That quotation, from Jean Devanny’s novel Lenore Divine, set in 1920s Wellington, published in 1926, and again, with introduction and explanatory notes, by Otago University’s English Department in 2012 (thanks, Shef Rogers, of Otago, and Kirstine Moffat, of Waikato universities), was brought to mind by the report in the ODT (4.3.24) headlined "Half of NZers not going to dentist due to cost".
Concern about children’s poor dental care led to the establishment in the 1920s of the school dental service, staffed by dental nurses (Civis’ mother was one in the 1930s) trained in a new institution in Wellington, situated for many years in what’s now Premier House).
As the Dental Services volume of the Official War History records, the Corps, re-established for World War 2, worked to achieve and maintain good dental health in all service personnel, to keep them healthy and fit for duty, and to fulfil the government’s promise "to return every man to civilian life dentally fit".
That comprehensive approach to dental health wasn’t part of the New Zealand social welfare reforms of the same period (unlike the National Health Service set up by Britain’s Labour government after the war). Apart from children, civilians were left to their own resources to fund dental care, and still are, apart from those sometimes subsidised because they receive a benefit. As the ODT article pointed out, tough luck for the working poor.
With a single amalgam filling costing over $300 on average (composite nearly $400), even those earning a "living wage" may struggle to pay for more than minimal dental care. And why bother to pay for regular checks if one can’t afford treatment?
Up to year 8 (last intermediate school year) state-funded dental care is available from dental therapists in school or community clinics: from then till age 18 by contracted dentists. Both require proactive enrolment by parent(s) — 2020 research showed many parents don’t know how to do so, and that the process can be convoluted and difficult. One wonders how cover now compares with a dental nurse in clinic at most primary schools, regularly working her way through each class.
Recent statistics are worrying. A 2022 paper in the Journal of the Royal Society of New Zealand showed dental decay was the commonest non-communicable childhood disease in New Zealand: 60% of Māori, 70% of Pasifika, and 33% of non-Māori/non-Pasifika children had already experienced dental decay by age 5.
And 3537 children aged 0-14 were waiting for dental treatment (most, presumably, extractions) in hospital under general anaesthesia in December 2021.
Preventing decay for as long as possible is important. Water fluoridation helps, as would reducing unhealthy food and drinks (Britain’s sugar tax reduced child hospital tooth extractions for decay by 12% within 22 months).
But adult decay remains a problem, causing pain, poor nutrition, life-threatening head and neck, and systemic, infections, and, in pregnant women, increasing the risk of having premature, low-birth-weight babies.
The National Party’s manifesto promised "targeting better health outcomes"; the coalition agreements "people-focused" services designed around "needs".
Why not target the most needy, those with Community Service Cards, for free dental care?
Are tax cuts for the better-off (and a skifield subsidy) really more important?
