Dental News - New Zealand’s dental system causing a childhood oral health crisis, experts say

Brendan Day, Dental Tribune International

Mon. 11. July 2022

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OTAGO, New Zealand: Dental care in New Zealand is among the most expensive in the world, leading many residents to delay dental check-ups or avoid them entirely. As a result, dental caries is the most prevalent non-communicable childhood disease in the country, children from socio-economically disadvantaged and Maori or Pasifika backgrounds being the most affected groups. Having reviewed the current state of children’s oral health in New Zealand, a team of researchers have declared that urgent and sweeping change is needed across the entire oral healthcare system to address this growing issue.

Led by Dr Dorothy Boyd, senior lecturer in paediatric dentistry at the University of Otago, the research team examined past and current provision of dental care in New Zealand for school-aged children. Though publicly funded oral healthcare has been provided to New Zealand children and adolescents since the 1921 introduction of the School Dental Service, “funding constraints and organisational ‘reforms’ led to deterioration” of this programme in the 1990s, according to the researchers.

The government’s 2006 introduction of a new strategic vision for oral health reoriented the School Dental Service to a focus on prevention rather than on treatment. Caries rates and oral health inequalities in New Zealand children have nevertheless continued to worsen. The researchers stated that, by the age of 5, 60% of Maori children and 70% of Pasifika children in New Zealand have already experienced caries compared with 33% of children from non-Maori or Pasifika backgrounds. In an under-resourced oral healthcare system, the proportion of Maori and Pasifika dental professionals is also well below the percentage of Maori and Pasifika people living in New Zealand“—17.1% of the national population identify as Maori, compared with just 3.6% of general and specialist dentists.”

“We all must agitate for changes that will enable children to grow up in Aotearoa New Zealand with the health that they deserve” — Dr Dorothy Boyd

In a press release, Dr Boyd outlined a number of factors that have made early childhood dental caries a pressing issue in the country. “Despite the hard work of dental professionals in the midst of the early childhood caries tsunami, every part of the oral healthcare system is stressed, with long waiting lists, inconsistent collaboration between primary, secondary and tertiary care, and inconsistent access to, and types of, care offered across the country,” she said. “Now is an opportunity for radical change, and that radical change is essential.”

Dr Boyd added that the scale of the problem would require a coordinated and collaborative approach that went beyond New Zealand’s oral healthcare services, since “the problem is too huge, and overlaps with many other health needs”.

“All children deserve to eat, sleep, learn and play without dental pain and oral infection,” she said. “We all must agitate for changes that will enable children to grow up in Aotearoa New Zealand with the health that they deserve.”

Dental Tribune International reported earlier this year that a survey of New Zealand residents found that four in ten avoided going to the dentist because of the associated cost. The only financial support currently available for low-income families who need to visit the dentist is NZ$300 per year—an amount that will be increased for the first time in more than two decades this December. Though this emergency dental grant will now be worth up to NZ$1,000, the cost of many dental treatments will remain prohibitively expensive for large parts of the population. According to Consumer NZ, a restoration can cost up to NZ$220, root canal therapy between NZ$800 and NZ$1,200, and implants around NZ$2,800 per tooth.

The study, titled “Oral health of children in Aotearoa New Zealand—time for change”, was published online on 18 May 2022 in the Journal of the Royal Society of New Zealand, ahead of inclusion in an issue.

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