New Zealand Dental Corps
The inspection and repair of the teeth of New Zealand Territorial Force volunteers in 1914 highlighted the nation’s poor dental health. The New Zealand Dental Corps (NZDC) was formed in 1915 to provide dental treatment in camps to members of the New Zealand Expeditionary Force.
The involvement of dentists and dental mechanics in active war service, including Henry Pickerill, dean of the New Zealand Dental School, enhanced the prestige of dentistry and demonstrated the value of public dental health programmes. After further active service in the Second World War, the NZDC became the Royal New Zealand Dental Corps in 1947.
The magic dentist
Captain Harold Dover was a dentist who served at Guadalcanal during the Second World War. He was also the president of the Wellington Society of Magicians, and was often called on to entertain the troops. His hardest audience was a surly detachment who were long overdue for home leave. He won them over by producing a cold can of beer from an empty roll of paper and ‘other impossible places’.1
The leader of the NZDC, Colonel Thomas Hunter, returned from war in 1918 determined to move the focus of dentistry from extraction to restoration and prevention of decay. As director of the new division of dental hygiene in the Department of Health, he successfully advocated the establishment of the School Dental Service (SDS) in 1921 to treat primary schoolchildren.
Social policy in this era focused on children’s health and welfare. The government considered it had a duty and right to intervene when it came to improving children’s health, to ensure healthy adults capable of contributing to society and continued success for the race, nation and Empire. The SDS was only one of several initiatives aimed at improving children’s health in the first part of the 20th century. Others included St Helens hospitals (1904), Plunket (1907), the School Medical Service (1912), and children's health camps (1919).
Welfare state initiatives
The election of a Labour government in 1935 and the passing of the Social Security Act 1938 led to general improvements in access to health care, including dental health care. From 1937 milk was provided free in schools, to supply calcium for teeth as well as improve children’s nutrition generally. By the mid-1940s free dental care had been extended to all students up to standard six (year 8) and many pre-schoolers were also under the care of the SDS.
While the proposed Social Security Act 1938 intended hospital treatment, medicines, and general practitioner visits to be free, dental services for adults were not mentioned. Although possibilities for further public dental schemes were discussed, nothing further eventuated until 1947 when the government extended free dental care to include adolescents. The Adolescent Dental Service (General Dental Benefits Scheme) was staffed by contracted private dentists and treated adolescents up to age 16 (later to age 18). Adults over this age were still responsible for funding their own dental care.
Dr Muriel Bell fought for the fluoridation of Auckland’s water supplies. She was opposed by the mayor, Dove-Myer Robinson – but succeeded in her campaign. As a result of her battles, she referred to herself as ‘Battle-axe Bell’.
Fluoride was introduced into the Hastings water supply in 1953 on a trial basis. This was considered a success, with children on fluoridated water supply requiring fewer fillings. Despite strong support from dentists and the Department of Health, the addition of fluoride to public water supplies to strengthen teeth was a contentious issue.
The 1957 Royal Commission of Inquiry into Fluoridation noted public concerns about the additive’s medical effects, a desire to maintain ‘pure’ food and drink, and the possible infringement of civil liberties and individual freedom. Fluoridation became an issue for local councils, to be decided by referendum.
Data collected by the SDS continued to demonstrate that children on fluoridated water supplies had fewer decayed, filled and extracted teeth. In the 2000s fluoridation continued to be a volatile political issue despite adverse health effects being unproven. Decisions by local councils on whether water would be fluoridated led to highly-charged debates between public health advocacy of fluoridation and opposition to introducing fluoride into the water supply by the anti-fluoridation lobby group, Fluoride Free New Zealand.
Anti-fluoridation activists claim that fluoride is a neurotoxin and that its presence in the water supply removes from individuals the right to make their own decisions about whether or not to consume fluoride.
In late 2016 the New Zealand government proposed legislation that will transfer responsibility for decision-making about the fluoridation of water from local councils to district health boards. If the Health (Fluoridation of Drinking Water) Amendment Bill is passed, local government will need to implement decisions about fluoridation made by district health boards. It is anticipated that this legislation will mean an increase in the fluoridation of drinking water in New Zealand.
In 2016 58% of New Zealanders lived in areas with fluoridated water supplies.