Ngapera Ronaki, 5, has her teeth checked at the mobile dental clinic at her school. Picture / Christine Cornege
Ngapera Ronaki, 5, has her teeth checked at the mobile dental clinic at her school. Picture / Christine Cornege

More pre-schoolers are being hospitalised with dental disease including severe tooth decay than any other age group, and the rate of admissions in New Zealand for all age groups have grown significantly in the past 20 years.

Children aged 8 or under had the highest rate of admission to hospital for dental care with 3- and 4-year-olds requiring significantly more treatment than anyone else, according to a report published by the Ministry of Health reviewing admission to hospitals for dental care between 1990 and 2009.

Between 2005 and 2009, 20.7 in every thousand children aged 3 to 4 years old were hospitalised for dental treatment, up from 17.8 in every thousand between 2000 and 2004. The number of 5- to 8-year-olds also rose to 12.7 in every thousand from 8.9 in every thousand during the same period.

The figures have alarmed health experts who say better access to dental care, greater access to fluoridated water, better diets and cleaning regimes would all contribute to improve dental health in early childhood.

In New Zealand basic dental care is provided free to children under the age of 18.

Hawkes Bay District Health Board clinical director oral health services, Dr Robin Whyman, one of the report’s authors, said children were admitted to hospitals because often it was easier and safer for younger children to be put under general anaesthesia to treat severe decay.

Dr Whyman said children needed to be seen by a community dental service earlier than the traditional practice where they were not seen before 2 years old.

Waikato District Health Board community oral health manager Diane Pevreal said lower decile schools generally had a higher rate of decay and poor dental health was often shown in family patterns. Maori and Pacific children tended to have poorer oral health and the report showed these groups had a higher rate of hospitalisation.

Hamilton dental therapist Jo McCaffrey, who has been in the industry for 35 years, said she felt the problem of tooth decay among pre-schoolers had got worse and said sugary drinks were a major culprit.

Ministry of Health chief dental officer Robyn Haisman-Welsh said reinvestment by the government in oral health since 2008 to fund fixed and mobile dental clinics had the potential to slow or reverse the trend of more children having severe dental issues. The aim of the $116 million capital investment was to promote earlier enrolment.

Sugar gets the blame

When Toni Ronaki’s sixth child was born, she thought she knew the answer to tooth decay.The teacher aide at Insoll Avenue Primary School in Hamilton had learned about dental care the hard way when her 14-year-old son needed his front teeth removed after drinking juice so was determined not to go through it again with her younger children.

But she was shocked last year to learn 5-year-old Ngapera required fillings and a stainless steel crown.

A check-up at the mobile community dental clinic at Insoll School this week found she needed another two crowns.

Ms Ronaki said she had taken Ngapera to the clinics for check-ups from 2.

She said Ngapera tried and “did her best to clean her teeth in the morning and at night”.

Ms Ronaki the only way she could have improved Ngapera’s dental health was by removing sugary foods and drinks from her diet altogether.

Keeping them clean

• Brush teeth for two minutes twice a day (after breakfast and dinner) with a fluoride toothpaste
• Enrol with the dental service at nine months of age and have regular check-ups
• Parents and health professionals “lift the lip” monthly and check children’s teeth for any signs of decay
• Children eat teeth-friendly, healthy foods low in sugar
• Children drink water and milk rather than sugary acidic drinks
Source: Plunket

Dental treatment in children, 2005-2009
Age/ Hospital admissions per thousand children
0-2/ 2.2
3-4/ 20.7
5-8/ 12.7
9-12/ 2.3
Source: Admissions to New Zealand Public Hospitals for Dental Care: A 20-year review

NZ Herald