There is absolutely no doubt that healthy teeth are vital for a healthy life.  

Poor dental care can actually kill you. There's a small number of cases from the States they read about recently where an untreated tooth abscess led to an infection that spread to the brain, and a number of children died as a result of that.  

Even without catastrophising, bad teeth are miserable. It's painful, leads to other infections throughout the body, it's unsightly - robs people of self-confidence if their teeth are all over the place.  

But at $353 per visit to the dentist, on average, dental health is not a priority for many people. It can't be. If the money's not there, it's not there.  

A new report has found that New Zealand's dental system as it stands is costing billions of dollars a year in lost productivity and social impact.  

The report from Dental for All, who are a group of health professionals, unions and poverty campaigners, is another call to arms to make free dental care universal, with campaigners saying the cost of not acting is exceeding what it would cost to bring dental into the public health care system.   

The argument against has always been the cost of it. We've seen how much our public healthcare system costs, ballooning costs, that successive chief executives of Health New Zealand have been unable to manage - bringing dental health into that adds another couple of billion to the cost. But Dental for All, and their argument is a bit like the argument David Seymour put up for funding more drugs from Pharmac. He said, well, it's going to cost us less in the long run than allowing diseases to develop and take hold within the community, so if we can prevent them from occurring in the first place, saves us down the track. That's precisely what Dental for All are arguing.  

While there is free dental care up until the age of 18, the New Zealand Dental Association policy director, Doctor Robin Wyman, told the Mike Hosking Breakfast, they believe free dental care should continue into your mid- 20s.  

“It would make some sense if you look at the research to increase the free dental care scheme which goes up to 18 years old into the mid 20s. That's where we see quite a peak of acute admissions into hospital in that young adult group. We're not talking about fractures and things like that, we're talking about infections and things that need to be treated.  

Where do you draw the line, though? If you said free, what is it? Is it a check up? Is it a filling? Is it root canal work? Is it veneers? What is it?  

I think we talk about the essential dental care - so check-ups and fillings, tooth out if that needed to happen, maybe you would go to root canal treatment, particularly if you're talking about front teeth and those sorts of areas. We're not talking about cosmetic treatments like veneers and orthodontics in that sort of area.” 

Dental for All estimates the current system is costing $2.5 billion in lost productivity, $ 3.1 billion in lost life satisfaction, or lack of quality of life.  

Another $103 million was spent on sick days through poor dental health. However, as Doctor Wyman pointed out to Mike they were looking at the lower 22 percentile, so not New Zealanders overall.  

This has come up periodically. The Greens proposed universal dental care, funded with the wealth tax. Labour were looking at free dental care when they were tossing out ‘please vote for us’ during the election campaign - one of them was free dental care for under 30s, gradually increasing that to the population overall.  

It is hugely expensive and it only gets worse as you get older. As teeth start to age, the gaps start to form, they start to erode and that's when you need the expensive dental work done. The crowns, the root canal and the like. If you can get through 15 to 18 and you don't need the orthodontics, the next time the big expenses hit is around about 50 plus as your teeth start to age.  

There are people who travel overseas because it is less expensive to go to Thailand and get your teeth done, even with the airfares, even with the stay in the hotel, than it is to go to New Zealand dentists.  

If things go Pete Tong, however, you're not covered by ACC, so it could end up costing you more in the worst-case scenario.  

All very well and good to talk about let's pay for the costs upfront and then we don't have to pay for the lost productivity, the quality of life.  You can make up any number really when it says look at your lost quality of life, lost productivity.  I've no doubt that there are people living in misery because of the state of their mouth and it's leading to bigger problems further down the track that sees them hospitalised.  

But again, if the money is not there, it's not there, just as it's true of household accounts, it's true of government accounts.  

Do we have $2 billion right now to put into universal dental healthcare? Adding that to what we already can't pay for in the public health system.  

Some people are lucky. Some people are born with great teeth. Never have to worry really. Others are plagued from the time they're born with chalky teeth that give way, cause problems, end up with cavities, can't afford to treat them and it just gets worse and worse and worse.  

Is it a case of having to come up with the money so we save money down the track? Do you buy that having a universal dental healthcare system would save us money in the long run, or is it something that you just have to deal with yourself? Pray that your parents gifted you good teeth?  

Back in the olden days, like the 40s, 50s and 60s, women used to have their teeth taken out before they got married and fitted with dentures, so they didn't cost their husbands anything. Can you imagine? Perfectly healthy teeth being ripped out of the mouth of a 19-year-old recently engaged woman as a kind of dowry paid for by the bride's family. We don't want to get back to that now, do we?   

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