Untreated dental disease abounds in Hawke’s Bay, and throughout New Zealand.
This is the experience of Havelock North dental team Wynton and Rachel Perrott, who have witnessed through their charity dental work the profound impact untreated dental disease can have on a patient’s overall quality of life.
Smilehaus Dental was one of two Hawke’s Bay dental practices that recently participated in the nationwide Smile NZ Free Dental Days programme (Dental@105, Hastings was the other practice). A joint venture between the Southern Cross Health Trust and the New Zealand Dental Association (NZDA), this allows dentists to open their practices to provide a range of treatments such as restorations, fillings, and extractions at no charge to patients who ordinarily cannot afford to access treatment.
“There’s nothing quite like relieving pain for someone who is unable to eat or sleep properly due to toothache and has been unable to afford to have treatment done,” says Rachel. “Or replacing front teeth for someone who hasn’t been able to smile for two years and is trying to make a fresh start and apply for jobs.”
During this year’s free dental day, Smilehaus saw some 35 patients, many with widespread tooth decay and advanced periodontitis (gum and bone disease).The Smilehaus Dental team carried out a number of tooth extractions and in one case re-built the front teeth of a patient who had had them knocked out during the first Covid lockdown.
“For each patient it made a huge life difference,” Rachel says. “But it is just a drop in the ocean.”
For Smilehaus, the Free Dental Day flagged a deepening concern about the state of teeth in Hawke’s Bay, and potential knock on health implications and the need for more Government funding —“the $500 WINZ benefit for emergency care does not focus on where we need change, it’s at the prevention end of care, before the damage happens” – and more focus on dental care and disease prevention.
“Dental disease is largely preventable but we need a multi-disciplinary approach to invest in prevention rather the ambulance at the bottom of the cliff.”
Wynton adds that water fluoridation is one of the most reliable and effective ways of preventing dental disease and he is concerned at the longer-term impact of fluoride being taken out of Hastings’ water supply in 2016. “What is the impact of this? We may be yet to see even more dental decay.”
According to Robin Whyman, Chief Medical and Dental Officer for Whatu Ora Te Matau a Māui, the proportion of children decay-free in Hastings has reached a plateau in the last few years (54% of Hastings five-year-olds were decay-free in 2011 up to just 63.6% in 2021) which may indicate an impact due to the lack of fluoride in the local water supply.
Whyman says the Hastings and Havelock North water supply was the first in the country to receive fluoridation in the 1950s (Napier has never had fluoridation). In Hastings fluoride was taken out of our water supply in 2016 and replaced with chlorine after the Havelock North campylobacter crisis.
In July this year a directive from the Director-General of Health, Dr Ashley Bloomfield ordered Hastings District Council to have its fluoride programme up and running again as agreed, by June 2023. This is in part a response to 2020 data for children aged 0-12 in the former Hawke’s Bay District Health Board region. This showed that overall, 40% of children had experienced tooth decay at age five on average, with Māori and Pacific children having significantly worse outcomes than other children within the region. For example, 57% of Māori children had experienced decay at age five compared to 27% for all other (non-Māori and non-Pacific) children.
The 2017-2020 New Zealand Health Survey results further showed for Hastings District Council that 50.2% of adults (15+) had one or more teeth removed in their lifetime due to decay, an abscess, infection or gum disease; 7.9% of adults (15+) had one or more teeth removed in the past 12 months due to decay, an abscess, infection or gum
“From the data summarised above, it is reasonable to conclude that there are significant levels of dental decay in the communities serviced by the Hastings Urban water supply,” the Director General wrote to the HDC. “There is strong evidence that Community Water Fluoridation reduces dental decay. There are therefore also significant opportunities for oral health improvement for the communities served by the Hastings Urban water supply. The evidence indicates that fluoridation of the Hastings Urban water supply would make significant improvements to oral health outcomes for the communities it serves.”
“We have shared concerns about the lack of fluoride in our water supply,” says Whyman, “and are very pleased it is going back in. The impact of fluoride on oral health is cumulative for both children and adults.”
New Zealand Dental Association Spokesperson on Fluoride and Sugary drinks, Dr Rob Beaglehole says numerous studies suggested tooth decay rates in children are reduced by 40% when there is fluoride, and 25% in adults.
“Fluoride strengthens enamel; if there is any decay it helps re-mineralise the tooth; and it helps get rid of the bugs that cause decay.”
Dr Beaglehole says the NZDA also wants the sugary drink industry levied and no junk food marketing to kids. “Sugary drinks do a huge amount of damage to teeth too and we need to deal with the sugary drink industry just like the tobacco industry.”
NZDA wants the Government to initiate a policy where only water can be bought and sold in schools.
Rachel Perrott say she is also concerned that the school dental service in Hawke’s Bay is struggling with long waiting lists.
Jeanette Frechtling, Oral Health and Child Development Services Manager, Whatu Ora Te Matau a Māui Matau confirms this. “We do have long waiting lists and there is a shortage of school dental therapists and oral therapists across New Zealand, and in Hawke’s Bay,” she says.
Currently the service in Hawke’s Bay has 32,000 children enrolled to Year 8. They are serviced by six mobile dental units, nine dental hubs and 17 therapists. With three new graduate nurses about to join the service.
“We don’t see every child, every year and we don’t need to,” says Frechtling. “But we will always see a child if there is an urgent problem or they are in pain. We keep a number of appointments free every day for this.”
She says parents need to know they can ring the hotline on: 027 2736 731.
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