put off going to the dentist because of the cost.
Young adults were worst affected, with those with young children putting priorities such as supporting their families, ahead of their own dental health.
In 2010 a Health Ministry oral health survey identified cost as a significant problem for 25 to 34-year-olds.
Most of them, 59.4 per cent, knew they needed dental care, but 61.7 per cent of those, had not seen a dentist because of the cost.
Librarian and mother of three children under seven, Lesley Longstaff, falls into that group.
Both she and her part-time graphic designer, photographer and stay-at-home dad husband Jonathan, have neglected regular dental care because of the cost.
Longstaff last visited a dental hygienist three years ago after getting frequent reminders from her dentist's surgery.
"I had my wisdom teeth out about six years ago and they kept sending me check-up reminders. They kept calling and eventually I said I'd come for a check-up. They spent a lot of time cleaning my teeth and making sure I knew how to floss.
"I had no idea how long I had been in there until I went out and they wanted to charge me more than $100, which at that time was close to what we were paying for groceries each week. I thought, `I'm not going to come back here in a hurry'."
Despite her dentist identifying problem spots that needed monitoring, she hadn't been since, and says she'll go only in an emergency because she has other priorities. "I'd rather feed my family than have somebody look at my teeth, and say they're lovely."
Her husband had been to the dentist twice in the last 10 years, since returning from the United States, where his dental work was covered by medical insurance and he had an annual check.
Associate Health Minister Tariana Turia said the Government was concerned at the high number of people aged 25-34 who avoided preventive check-ups because of the cost, but shifted ownership back on to consumers.
"The Government spends nearly $150 million each year to make sure our teenagers are `dentally fit' when they become adults at 18, and it's important our young people don't waste that investment in adulthood."
Turia encouraged early attention to minor dental problems, to prevent the cost of treatment becoming a barrier later. "I encourage all young people to keep brushing their teeth and stop drinking juice and fizzy drink. Wai Maori is the answer – pure, healthy water."
Public health dentist Dr Neil Croucher said despite improvements, New Zealand still had high oral health problems, often associated with poor general health.
"Those people who have poor oral health are more likely to have chronic diseases early in their life, like diabetes. There are also a few direct links, and one is poor oral health and increased incidence of heart disease," he said.
He said prioritising oral health care should be an issue. "Going to the dentist is important, but cost is a barrier to many people, and because private dentistry isn't cheap, it has to be a priority for that person to decide to go."
He said there was little doubt cost was a barrier. "Cost is a factor to most low and middle-income earners, and even I worry about how big the bill is going to be, even as a high-income earner."
He said regular visits to a dentist meant long-term problems could be avoided. "When people don't attend once a year they miss out on the chance of disease being detected early, and on having prevention and treatment intervention."
Expense all depends on where you are sitting
A New Zealand Dental Association fee survey in 2010 calculated the average dentist's hourly rate was $455.
Association chief executive David Crum said there was some truth to the stereotype of dentists driving Porsches, because they did earn a high income, but he said dentistry was a highly skilled profession.
"Dentists' incomes are similar to doctors and lawyers, but less than politicians. And measure it against training for five years at university in the most expensive course, student loans of around $100,000, and a cost of purchase to practice of about $300,000."
He said because Government funding for dental care stopped at 18, patients had to meet the bill, and dentists could not share their workload with lesser-skilled people.
"A lawyer can employ a number of less well-trained people to do the work, but for dentists, it's their one pair of hands that generates the income."
He also said equipment costs were very high. "A chair can cost around $100,000."
Health Funds Association chief executive Roger Styles said New Zealanders tended to see dentistry as a routine cost, rather than one they needed to take insurance to cover.
He said dental insurance here was most commonly offered as an add-on to an existing health policy.
In tough economic times there was an increasing trend to trade down more comprehensive policies to cheaper ones, most of which did not include dentistry.
But Sunday Star-Times reader poll respondents were less understanding about the high costs of visiting the dentist. One warned that young people she worked with prefered having teeth pulled rather than having them fixed, because of the cost. "The next generation will not have their own teeth."
Many confirmed the cost of visits made treatment impossible. "Although I know I need to go, the cost is far too much for my budget," one said
The Star-Times made random inquiries at several dental sugeries, and found a range of pricing.
- Sunday Star Times