Basic dental treatment is free for children. See what it would be like to make it free for others.
Every day, in elementary and middle schools across the country, children go to the dentist. Sometimes this service is provided in school dental clinics. other times, it’s in a mobile dental van. Lateisha Chant is one of the oral health therapists in this van, working mainly in kura kaupapa Māori around the Wellington area. “I love my job – I’m so lucky to be able to build good relationships with my community,” she says.
As an oral health therapist, Chant diagnoses teeth and gum problems, but also provides education on how to take care of your mouth, which is important for children to know from a young age. “In school dental services, we go in and can see the kids quite regularly and by having that regular care, we can catch things before they get older,” she says.
Along with the children come their parents – some of whom ask if they too can be healed. But the funding just isn’t there. At recent school holiday clinics, Chant had many parents requesting dental care each day. “It’s heartbreaking, because you just want to help them on a human-to-human level,” says Chant. “I do what I can to help tamarins, but if they’re over 18, it’s like – I’ll give them toothpaste samples.”
Chant is a supporter of it Dentistry for everyonea campaign to make dental visits free for everyone in New Zealand. Her experience working with children, who can receive free dental care, shows some of the ways in which expensive dental care fails to deliver for everyone and why the system needs reform.
Once the children go to high school, then their free dental care is provided by private doctors contracted by the government, not all of whom are dentists. This contract has not been updated for 20 years, says David Excell, president of the New Zealand Dental Association, and is not financially viable. “Many dentists only provide contract care out of goodwill.” A review to look at the conditions is currently underway and will be completed in 2026. Dentists who see teenagers from year nine onwards often find issues that require more expensive, complex, time-consuming treatment – because these children had issues that were not addressed earlier.
Currently, Excell says, the dental service is “way behind” when it comes to seeing under-18s, with only around 70% receiving the full care they are entitled to. Dentists like Chant are in demand, but the workforce is small and training is only available at Otago University and Auckland University of Technology.
The same goes for dentists. “We still produce just 60 dentists a year, and that number hasn’t changed since 1985. Since then, our population has grown by two million,” says Excell. Currently, about a third of dentists are trained overseas, but the number of dentists immigrating to New Zealand is increasing. “We are starting to rely on the overseas trained workforce – in a few years only 50% of dentists could be trained in New Zealand,” says Excell. NZDA has called for an increase in the dental workforce to 90 funded positions in the dental school at the University of Otago each year.
In some areas, the issue is access. Dental for All recently held a roadshow across the country, with free dental days and opportunities for people to share their experiences of the dental system. The team found that in some areas, such as the East Coast, mobile dental clinics had not visited schools for years. “Making dentistry truly public – creating a comprehensive community dental service for children, teenagers and adults – would improve planning and accountability for the under-18 service and means the government needs to respond to the fact that oral health is part of general health and needs urgent attention,” says Hana Pilkinton-Ching, Dental for All campaigner.
Chant worked in Te Tai Tokerau before moving to the Wellington area. “It’s really hard to staff — it’s a big, high-need area.” Some new graduates are recruited through the voluntary bonding scheme, a Te Whatu Ora initiative where health professionals are paid extra money to work in areas where there are not enough of them. The money can be used to offset student loans immediately. She is optimistic that more Māori health professionals will come through dental training. “A lot of them actually go back to where they were born and raised, wanting to give back to the community,” he says.
What about adult dental care?
If subsidized under-18 dental care falls short, then unfunded over-18 dental care leaves even more people behind. The Department of Social Development has increased the “special needs” grant for dental care from $300 to $1,000 in 2022but many people don’t qualify – for example, if you have other savings you could use instead. Multiple fillings, extractions or root canals can cost well over $1,000, especially since those in greater need tend to visit the dentist only when they are in severe pain.
NZDA provides full oral care in partnership with ARCH, the Aotearoa Charity Hospital. Ten $10,000 grants for low-income adults who could not otherwise access care are available in the 2025 funding round. With dentists providing care not billed for their time, this has provided more than $430,000 in dental treatment for 300 people across the country. Many of those who received treatment were found through city missions or other charities that work with the homeless.
Instead of the limited treatment options covered by MSD’s $1,000 grants, dentists were able to perform extractions, provide dentures, and restore people’s mouths to full function. “It’s just life-changing,” says Excel. For people who have access to a full treatment program, this funding is amazing, but it does not account for the number of people who do not receive treatment. Some of the stories of unmet need are told in a Dental For All Exhibition since early this year, which includes people being charged to pay for root canals, having to prove they don’t have savings to access the MSD dental grant, and canceling other health appointments to prioritize dental care.
NZDA supports the extension of full dental care until at least the age of 25. “When people leave home, go into the workforce, we lose them,” Excel says. “A small filling caught at an annual checkup won’t turn into a root canal, extraction, or debilitating infection that lands you in the ICU.” Although the costs would be high, preventive health care saves money, Excell says – both on treatment and on other costs like sick days, poorer nutrition if people can’t eat normally, and lost quality of life from pain and discomfort.
Oral health is an inherent part of any other health care: what happens in the mouth, of course, affects the rest of the body. Excell believes New Zealand’s exclusion of oral health from the otherwise subsidized health system makes dental care look trivial. “Dentistry is treated as polite,” he says. “If the government doesn’t see dental care as a priority, why should New Zealanders?”
Tule Misa, president of the Pacifica Dental Association, practices in Christchurch. She sees the impact of unaffordable dental care every day: her patients “don’t sleep, they don’t go to school, they don’t go to work because of the problem they have with their teeth,” she says. Sometimes, people knock on her door when she’s at home, asking for help with their teeth – but the most she can offer is a prescription for pain. He has seen members of the Pacific community take out loans to pay for dental treatment with consequences along the way. “Then they have to pay for the loan and the cost can be very high.”
If free dental care was to be made more widely available, whether for 18-25 year olds or for everyone, there is much to learn from the current dental care provided to under-18s in terms of how to make it more accessible. Many of Misa’s patients do not feel comfortable in the dental office.” It feels scary and unknown,” she says. “A lot of people won’t access care until they’re in pain.” Time is also a factor – when she babysits, she finds that parents with shifts often can’t make appointments. “There are a lot of people that, until I see them, all I can do is pick them up [their tooth] out.”
“We don’t see many under-18s because they don’t know it’s free,” says Misa. Would like to see the model he is using youth “one-stop shops‘, offering primary health and mental health care, to dental care, where the focus is on making the environment welcoming and inclusive. He also believes a dental equivalent of Healthline would make it easier to seek help. come in when you need it.”
Making dentistry accessible to all was a political platform of Labour’s 2023 campaign and is a pillar of Alternative Greens budget for 2025. Dental care extended to the age of 25 for Community Service Card holders New Zealand First’s policy for 2023but not part of their coalition agreement with the National. In other countries, such as the UK, dental care is fully integrated into national health schemes. “I just want people to be able to get care whether they can afford it or not. I just can’t wait – I hope to see it in my lifetime,” says Misa.
