The individual and collective economic reasons for including oral health in our public health system are clear, and there are distinct social benefits too \u2013 a sense of shared dignity and respect for all. <\/p>\n
When I was a young person with a broken front tooth, the replacement snapped off at numerous inconvenient times over my teen years. Once or twice, there were delays in fixing it, and I remember vividly being an embarrassed teenager trying not to open my mouth, smile or laugh, and covering my mouth while eating.\u00a0<\/p>\n
After I turned 18 and was no longer able to access free dental care, there was a drastic change in how regularly I would go to the dentist. Over the next decade as a student, spending years on low wages or stipends, the costs associated with a visit to the dentist were a scary unknown. Over seven years of postgraduate study I didn\u2019t go to the dentist once. Although, as I waited, I was fully aware that those unknown problems could be intensifying in severity \u2013\u00a0and therefore associated cost \u2013 over the time I delayed.\u00a0\u00a0<\/p>\n
The broken tooth of the author\u2019s youth<\/p>\n
Across my cohort of postgraduate students, and the many undergraduate students I taught, the vast majority were also neglecting their oral health. It was only severe emergencies that pushed people to act. Postgraduate tertiary students are one very specific cohort of our population, and this illustrated to me that it was only the very tip of a huge iceberg, where the magnitude of this issue was obscured below the surface.\u00a0<\/p>\n
I am a political geographer who has spent several years thinking and writing about social infrastructures<\/a> as places of connection and sociality, as sites where we encounter each other: they improve both our everyday lives and the cohesion of our broader communities as well. Much of my work has been around the myriad benefits of a specific type of collective space \u2013\u00a0the public library<\/a>. Without the collective funding that goes into provisioning libraries, the books and services that we can all access would be impossible to imagine for most individuals. The benefit of sharing is illustrated clearly: in the large spaces, the storytime sessions, the collections of \u2013\u00a0in Auckland \u2013\u00a03.5 million different items to borrow!\u00a0<\/p>\n Public libraries use the power of the collective, drawing on tax across a large base, to provide services of a quality and scale we could not access individually. Recently, I have become interested in another type of collectively provisioned service\u00a0\u2013\u00a0the idea of accessible, public oral health services advocated for by Dental for All<\/a>.\u00a0<\/p>\n Established in 2022, Dental for All calls for universal, free, Te Tiriti o Waitangi-consistent oral healthcare. It is a campaign supported by a coalition of oral health workers (dentists and oral health therapists, including Te Ao M\u0101rama \u2013 the Aotearoa M\u0101ori Dental Association), unions (ASMS, Workers First and E t\u016b), and poverty action groups (including Auckland City Mission and Auckland Action Against Poverty). They have done research on the state of oral health in Aotearoa, engaged with politicians, organised more creative actions (including hosting a gig), and are now in the midst of a national roadshow.\u00a0<\/p>\n They support universal oral healthcare as an example of universal services. Universal basic services guarantee access to the day-to-day shared essentials that each person needs to live a dignified life. The services can be understood<\/a> to include the provision of basic food, transportation, education, healthcare and housing. Researchers internationally have argued that true universal healthcare coverage cannot be achieved without the inclusion of oral health.<\/a> Our system already illustrates that public healthcare is possible, and more than that \u2013\u00a0that it is highly desirable. ASMS polling<\/a> shows 74% of people in New Zealand already support free dental care.\u00a0<\/p>\n In a growing cost of living crisis, where everyday expenses for New Zealanders are growing at every turn, a visit to the dentist continues to be delayed by many. As a recent study in Dunedin illustrated<\/a>, people often \u201coperated on a \u2018hierarchy of needs\u2019 in their family lives \u2013\u00a0and other necessary payments such as rent, mortgage, food and other essentials were given higher priority over accessing oral health services\u201d. These delays have huge flow-on effects, for individuals, families and the country at large.\u00a0<\/p>\n A recent iwi-led initiative in the Whanganui area<\/a> offering access to free dental clinics over a short period of time was overwhelmed with people, and illustrated the scale of those people across the country in \u201cextreme need\u201d.\u00a0<\/p>\n The latest NZ Health Survey reports that 45% of adults are not accessing dental services because of cost. Earlier research had illustrated that 40% of New Zealanders<\/a> cannot afford dental care at all. This has extraordinary impacts on the quality of people\u2019s daily lives, as well as escalating costs for the country as a whole.\u00a0<\/p>\n In a recent report commissioned by Dental for All,<\/a> the current system was found to cost New Zealand $2.5bn a year in lost productivity, and $3.1bn in lost life satisfaction or quality of life. An estimated $103m was spent annually on oral-health-related sick days.\u00a0<\/p>\n This exclusion of oral health from our public health system had always seemed arbitrary to me. I recently learned it was originally designed as a key part of our public health provision<\/a>: \u201cWhen Prime Minister Michael Joseph Savage and his government designed these health reforms, dental care was intended to be included, but the dental profession organised strongly against this,\u201d wrote Bryce Edwards in a piece for Newsroom. \u201cA compromise was eventually established of giving free dental care to children, and leaving adults to use privately-provided dentists.\u201d\u00a0<\/p>\n Dental for All argues for this exclusion to end. I am not a part of this campaign group, but I support this cause \u2013 and I think it offers an opportunity to reflect on the value of universal services, in particular during a cost of living crisis.\u00a0<\/p>\n With Dental for All we can see the benefits of collectivity from an oral health perspective. There are both individual and collective economic reasons to support the inclusion of dental care into our public health system, as described above. But it also has distinct social benefits. In this time of growing polarisation, the stigma and shame<\/a> attached to neglected oral health can further push people out of the community, further isolating them<\/a>. In direct contrast to this is the feeling of inclusion that comes with being able to treat health issues through the same system all others in the country have access to. This offers a sense of shared dignity and respect to all people. Universal services both allow and increase broad participation in society, strengthening our cohesion, commitment to each other and solidarity.\u00a0<\/p>\n Let us remedy this ongoing exclusion and roll out universal healthcare as it was first intended.\u00a0<\/p>\n","protected":false},"excerpt":{"rendered":"The individual and collective economic reasons for including oral health in our public health system are clear, and…\n","protected":false},"author":2,"featured_media":22728,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[34],"tags":[492,3187,134,527,111,139,69,2114,2935,23547],"class_list":["post-22727","post","type-post","status-publish","format-standard","has-post-thumbnail","category-healthcare","tag-comments-enabled","tag-dental-care","tag-health","tag-healthcare","tag-new-zealand","tag-newzealand","tag-nz","tag-opinion","tag-society","tag-universal-free-dental"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/22727","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/comments?post=22727"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/posts\/22727\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media\/22728"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/media?parent=22727"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/categories?post=22727"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/nz\/wp-json\/wp\/v2\/tags?post=22727"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}