'It's heartbreaking to see the level of decay' - children waiting months for surgery
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Children as young as 18 months are waiting a year for dental surgery to treat advanced tooth decay, a situation one paediatric dentist calls "alarming".
Dr Katie Ayers has donated many hours of her time since 2016 to carry out more than 50 free surgeries at a private hospital in Hamilton to try to clear some of the backlog.
"Across the country we've got about 5500 children on waiting lists for dental treatment, which is 1500 more than about two years ago, so it's quite alarming."
All of those children were waiting for treatment under general anaesthetic, with about 2000 of them in Auckland alone.
Very advanced tooth decay was painful and debilitating, Ayers said.
"Sometimes you get the child to sleep and you look in their mouth and it's just heartbreaking to see the level of decay and you can see some quite significant swellings and infections associated with the teeth."
Ayers said there was a combination of factors that led to severe tooth decay in young children, with sugar a significant contributor along with a lack of dental clinic visits due to delays.
"I think children are just having more sugar in their diets and unfortunately aren't getting check-ups as often as they were prior to Covid.
"Some children aren't getting seen for two or three years in the community oral health service, so by the time they're seen they might have quite advanced problems. They then have to go on a waiting list for treatment."
When breast or formula milk sits on a baby's teeth for extended periods it can cause early tooth decay.
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123RF
Ayers said decay could start early when breast milk or formula sat on the teeth for many hours, which often happened during continuous feeding including putting the baby to bed with a bottle.
She wanted more education for young parents about the role of milk and formula in the development of dental decay.
"When parents come with these young children with advanced decay, they have no idea that the way the child was feeding was a risk factor."
Snacking, not cleaning teeth twice a day, not using a fluoride toothpaste or fluoridated water, and a diet including sugar all contributed, she said.
"A lot of these children have a number of teeth affected and often quite deep decay that might mean that some teeth need to be removed and others get fixed all while they're under the same general anaesthetic."
Lollies are often given out after sports games and by hairdressers and doctors.
Photo:
RNZ / Diego Opatowski
Ayers said Covid lockdowns in 2020 and 2021 prevented routine check-ups and workforce shortages were also having an impact.
"We have not enough oral health therapists in the public system to meet the needs of all the children that need to be seen.
"That extends also into the hospital situation where we've got shortages of anaesthetic technicians for example who assist anaesthetists with caring for children while they're asleep.
"So there have been times where different hospitals haven't been able to run operating lists because there aren't enough staff."
Ayers was recently acknowledged by the Braemar Charitable Trust for undertaking more than 50 free specialist paediatric dental surgeries on urgent cases.
The surgeries were performed at Braemar Hospital where anaesthetists also donated their time and the trust funded medical supplies and drugs, which were provided at cost by the private hospital.
About 8000 children are hospitalised every year for specialist dental treatment under general anaesthetic, costing the taxpayer up to $5000 per surgery, the trust said.
Ayers said most services had at least a six month wait, and up to a year in some places.
Dr Katie Ayers, left, is a specialist paediatric surgeon for the Midland region, covering Waikato, Bay of Plenty, Tairāwhiti, Lakes and Taranaki.
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Supplied
Health New Zealand chief clinical officer Dr Richard Sullivan said 53 percent, 2942 of children on the waitlist for dental surgery had been waiting more than four months.
In total there were 5564 waiting in March this year.
Sullivan said a lack of access to community services for children and adolescents was driving the growth in demand for hospital dental treatment.
"Improving dental waiting times for children is part of a broader strategy to reduce elective surgical waiting times," Sullivan said.
"A recent national boost to outsourcing will increase the number of procedures we are able to deliver, including for paediatric dental, by utilising additional capacity in the private sector."
He said Health NZ also continued to contract mobile surgical dental services, particularly for children in smaller urban and rural areas.
Regions had also established their own initiatives to meet the government's health targets, Sullivan said.
In Canterbury an extra $500,000 had been secured for the paediatric dental service to outsource 100 procedures under general anaesthetic and run additional first specialist appointments (FSA) for 300 children by the end of this month.
Evidence showed oral health at age five predicted the oral health of a person at age 26.
"Providing support from an early age helps encourage good habits and reduces the likelihood of needing costly dental treatment in later years."
Sullivan said hospital teams provided dental services that couldn't be completed in the community because of special medical needs or behavioural difficulties, or the child needed multiple procedures not tolerated under local anaesthetic.
A number of actions to reduce waitlists had been identified in some regions including increasing theatre capacity with twilight and weekend lists, introducing a monthly Saturday theatre list, using private providers and mobile dental units, and outsourcing.
There were also plans to address equity and access barriers.
Sullivan said oral health therapists were now a priority workforce with AUT and Health New Zealand supporting Bachelor of Health Science (Oral Health) students to train closer to home.
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