Source: Radio New Zealand
A dentist provides dental care to a girl. AFP/ Thibaut Durand/ Hans Lucas
Nearly half of adults in Aotearoa are avoiding dental care because they cannot afford it, leaving many in chronic pain, at risk of serious infection, or in need of hospital treatment.
New research and frontline experiences are painting what advocates describe as a system failing to meet basic health needs, with growing calls for dental care to be fully integrated into the public health system.
Dental for All, a coalition of health workers, unions, community organisations and advocates travelled the country last year speaking directly with whānau about their experiences.
Dental for All campaigner Max Harris said the stories they heard were confronting.
“We heard about the shame and pain people face when they can’t get to the dentist, and how problems get worse over time,” he told RNZ.
“We also heard about the home remedies people resort to, things like using pliers or fishing wire to pull teeth, or relying on painkillers just to get through.”
There are growing calls for dental care to be fully integrated into the public health system.
A system built without teeth
According to the latest Ministry of Health survey, 47 percent of adult New Zealanders reported not visiting a dentist due to cost, with even higher rates among Māori and Pasifika.
Research commissioned by Dental for All also estimated untreated oral disease was costing the country around $2.5 billion each year in lost productivity and $3.1b in reduced quality of life.
“That is people missing work, missing job interviews, or living with constant pain and stigma,” Harris said.
“When you compare that with estimates that universal dental care could cost between $1 and $2 billion a year, it starts to make economic sense as well as human sense.”
According to a Talbot Mills poll in 2023, 74 percent of New Zealanders agreed that adult dental care should be funded in the same way it is funded for tamariki. So why wasn’t it?
Harris said that gap dated back to the system’s foundations.
“When the public healthcare system was set up in 1938, some dentists lobbied to carve teeth out of the system and it has essentially stayed that way ever since.”
Auckland City Mission opened the doors of its new onsite dental clinic in July 2025, delivering lifechanging dental care for those that need it most, free of charge. Supplied / Auckland City Mission
Across the country, demand for affordable dental care continues to grow.
At teaching clinics run by the University of Otago Faculty of Dentistry, patients could receive reduced cost treatment from senior dental students under supervision.
In Auckland, the waitlist for student led care sat at around 950 people and was currently closed due to capacity.
Across both Auckland and Dunedin clinics, more than 14,800 patients were treated in 2025, delivering nearly 60,000 appointments.
Director of Dental Hospital and Clinics Janine Cochrane said demand had remained strong in recent years, reflecting wider national trends.
But even with those services, need continued to outstrip supply.
In July last year, Auckland City Mission opened a free dental clinic aimed at people who had struggled to access care.
In its first seven months, the clinic treated around 380 people and built a waitlist of more than 100.
Director of housing and health Brendan Short told RNZ that many patients had gone years without treatment.
“The people that we support have been marginalised from mainstream and public health care for a very long time,” he said.
“It is really clear that there is not enough funding for oral care in New Zealand for the general population. Dental care is essential healthcare and it seems that this is a blind spot for us as a nation.”
Auckland City Mission director of housing and health Brendan Short. RNZ / Layla Bailey-McDowell
Living with pain
Short said the impact of untreated dental issues went far beyond physical pain.
“Avoiding social situations, hiding one’s smile, or even missing job opportunities are everyday realities,” he said.
He said many people had normalised living with pain.
“It is quite common for people to live with pain, to think that what they are putting up with is normal or is okay, and it is not.”
The Auckland City Mission dental clinic operated three days a week and relied heavily on volunteer dentists.
“This is not possible or achievable for us without those volunteer dentists. They are superstars,” Short said, adding that some even travelled from outside Auckland, including as far as Taranaki.
Volunteer dentist Roger Tiang told RNZ that demand was constant at the clinic, highlighting the need for these spaces.
“Every time I come in my shift is fully booked,” he said.
Tiang said cost and sometimes discomfort with mainstream services were key barriers and that delaying care allowed small issues to escalate.
