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Public sector oral health service provision for high needs and vulnerable New Zealanders

The Strategic Vision for Oral Health in New Zealand identifies vulnerable New Zealanders and those who have high needs as priority population groups. High needs and vulnerable people are disproportionately impacted by poor oral health, a situation that is likely attributable to the difficulties they face in accessing and affording dental services, and their poorer access to other social determinants of health. In New Zealand, ethnic differences in oral health are also evident, with Māori and Pasifika having poorer oral health and access to oral health care than other ethnic groups. Moreover, they are overrepresented in the vulnerable population because they are more likely to live in poverty and be affected by material disadvantage.

While the treatment needs of high needs and vulnerable populations may be met in primary care, the complexity of treatment and patient management for this population group often requires care delivered by appropriately skilled and trained personnel in a hospital setting. Relatively recent epidemiological and demographic changes in the New Zealand population—an ageing population, greater life expectancy, increased multimorbidity prevalence and improved tooth retention—place considerable demand on the nation’s hospital dental services. Such changes are expected to continue, suggesting that the high needs and vulnerable proportion of the population will increase in the near future, further pressuring hospital dental services. The poor oral health experienced by high needs and vulnerable New Zealanders suggests that the group’s oral health needs are not being met. To better understand the reasons for this unmet need, and for planning their future oral health needs, it is critical to explore, and identify the gaps in, the current hospital dental services.

This report presents findings from such investigations with clinical leaders of New Zealand’s hospital dental services and recommendations for service improvements. In doing so, it provides a thorough understanding—from the participants’ perspectives—of the national situation concerning the hospital-based dental services for New Zealand’s high needs and vulnerable population. Such information is urgently needed to inform actions to improve oral health service provision to high needs and vulnerable New Zealanders, and ultimately improve their oral health.

Smith M, Ferguson CA, and Thomson WM. (2019). Public sector oral health service provision for high needs and vulnerable New Zealanders. Wellington and Dunedin: Health Promotion and Policy Research Unit, University of Otago, Wellington and Sir John Walsh Research Institute, University of Otago, Dunedin.

Full report (PDF file, 3.1 Mb)

Executive summary (PDF file, 816 Kb)