Thousands of children waiting months for dental surgery

There are concerns about the number of children waiting longer than four months for dental surgery.

• Over half of the children on the dental surgery waiting list have waited over four months.
• Health New Zealand data shows 2942 children have been waiting more than 120 days.
• Workforce shortages and Covid-19 impacts are contributing to the growing waiting list and delays.

More than half of the children on the waiting list for dental surgery have been waiting more than four months.

Data from Health New Zealand shows that as of March, there were 5564 young people aged 14 and under on the waitlist, with 2942 waiting more than 120 days.

The overall waitlist has grown by about 1500 children in two years, up from around 4000 in March 2023.

Hospital teams carry out dental services that can’t be completed in the community for a variety of reasons. They include special medical needs, behavioural difficulties, or because the child needs multiple procedures at the same time such as extractions, and wouldn’t be able to tolerate this under local anaesthetic.

Dental Association director of dental policy Robin Whyman said the number waiting longer than four months is “concerningly large”.

“Most of these children will have been referred with quite a high level of dental disease.”

He said sometimes they have more complex dental conditions that need to be addressed, such as developmental problems in their teeth that need to be extracted.

“Most of the children will have had some level of infection, and pain, and so that continues to be managed almost on a day-by-day with things like pain relief and antibiotics until they can get access to care, which is not what we want to have happening.”

He said waiting more than four months can not only feel like a long time for young children, but also has some level of clinical risk.

“Children can go on to develop quite severe infections from the infected teeth, so concerning for the children, concerning for their parents, and also concerning for the clinicians.”

He said “we need to get the waiting list down as quickly as we can”.

“But realistically, this is going to take months, if not a year or so probably, to bring under a level of control.

“What really needs to happen is a focus on the early years and the issues that are driving the levels of dental decay we’ve got.

“That’s sugar in our diets and the levels of sugar consumption, but also the demand and the ability to deliver the community oral health services where many of these children can be seen earlier and disease prevented.”

Dental Association director of dental policy Robin Whyman says there needs to be a co-ordinated effort to increase the workforce in community oral health. Photo/File

Health New Zealand chief clinical officer Dr Richard Sullivan has acknowledged a lack of access to community services for children and adolescents is driving the growth in demand for hospital-level dental treatment.

“All dental services across the country were significantly impacted in 2020 and again in 2021 due to the Covid-19 lockdowns. This resulted in delays in both community and hospital dental care across the country.”

He said another issue that has contributed to waiting list growth over the last few years, and continues to impact capacity, is domestic and global shortages in the oral health workforce.

Whyman said Health New Zealand data shows that in 2023 there were 825,000 children enrolled with a community oral health service, and around 36% of them were overdue for care.

He said the workforce is a big challenge here, with a significant number of vacancies.

Whyman said there needs to be a more co-ordinated approach with the tertiary education sector to address shortages, particularly for dentists and oral health therapists.

There has been some increase in oral health therapy training positions, but he said the number of dentists in training hasn’t changed at all.

“Without an increase in the supply of both workforces, we will continue to struggle to deliver the oral healthcare we need.”

Sullivan said there are a number of initiatives under way to improve access to dental care in the community.

They include making concerted efforts to address the backlog of children who are overdue to be seen at a community oral health service, including referring Year 7 and 8 children to funded private dental practices.

Health NZ’s Chief Clinical Officer, Dr Richard Sullivan says they are utilising capacity in the private sector to try and reduce wait times. Photo / Alyse Wright

There was also funding for 20 new mobile dental clinics in Budget 2022 - which are being delivered in two tranches, prioritising areas with the highest inequities. So far, six of the seven in the first tranche have been delivered.

Oral health therapists are being treated as a priority workforce - with a collaboration between AUT and Health NZ working to address the shortage by supporting Bachelor of Health Science (Oral Health) students to train closer to home.

Sullivan said improving dental waiting times for children is part of a broader strategy to reduce elective surgical wait times.

He said a recent national boost to outsourcing will increase the number of procedures they are able to deliver, by utilising additional capacity in the private sector.

Sullivan said Health NZ also continues to contract mobile surgical dental services, particularly for tamariki in smaller urban and rural areas.

“Over the last two years, more than 2500 children aged 0-14 years have received dental care through this service.”

He said regions have also set up their own programmes to help meet the Government’s health target - such as one in Canterbury, where half a million dollars is being spent on outsourcing 100 procedures under general anaesthetic and running extra first specialist appointment clinics for 300 children by the end of next month.

Whyman said the initiatives Health NZ has under way are the right ones.

“It comes down to an issue of supply and being able to deliver more care... more theatre lists and using resources such as private surgery and mobile surgical services is a good way of increasing capacity.

“The challenge that will sit there, is that it needs the workforce associated with the group - and not just a dentist workforce, this needs anaesthetists, it needs theatre nursing teams, it needs anaesthetic technicians.”

He said they all need to be available, and many of them are needed to deliver other waiting list priorities as well.

Danica MacLean is an Auckland-based News Director and Senior Reporter for Newstalk ZB, with a focus on health stories. She joined NZME in 2017, initially working for the Northern Advocate before switching to radio. She has previously worked for Stuff in Northland.