“If we do not catch things early, problems get bigger and we end up dealing with much bigger issues than we would have if we had seen them earlier.”
After more than 25 years in dentistry, he believed oral healthcare should be treated like any other part of the health system.
“People might not realise it, but if you cannot chew your food properly or you are living with infections in your mouth, that can affect your overall health.
“It is part of your health. Just like the rest of the health system in New Zealand, there is public healthcare and dentistry should be part of that as well.”
ActionStation and Dental for All campaigner Jasmine Taankink says poor oral health is “just another negative implication of colonisation” and Māori not being able to exercise tino rangatiratanga. Supplied / Jasmine Taankink
Longstanding inequities for Māori
For Māori, barriers to dental care were often compounded by cost, distance, and access, layered on top of longstanding inequities within the health system.
ActionStation and Dental for All advocate Jasmine Taankink said poor oral health outcomes for Māori could not be separated from colonisation.
“We know that upon arrival to Aotearoa, English settlers were really impressed with the overall physical health of our tūpuna Māori, especially their oral health. That’s quite widely documented,” she said.
“Our tūpuna Māori didn’t have cavities, they didn’t have massive oral health problems. So poor oral health is just another negative implication of colonisation and us not being able to exercise our tino rangatiratanga”
She said solutions must be grounded in Māori led approaches.
“We have the expertise within our own communities to develop solutions that work for us.”
Tumuaki of Te Ao Mārama (New Zealand Māori Dental Association) Leeann Waaka says whānau should not have to suffer in silence any longer. Supplied / Leeann Waaka
Leeann Waaka, dental therapist at Hauora a Toi and Tumuaki of Te ao Mārama (New Zealand Māori Dental Association) said the situation had remained largely unchanged for decades – with many left suffering in silence.
“The current suffering for our people is real, and it has not got any better since, well, what, 30 years?”
Waaka said while cost was a major issue for whānau, accessibility, especially in rural areas, remained a problem.
“When you are looking at a current structure and your lens is a holistic lens, it really does not fit.
“Whenever you need something, you should be able to access it, right there and then. Unfortunately that is not the case for dental.”
After travelling the country with the Dental for All kaupapa, she said the stories shared were confronting.
“Many have suffered in silence for a long time, It’s heartbreaking.
“I come from up north. I knew it was bad up there, but when we went up there for the roadshow, I don’t even think we could have imagined just how bad it is … It is inhumane.”
Waaka, alongside Dental for All and Te Ao Mārama, was pushing for a Te Tiriti consistent system – which would mean properly resourcing Māori providers and enabling iwi and hapū to design services that meet the needs of their people.
“It is reimagining the system and starting to rebuild it to what it needs to be to serve our whānau. Our people deserve better.”
Dental for All campaign set out on a national roadshow last year, hearing concerns from whānau and building public support over communities. Supplied / Dental for All
Looking overseas for solutions
Dental for All’s latest research pointed to countries including Niue, Japan, Brazil, Canada and the United Kingdom, where dental care was integrated into public health systems.
Harris said those models showed change was achievable.
“It ultimately comes down to political will,” he said.
“We have seen other countries make the decision that oral health is part of overall health and design their systems accordingly.”
Dental for All was now developing a detailed policy proposal outlining how such a system could be introduced in Aotearoa.
“This could be something we look back on as a once in a generation change to strengthen our healthcare system.”
Waaka said the focus must remain on equity and wellbeing.
“All knowledge systems matter, and coming together to bring the best of those knowledge systems is key for when we are serving our people,” she said.
“Our people deserve the best and nothing less.”
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– Published by EveningReport.nz and AsiaPacificReport.nz, see: MIL OSI in partnership with Radio New Zealand
LiveNews: https://livenews.co.nz/2026/03/20/too-expensive-to-smile-calls-grow-for-universal-te-tiriti-consistent-dental-care/