A leading Māori dental advocate is calling for a major overhaul of Aotearoa’s oral health system, warning that cost, access and cultural barriers are leaving many whānau without basic dental care.
Leeann Waaka, Tumuaki of Te Ao Mārama, the New Zealand Māori Dental Association, says urgent action is needed to introduce universal dental care grounded in Te Tiriti o Waitangi principles to ensure equitable and culturally responsive services.
For many Māori, the biggest barriers remain affordability and access, with adult dental care largely excluded from public funding. Long wait times, limited services in rural areas and a lack of culturally safe environments are also preventing whānau from seeking regular care, often leading to avoidable pain, infection and long-term health complications.
Advocates say the current system is heavily focused on treatment rather than prevention, meaning issues are often addressed too late, at greater cost to both individuals and the health system.
A Te Tiriti-consistent model would require a fundamental shift in how services are designed, funded and governed. This includes shared decision-making with Māori, targeted investment in kaupapa Māori providers, and funding models that prioritise prevention and early intervention rather than crisis care.
There are also calls for greater Māori representation across the dental workforce, alongside expanded training in cultural competency to ensure practitioners can engage effectively with whānau. Community-based services delivered through marae, schools and local health providers are seen as key to improving trust and accessibility.
Strengthening the workforce will also require pathways to support more Māori into dental careers, helping build a system that reflects and understands the communities it serves.
In the short term, advocates are pushing for practical prevention strategies, including free or low-cost check-ups, expanded mobile dental clinics, school-based programmes and public health campaigns focused on oral hygiene and nutrition.
Measurable outcomes over the next one to two years could include increased rates of regular dental visits among Māori, reductions in preventable tooth decay and hospital admissions, and improved access to early intervention services.
The push for universal dental care is gaining momentum as inequities in oral health continue to widen, with growing recognition that meaningful change will require not just more funding, but a system redesigned to meet the needs of Māori and all New Zealanders.
