Any mention of dental treatment in a social network group often evokes instant sharp, reactions of fees charged.
“It’s a rip off,” laments Dave Williamson . “I paid $350 for a cavity filling recently and I’ve a couple more to be done soon. How am I going to afford this?”
Chris who joined in the conversation, commented “Why am I charged $80 for a mouth examination- with X-ray cost additional, when I pay only $19.50 for my GP consultation? I’m not even sure when I’ll be able to get my tooth pulled out.”
Dave and Chris are not alone in postponing treatment for fear of high dental fees.
According to one Ministry of Health report, 44% of adults avoided dental care and 25% did not take up recommended dental treatment due to cost.
In their Nov 2020 fee survey New Zealand Dental Association (NZDA) noted the average fees of extracting a single tooth (normal, average, uncomplicated) was $247, but a surgical extraction could set you back by nearly $400. Their next survey is due in 2023.
But, why is the dental treatment so expensive? Or, are the costs high because people allow the dental issues to deteriorate and eventually end up paying much higher?
Chris, like many others, don’t realise dental care in New Zealand is not subsidised by government funding, except for those under the age of 18.
Dentists, however, disagree their charges are over-priced as there is a great deal of value in what they do to help patients, and a clinic is expensive to operate.
NewsViews decided to explore more on this issue, but efforts to elicit a response from nearly a dozen dentists failed, except a couple of them who spoke informally, on condition of anonymity.
However, when approached, NZDA – the professional association of dentists with over 2900 members, promptly responded and outlined the factors and justification behind the fees charged for dental treatment.
“There are high costs associated with the set-up and operation of a dental practice,” Dr Mo Amso, CEO, New Zealand Dental Association told NewsViews.
“Unlike GP visits there is no government subsidy for visits to the dentist. Another key difference is that GP visits are often office-based rather than surgical”. Continue reading...
There are significant hidden costs that patients don’t notice, but are added to running costs of clinic.
“There are fixed costs before time in the chair even begins. There are significant costs involved in operating a surgery, including sterilisation for infection prevention control, cost of medical equipment, and the cost of dental supplies,” Dr Amso adds.
There is definitely logic in their argument as dental practice is a capital intensive business and expensive to run.
When NewsViews asked a dental practitioner who also owns the practice, if they would be willing to reduce the fees charged, the answer (on condition of anonymity)was, “If I reduce my fees, say by 10 or 15%, would my operating costs go down?
“No, because my overhead running costs are not variable – for example, rent, salaries, supplies, insurance, etc, and these are nearly 65-70% of my gross billings.
“Unless I proportionately increase the number of patients I treat, any reduction in fees will erode my profits.
“Not only that, I often sacrifice my weekends and try to be available 24/7 for emergency consults.”
People also fail to realise every procedure in dentistry is customised. “It’s not one-size fits-all, or mass produced.”
Dentist’s clinic is akin to a ‘mini-hospital’ and even a basic setup has to have a surgery, sterilizing room, reception and a waiting area at the least.
On top of it are the essential equipments – dental chair, X-ray/3D imaging systems, surgical equipments, intraoral cameras, chairside CAD/CAM systems, systems for infection control protocols, and the lists goes on.
Dentists cannot perform alone and need trained dental assistant(s), a receptionist and a dental technician for restoration work. They also have to pay laboratories for the technical work they get done for dentures, crowns, etc.
“Let us put it this way,” quipped another local dentist who did not want to be identified. “Dentists do not generate income unless there is a patient ‘in‘ the chair, and any patient turning up late for their appointment or cancelling at last minute, costs money. That means, at any given time if I’m not treating a patient, it is actually a cost to the clinic.”
As every treatment is different, the surgery has to be kept ready specific to the upcoming appointment- be it extraction or filling.
Therefore, some clinics now charge a $50 cancellation fee if an appointment is cancelled within 24 hours of scheduled time.
Covid-19 also heavily impacted treatment costs due to stringent sanitization protocols for the safety of patients, including use of disposable PPE gowns, etc. Additionally, shortage/ higher costs of surgical supplies, rising wage bills added to clinics’ running costs.
Some dental practitioners blame people themselves for having to pay high fees by neglecting their dental care.
“They avoid regular check-ups until their pain and suffering become unbearable. Unfortunately, due to this delay they end up paying more then what they might have done at the first instance.”
Realising inability of some people to pay upfront for their treatment, most clinics now offer interest free payment options.
During 2021, Work and Income helped approximately 40,000 people to meet their emergency dental costs, at an average cost of $870. From Dec 2022, the Government is raising dental treatment limit to $1,000 for low income earners.
According to Dental Council of New Zealand, the regulatory body of oral health professionals, there are currently 4,768 practitioners holding certificates (APC) to practice across six professions. Out of these, 2,447 are general dentists.
It might sound good to scout around to compare costs, but cost itself should not be a factor when it comes to choosing the right dentist as low fees may not always guarantee quality dental work.
So, to reduce your dental bills, adhere to the adage: Prevention is better than cure.