A Rotorua dentist is concerned about the welfare of his patients after guidelines have prohibited him from treating them during the Covid-19 pandemic.
Dental practices across Rotorua have been told by the Dental Council only "emergency" work is permitted in level three because of the risk of spreading Covid-19.
But Kuirau Dental owner Dr Angus Campbell said the guidelines were unclear and lack of personal protective equipment (PPE) was making it impossible to follow.
"Patients are now, after five weeks, having to deal with a lot of pain and as a result, there is now a growing population with serious dental needs.
"There are many more people with dental problems that are far worse than they should be, had adequate PPE been available to dentists in this state of emergency that the government declared."
Campbell said dentists had been advised to treat non-emergency infections and pain with non-face to face communication and prescriptions of antibiotics.
The guidelines jointly established by the Dental Council and the Ministry of Health say not to use generating aerosols, which make up most of the dental tools used.
"I have patients halfway through root canal treatments and patients with rapidly deteriorating conditions who will now be in a much worse situation and require much more invasive treatment due to the fact I was not able to work."
Plus, the inability to source PPE from the district health board and the cost from getting it from overseas suppliers were creating a major financial risk and headache for the dental industry, Campbell said.
He predicted the added cost of PPE would add $100 per patient and not being able to operate would have "major" financial consequences for many surgeries.
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Campbell wished the government included dentistry in the financial aid package to general practitioners and pharmacies.
"Dentistry is seen as the poor cousin of medicine and the government has yet again ignored dentistry."
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".
"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?"
Dentists believe they have been left off the radar during the Covid-19 crisis because there is no government funding for adult dental care, he suggested.
But oral health care was an important part of general health and all New Zealanders had a right to access it, he said.
Crum said dentistry in New Zealand is largely privately funded, with only small amounts of public spending out of $1.5 billion spent each year.
"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."
A Ministry of Health spokeswoman said restrictions on 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 supported 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.
Only urgent care was able to be provided because of 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 require an aerosol-generating procedure to remove bone or divide the tooth."