Pyes Pa and Omokoroa dental surgery owner Dr Riaan Kriek. Photo / Supplied
Pyes Pa and Omokoroa dental surgery owner Dr Riaan Kriek. Photo / Supplied
Tauranga dentists are feeling "shut out" from being able to help their patients during lockdown, with some experiencing long lists of people in pain.
Dental practices across the Bay have been told only "emergency" work is permitted during level 3 by the Dental Council, due to the risk of spreadingCovid-19.
But Tauranga practice owner Dr Riaan Kriek said the guidelines were unclear and was causing financial stress.
He said life-threatening problems, facial swelling and serious trauma were deemed as an emergency by the Dental Council.
"They have this list of problems, but we aren't allowed to use our dental handpieces," Kriek said.
"We can see the patient but we can almost not do anything for them, because to use the aerosols we have to go to a special surgery where there is a unit that sucks the air out and there is negative pressure airflow, yet we haven't been told where we can find a surgery like that."
The owner of both Pyes Pa and Omokoroa Dental Surgery said he understood there was public safety involved but at the same time, he had a long list of people in pain.
"We are trying to be patient and we do understand there is a huge health risk involved, but now the risk is lower we expect the regulations to ease so we can help our patients.
"We have a waiting list of people that are in trouble at the moment but we just have to give them antibiotics and try and keep them pain-free."
Handpieces used by oral health practitioners cannot be used following guidelines from the Dental Council and Ministry of Health. Photo / File
Kriek said it may sound like empty excuses to those needing help but his hands were tied.
And, Kriek feared the industry would be further out of reach for those in financial hardship as he was having to combat the cost of PPE.
"It is about $80 per patient if you have all the full gear for the dentist and the dental assistant, and then we have to somehow pass that onto the patient which is also not a nice thing."
But the financial hardship doesn't stop there. Kriek said the longer the doors were shut, the harder it would be to reopen without some of his colleagues being made redundant.
It would be an impossible decision to make for Kriek who views his 20 staff across both practices as family, and his only hope was the Government would step in to help as it had done or pharmacies and general practices.
"We are the ugly cousin I think, no one wants us. They just think we will sort ourselves out, unfortunately."
New Zealand Dental Association chief executive Dr David Crum said dentistry had been largely ignored by the Ministry of Health and he felt "shut out".
He said oral health was an important part of general health and as such all New Zealanders had a right to access good oral health care.
"Doctors and pharmacists are still able to work and receive at least some form of income, albeit at a reduced capacity. Dentists are not. Why is this?
"One hypothesis is, that because there is currently almost no government funding for adult dental care in New Zealand, dentists believe they have been left off the radar during this Covid-19 crisis."
New Zealand Dental Association chief executive Dr David Crum. Photo / Supplied
Dr Crum said expenditure on dentistry in New Zealand is largely privately funded, with only small pockets of public spending out of $1.5 billion spent each year.
In obeying the new Ministry of Health guidelines dentists were being forced to access the very scarce supply from overseas, Crum said.
"The reality is that if you are an adult New Zealander, you will be expected to pay for your own dental care and the PPE to provide this safely with limited exceptions."
In response to Crum's allegations, a Ministry of Health spokeswoman said restrictions on delivery of oral health services were safety-focused, based on the distinctive risk profile of oral health services and aligned with wider Government and health sector guidance.
The ministry considers the guidance it has been jointly developing with the Dental Council was clear and supportive of safe oral health practice, the spokeswoman said.
"The Ministry of Health and DHBs have the main responsibilities for publicly funded oral health services, while private sector oral health practitioners have the main responsibilities for privately funded oral health services.
"These longstanding arrangements have not changed with Covid-19."
Dental Council chairman Andrew Gray said the guidelines were similar to those developed in countries with comparable regulatory schemes and had been recognised internationally.
Nothing more than urgent care was able to be provided due to the close personal contact required in dentistry, Gray said.
"Dental treatment frequently involves aerosols, often for extended periods, with the clinician in close proximity to a patient who is not wearing a mask.
"Simple dental treatment is very limited without aerosol generation and although the risk with simple extractions is less, there remains the risk of complications, such as tooth-breaking which will then require an aerosol-generating procedure to remove bone or divide the tooth."
