Fluoride Action Network

‘Onerous’ dental contracts slammed

Source: Otago Daily Times | July 11th, 2022 | By John Lewis
Location: New Zealand

A Dunedin dentist is refusing to re-sign what he calls an “utterly onerous and loss-making” government contract to provide free dental healthcare to children, and others are calling for it to be rewritten.

Three-year Dental Benefits contracts were due to be re-signed earlier this month, but many dentists are holding out.

One Dunedin dentist, who wished to remain anonymous, said the contract was “derisory and full of obligations that you would never sign”, and his dental practice was among many which were not re-signing because it was “utterly onerous and loss-making”.

The Ministry of Health’s operational guidelines said the majority of patients were expected to be in good oral health, requiring only preventive care such as fluoride varnish application and/or fissure sealants, and relatively little restorative care.

It also said some adolescents might require multiple services such as fissure sealants, preventive resin restorations and/or occlusal restorations within a particular treatment episode.

However, dentists say the statement does not reflect the reality of the needs of New Zealand youth today.

They were requiring more expensive dental work, given the increasingly damaging environment for teeth due to diet, home care and the lack of fluoridation in the water.

Another dentist, who declined to be named, outlined the issues dentists were facing with the contracts.

The source said dentists were being paid between $130 and $220 to spend up to 1.5 hours examining, cleaning, doing fissure sealants, three fillings and fluoride application and providing oral healthcare education.

But that was not financially feasible for any business. They did not believe the Government would fund itself the same way.

Capitation schemes, where the patient pays no fee at all, meant dentists took all the responsibility (and the cost) of underfunded or unfunded treatment, which was meant to be provided under the capitation scheme.

The dentist said dentists did their best to educate children, but in an environment of increased acidic challenge to teeth from fizzy drinks and sugar, they could only do so much.

For many years, dentists had seen the treatment of children as a way to build their practice.

But anecdotal evidence showed an increasing number of adolescents stopped having yearly exams once they had to start paying for them, the dentist said.

Geographic mobility and finance were among the reasons why.

*Original article online at https://www.odt.co.nz/news/dunedin/health/onerous-dental-contracts-slammed