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Dental health a very good reason to smile

Wairarapa’s numbers for decayed, missing, and filled teeth data is the third-lowest for five-year-olds in the country. PHOTO/STOCK.ADOBE.COM

A dental health expert says initiatives to improve children’s dental health show promising results, but many challenges remain.

Lynette Field, manager of the Wairarapa Oral Health Service, updated the board of Wairarapa DHB last week about the outcomes of recent programmes.

“Wairarapa is doing well nationally,” she said.

“Our dmft [decayed, missing, filled teeth] is the third-lowest for five-year-olds in the country. We are doing really well.”

The data was collected annually from January to December. The results related to a 2020 study that involved 386 out of about 600 five-year-olds in the region.

“Overall, 67.67 per cent of those were caries [cavity] free,” Field said.

She said statistics for Maori children were not as good, with less favourable outcomes than for other groups.

Good dental health was linked to economic indicators, with deprivation often going hand-in-hand with dental health challenges.

“Deprivation in Wairarapa is the big thing; it’s not fluoride or non-fluoride, it’s deprivation. Our most deprived population is in our fluoridated area.

“I can’t stress that enough,” she said.

Field said 165 children in fluoridated areas were included in the study, of whom 104 were cavity-free.

“In the non-fluoride areas, caries-free was 26 per cent.”

“Our deprivation is big in Masterton. It’s the biggest thing,” she said, saying this factor had changed the way children were treated.

Resources had been focused on schools in less well-off areas after the covid lockdown to make sure high-risk children were seen and assessed.

Baby clinics were also held, although attendance had been variable.

“Unless the interest is there, they don’t come. We now make phone calls,” she said.

If phones remained unanswered, health workers would make a home visit.

A complete dental health surveillance programme was in place for young children, including fluoride-related treatments in appropriate cases.

“We aim to see children four times before they are five,” she said.

This was a high number of visits compared with other parts of New Zealand, with the region punching above its weight.

“Most DHBs see them at two years, then they might see them at four and a half,” Field said.

There was generally a six-, 12- and 18-month recall, depending on the case. Covid had caused the 18-month recall to be dropped in case of lockdown delays.

“This new environment is tricky. So you have to be more cautious,” she said, referring to risks posed by covid.

Field said they worked with Kohunga Reo to introduce the programme with a broader general health focus.

“It’s an educational programme with the parents,” she said.

The programme had focused on high-risk kindergartens in Masterton, Carterton and Featherston.

The covid outbreak had interrupted the programme, and the Dental Council had changed the rules on cross-infection.

“There is no way in level 2 we can go into anywhere,” Field said.

“The idea is good, and it’s there, and it will work in the future.”

Studies around the world showed additional fluoride helped child dental health. Field said Wairarapa could benefit from considering applying the results of these studies.

Cost and resourcing were further constraints.

“Staffing is the thing,” Field said.

Wairarapa was entitled to six and a half full-time equivalent dental therapists and the same number of dental assistants for the region.

Succession planning was another critical consideration for future-proofing the programme.

The Wairarapa Oral Health Service is one of the most frequently visited Wairarapa DHB services.

The community service strongly emphasises preventing tooth decay and providing parents with advice to support their children’s good oral health at the time of their child’s appointment.

The service offers free basic dental care to children who meet the criteria for publicly-funded health services from birth until they start high school.

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