The Government's 'Wellbeing Budget' is out this Thursday, but don't expect much help when it comes to the wellbeing of your teeth - despite dental care being a big and obvious health problem in New Zealand.
Everybody deals with teeth issues in some way, and that's why it's the topic for Newshub's latest 'Because It Matters' campaign.
Official survey figures reveal that almost half of Kiwi adults don't go to the dentist - 44 percent or 1.6 million people - many because they simply can't afford to.
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It's expensive, as once you're older than 18 and working there's no taxpayer subsidy whatsoever, and virtually no help for beneficiaries either.
That's even though poor oral health can lead to other illnesses, such as diabetes, heart disease and possibly even cancer, and can also have a negative impact on mental health.
For many, it is a crisis. This X-ray illustrates one woman's struggle with her teeth and the many ways it's impacting her life.
The dentist's office is known as the 'murder house' to some, but for Crystal Selwyn it's the answer to her dreams - if only she could afford what she needs.
Selwyn is a true Kiwi battler. She's bringing up six kids on her own and works five nights a week as a cleaner at Waikato University. She would like to get a higher-paid job, but her teeth are holding her back.
"A lot of jobs I want to get into are customer service, but I don't have the confidence to even go into a job interview and say 'I want to be your frontline face' sort of thing."
That's because she has a genetic condition that means her teeth are very soft and more prone to decay. It even affects her on the sideline watching her kids play sport.
"You want to cheer them on as much as possible, but at the same time you're like [covering your mouth], that sort of thing," she told Newshub.
She needs work done - lots of it. Every tooth has rotted and needs to be removed.
Like many New Zealanders, she has no idea how she's going to pay for it. Based on official costs from the Dental Association:
- Her examination and X-rays: $152
- Scans of her jaw: $182
- Gum treatment: $360
- Upper and lower dentures: $2500
- A denture re-line: $428
- All the extractions: $229 per tooth, $4580 for all 20 teeth
"Even extractions are expensive, so I was hoping they'd all fall out and I could just get dentures," Selwyn says. "But apparently that doesn't work."
All up, she's facing a bill of $8259.
"It's such a regulated and high-quality industry," dentist Assil Russell says.
"That's an understandable cost, but for someone like Crystal, it's unaffordable, it's unreachable."
But it has to be done - her pain is unbearable.
Russell sees low-income workers like Selwyn every day needing dental work they can't afford.
"For them it is a crisis. It's a crisis for the way they live and their families and it impacts on their life quite a lot."
She believes the Government needs to step up and subsidise dental care for adults.
Jonathan Broadbent, the leading expert on public dental health, agrees.
"Right now it feels like publicly funded dentistry plays second fiddle," he says.
"It is not high up the priority list despite the fact that dental problems are the most prevalent diseases faced by our population."
Poor dental health is proven to lead to other medical problems throughout the body, and that increasingly includes mental health.
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Russell's inbox is full of messages from patients struggling with depression brought on - or made worse - by poor oral health.
"If you can't go out and get a job because no one will hire you because your teeth are so bad or you've got bad breath, how are you supposed to feel good and emotionally stable?"
Selwyn is keen to move on from experiences like that, and she's got a reason to grin thanks to the Revive a Smile charity and funding from the Southern Health Cross Trust. She'll receive dentures for a completely new smile free of charge.
She's one of the lucky ones. Revive a Smile is a small charity that relies on donations and can only help 1100 people a year.
Free care for all adults would cost New Zealand $1 billion a year. Targeted care, possibly at low earners like Selwyn, would be much cheaper.
Health Minister David Clark told Newshub there's nothing in Thursday's budget for dental health, and most likely nothing this term.
That's a problem, because this crisis is urgent - and worse than many think.
Newshub.
