Photo: Unsplash / Jonathan Borba
The crippling cost of dental procedures in New Zealand is prompting Kiwi-Indians to seek treatment in India.
Some have pointed out that the expenses associated with a return trip ticket to India are lower than what they would pay for dental work performed locally.
In recent weeks, political parties such as Labour and the Greens have introduced dental policies as part of their campaign for the upcoming general election.
Philips Augustine and his wife, Anju Anil, recently returned to New Zealand following a trip to India, during which they both underwent dental procedures.
"In March 2022, I visited a dental clinic in Auckland due to some dental issues," says Augustine, a transportation engineer. "While the initial checkup was free, the X-ray cost $70."
To his surprise, Augustine was given a quote of $900 for filling a cavity and cleaning his teeth and gums.
Comparing costs, he found the quote to be significantly higher than what he would pay for the same procedure to be performed in India.
Consequently, he decided to postpone the dental work until he could return home.
One month after Augustine's appointment, Anju Anil visited the same clinic after experiencing severe pain. The dentist recommended a procedure involving extraction and an implant, giving her a quote that left her stunned.
"For the extraction, implantation, along with additional procedures such as scanning and X-rays, the total cost was estimated at just over $6000," she says.
Given Anil's discomfort, the couple decided to proceed with the extraction, which set them back approximately $1000. They opted to delay the remainder of the treatment until their next trip to India.
Fast forward to May this year, the couple returned from India after a holiday and their dental procedures.
"For my filling and cleaning and a total checkup, it only cost $30. For my wife, it only set us back around $300, including the implants and X-rays," Augustine says.
He says his family is not alone in travelling to India for dental treatment.
"Visiting the dentist is something I do every time I'm in India," he says. "It's not just my family. I know other people within the community who do the same, solely because it's incredibly expensive here in New Zealand."
Augustine says the government should subsidise adult dental care or at least incorporate it into the public health system.
"I'm not sure whether it's possible or not but, with the cost of living, high petrol prices and my mortgage, it would certainly help," he says.
Philips Augustine and his wife, Anju Anil, recently returned to New Zealand following a trip to India, during which they both underwent dental procedures. Photo: Supplied
Funding shortfall
Robin Whyman, director of dental policy at the New Zealand Dental Association, says the association has been engaged in discussions with various organizations and, notably, political parties over the past few years regarding the costs associated with the dental industry.
"The approach that the association has been proposing to ministries and politicians is the need for additional support for dental care, beyond the existing public funding," he says.
He says the current system lacks public funding for adult dental care and the burden of dental expenses falls entirely on the average New Zealander who seeks dental services. This includes not only costs associated with dental procedures, but also compensation for the people involved, including dental assistants, reception workers as well as expenses related to building leases and materials.
All factors collectively contribute to the overall cost of a dental visit.
Whyman also raises concerns about the potential risks associated with having dental procedures performed overseas. He says when dental care is administered in New Zealand, the dentists, oral health practitioners and dental hygienists involved are all registered with the New Zealand Dental Council, ensuring that there are established standards of care in place.
"If you opt for dental care abroad and complications arise, it can be challenging to comprehend the level of care being provided and identify the causes of those complications. This can lead to more expensive efforts to rectify or address problems once you return to New Zealand," he says.
Robin Whyman is the director of dental policy at New Zealand Dental Association. Photo: Supplied
Comparative costs
Piyush Mehta, a dentist in Delhi, India, regularly sees overseas citizens seeking dental treatment in his clinic.
"On an average, I have around 25 patients coming from different parts of the world, including New Zealand," he says.
Mehta says the individuals are primarily driven by concerns over the exorbitant cost of dental care in their home countries, making India an attractive option during their vacations.
But just how affordable are dental procedures in India compared to New Zealand?
According to a 2020 survey by the New Zealand Dental Association, a full examination, which typically assesses a patient's dental health, identifying problem areas and necessary work, can cost an average of $98 in New Zealand, with prices varying by location.
In Wellington, for instance, a routine checkup with an X-ray typically costs $95, while in Otago and Southland, costs can reach $123.
A similar procedure in Delhi, such as at Mehta's Smyle Kraft Multispeciality Dental Care, amounts to a fraction of the cost, totalling 1500 rupees ($30).
In New Zealand, a 15-minute appointment with a dental hygienist typically costs around $80, with longer appointments required for extensive cleaning. In India, a full cleaning session will only set patients back between 1500 and 2500 rupees ($30-$50).
Tooth extractions in New Zealand can be notably expensive, averaging $242 for a single tooth. In India, the same procedure costs just 1000 rupees ($20). A surgical extraction is $380 here and 10,000 rupees ($206) in India.
According to data on the Medsafe website, most Kiwis over the age of 30 have had multiple dental amalgams - a metal alloy used for fillings.
On average in New Zealand, a filling typically sets patients back $170 for a tooth. In India, the cost varies between 1000 and 3000 rupees ($20-$61) depending on the complexity of each case.
A crown - or dental cap - is a restoration that caps or encircles a damaged tooth. They're sometimes used to replace large fillings, protect a weak tooth or restore a fractured tooth.
This procedure costs considerably more in New Zealand, with an average price of $1450. In Delhi, the cost varies between 3000 and 15,000 rupees ($61-$310), depending on factors such as material choice and additional costs.
Prohibitive expenses
Kiwi-Indian Anju Jay knows first-hand how much cheaper it is to seek dental treatment in India after returning there to fix a problem with her teeth earlier this year.
"I had to undergo a root canal and an extraction and, yes, that prompted our trip to India," she says.
Jay, a software professional in Wellington, received a quote exceeding $4000 for the procedure at a Wellington dental clinic.
"It was prohibitively expensive, so I had to go to India to get it done," she says.
She traveled to India with her family and completed the procedure for around $1000.
Jay says her family will only visit a dentist clinic if the pain is unbearable.
Despite living in the country for six years, she has visited a dentist in New Zealand just twice.
Like Augustine, she also calls for government intervention to assist people in similar situations.
"The costs are significantly higher compared to India, and we cannot afford frequent dental visits," she says.
Labour leader Chris Hipkins, with Nelson candidate Rachel Boyack, getting a check-up at the dentist in Tasman Dental Centre, Nelson, on 11 September, 2023. The dentist says his teeth look good. Photo: RNZ / Nathan Mckinnon
The politics of teeth
In August, the Green Party unveiled its dental policy, aiming to rectify what they call a "broken and cruel" dental health system by proposing to make dental care free for all. To fund this initiative, the party plans to implement "fair and straightforward changes to the tax system".
In September, the Labour Party launched its election campaign with a pledge to expand free dental care to individuals under 30 years of age.
Labour positions this dental policy as the first step toward achieving universal free dental care while also allocating resources for training additional dentists in the upcoming years.
Under the proposed free dental care, services would encompass annual checkups, teeth cleaning, basic fillings and extractions. The government's initial focus would be on individuals aged 18 to 23, commencing in July 2025, and then extending coverage to those under 30 the following year.
Te Pāti Māori wants free dental care for families earning less than $60,000 per year, while The Opportunities Party seeks free primary dental care for young people through their Teal Card.
As yet, the National Party and ACT Party have not unveiled any dental policies.
Augustine says a party's dental policy is key in deciding which party to support in the upcoming election.
Jay agrees, highlighting dental care as a significant social issue in New Zealand.
"As a voter, yes, I'm considering those policies," she says." It is a social issue - a big one for New Zealand."