A New Zealand dentist who runs a mobile charity clinic says she has patients come weekly seeking help for the aftermath of DIY tooth extractions.
The state of dental care for many lower socioeconomic groups has spurred Dr Assil Russell to lobby the government into making dental work more affordable.
"We see people on a weekly basis coming in that have tried to take their own teeth out and they've left behind half of the root," she told 1 NEWS.
"They are in so much pain and they just want to get some sort of relief, and it does relieve because it will kill the nerve a little but they will be left with a potentially life-threatening foreign bodies," she said, as the leftover root becomes infected.
Neglect wasn't the reason behind the poor state of many New Zealanders' oral health, instead cost was the driving factor.
"They're hard-working Kiwis on very low incomes, they have families, and they're not on the benefit so they try to improve themselves. They pay tax but they get no help."
Recently, Dr Russell said a woman in Northland arrived at the mobile clinic. She was pregnant, but her face was hugely swollen.
"The infection was so bad we couldn't treat it on the mobile clinic, we had to send her to the hospital."
She said bad oral health can then detrimentally affect overall health.
"It makes people more prone to getting diabetes, heart disease, the mouth is the portal to the whole body, and to separate that from the rest of your health is ridiculous."
"We need to be helping the people who are struggling and are in pain, now."
Dr Russell's petition has gained over 2,300 signatures.
It asks for subsidised dental care for at-need communities, the age for access to free dental care increased to 20, and the removal of GST from dental services.
Her long-term aim is universal health care, "but in the meantime there are concrete steps that can be introduced now".
She said at-need communities could include the elderly, people with health and disability issues, the homeless, and those living in low decile areas.
"Those are the types of communities where they really don’t have access to care, and even if there is a dentist nearby they're not able to use those services because of the cost."
Increasing free dental care to age 20 from 17 could help younger people who are studying or employed in lower paying jobs to afford to go to the dentist, she said.
Dr Russell said the high level of regulation pushed up prices for dentists, which was why they suggested the removal of GST.
"It's really expensive to run a clinic. The materials have to be the best, we have to pay for licences, so removing GST… will immediately help to reduce the prices because that price isn’t being passed onto the consumer."
When asked if she thought it would save spending over the long haul, Dr Russell said, "without a doubt".
"It will save taxpayer money in the long term."
"These people are not going to the dentist to relieve these infections and they end up in hospital. That is the tax payer footing the bill."
She said many people who turned up to their mobile clinics had infections that were "definitely preventable", and it wasn't just the rural locations experiencing it.
"It's so common in the communities we’re working in, even in Auckland.
"There are dentists everywhere in Auckland, so obviously this is something is affecting people nationwide."
The "vicious cycle"
Some New Zealanders on WINZ benefits are able to access emergency dental grants of about $300 a year, but that usually is only enough to pay for a check up, x-ray and work on one tooth, she said.
"What happens with these people they don't want to spend more than $300, because anything more than that they have to pay it back and they just can't. They come in every year and get a tooth out. It's a vicious cycle . It's not fixing the problem."
The grant of about $300 has not changed since 1996.
Kay Read of the Ministry of Social Development told 1 NEWS people don't have to be on a benefit to qualify for the grant.
According to the Work and Income website, a single adult would have to be earning less than $29,004 a year to be eligible.
"It is important people know there is somewhere to go and options to consider if they need support or help with an urgent need for essential items – this includes food, power, health costs (including medical and dental care) and other costs as well."
Last year, there were 68,486 grants issued, worth a total of $25,738,621, averaging to about $376 per grant.
This was up from 67,545 in 2016, worth a total of $24,400,222.
Dr Russell said bad oral health could have an adverse influence on people's lives.
"Imagine going to a job interview and your tooth is half broken, or you can't smile or you have really bad breath because there is an infected tooth in there. It affects people's overall quality of life, it stops them from being functional members of society."
Ministry of Health
In the year to June 30, 2017, District Health Boards spent a total of $8.6 million (GST excl) on emergency dental care for low-income adults.
A Ministry of Health reinvestment programme put $116m in additional capital funding into District Health Boards to go towards for the Community Oral Health Service (COHS), with an extra $32m put into for operating funds.
"There are already signs of improvements in oral health outcomes. The ongoing objective is to continue to secure these benefits, with a particular focus on reducing inequalities, increasing the engagement of pre-schoolers and their families/whanau… and reducing preventable hospital admissions," a Ministry of Health spokesperson said.
They said a re-orientation of the Community Oral Health Service instead puts emphasis on early engagement with pre-school children, which comes as admissions for preventable dental conditions for children aged 0-14 has increased.
"As a result, it is expected that the number of pre-school children referred for hospital treatment due to dental decay will continue to increase, before it reduces."
The MoH said some pre-schoolers with a high level of decay were harder to treat in the dental chair, with many needing general anesthetic in a hospital setting.
However, they said the number of children hospitalised for dental treatment has risen internationally, but overall children's oral health is actually improving.