Hundreds of Bay of Plenty children waiting for dental surgery

There are about 350 children aged 12 and under waiting for dental surgery in the Bay of Plenty. Photo / Christine Cornege

Delays of more than a year for children needing dental surgery are being blamed on Covid-19, as more than 500 sit on waiting lists in the Bay of Plenty.

One paediatric dentist is concerned many of those waiting will be in pain - impacting their families - and may face worsening decay that could mean they lose more teeth.

About 350 children aged 12 and under are on the surgical waiting list in the Bay of Plenty and there are 154 young people aged 15 and under waiting in the Lakes region.

Te Whatu Ora Hauora a Toi Bay of Plenty community and hospital dental/maxillofacial services department head Rudi Johnson said the wait time for patients needing "extensive treatments" could be up to 15 months.

It was typically shorter for those needing simpler procedures such as tooth extractions, she said.

Johnson said the average wait time was usually about six to eight months from referral date to hospital discharge, but lockdowns and the "knock-on effects of the pandemic" had resulted in the wait time increasing.

"This has been due to reduced access or no access to operating facilities for our dental team as, understandably, priority for the limited operating theatre access was given to other cases such as cancer and trauma patients," she said.

In recent weeks the situation had improved with some dental operating lists being reinstated, she said.

It also had access to additional operating time at other sites including Whakatāne and Braemar hospitals, and Park St Eye Clinic.

She said children were usually referred to hospital dental services "due to severe dental caries [decay] and them being unable to cope with a regular dental clinic environment".

Prioritisation was mainly based on the urgency of the patient's needs, severity of pain and discomfort, medical complexity and any special needs.

She said there were about 100 teenagers and adults waiting on hospital-based dental or maxillofacial surgery in the region.

Figures from Te Whatu Ora Lakes, formerly known as the Lakes District Health Board, show 79 patients aged five and under and 75 between the age of six-15 were on the waitlist.

Te Whatu Ora Lakes community oral health services manager Juan Restrepo said three dentists in the region did about 10 general anaesthetic sessions every month.

Children on the waiting list were prioritised by contracted dentists depending on their clinical criteria, with urgent and semi-urgent classifications, he said.

The wait time for a patient on the routine list could be one year.

He said most surgeries were for tooth decay or extractions that could not be treated in clinics.

Other reasons included if the patient was "too young to be cooperative" or if they had
disabilities that made treatment under general anaesthetic necessary, he said.

There were 44 patients aged over 15 on the waitlist.

Paediatric dentist Katie Ayers said the pandemic had increased the wait time for children needing surgery under general anaesthetic nationally, but each area was working hard to address the issue.

The community oral health services not being able to carry out general checkups during lockdowns also meant children were presenting more advanced tooth decay, resulting in more needing surgery, she said.

"A lot of the children have not been seen for over a year, so when they present some of them have quite advanced tooth decay. They may need a combination of fillings, silver caps on teeth or teeth to be removed."

The delays were of more concern to Ayers than the number of children on the list.

"In the Bay of Plenty the usual wait time would have been six to eight months, but my understanding is now it is significantly more than that."

Ayers, who was also a New Zealand Dental Association spokesperson, said many of the children waiting would be in pain and have ongoing infection which was "really tough" on them and their family.

Paediatric dentist and NZDA spokesperson Katie Ayers. Photo / Supplied

"Extending the waiting time means that they are in pain and suffering from an infection for longer," she said.

"If the children aren't eating well and sleeping well - that's going to impact on other family members."

Children's conditions would continue to worsen as they waited, meaning they would be more likely to need teeth removed by the time they presented for surgery.

"That, in turn, can have implications on the spacing of teeth - and increase the chance that the children will have crowding or need braces later on."

Ayers hoped the recent water fluoridation directive would help improve tooth decay rates for children in the Lakes and Bay of Plenty areas and reduce the need for treatment under general anaesthetic.

"The hope is that it really will. But that will take time to come into effect."

Dentist Bernie Pollard, who owns Tauranga clinic Dental Solutions, said it was "saddening" to see the number of children waiting for surgery across the region.

He had patients as young as 18 months.

In his view, hospital staff were working under challenging circumstances with Covid and staffing levels playing a "big factor" in the delays.

"I believe the service is well funded, but just getting through it in the last few years has been a nightmare."

Pollard said he had several patients with special needs on the waitlist for surgery under general anaesthetic. But their procedures were "constantly being put off" as their dental needs were minor in comparison to others.

"It's got to be needs-based. Just the same way I triage a roomful of patients, those in the most pain and with the most health risk get seen first."

He believed the majority of children on the waitlist would have broken or abscessed teeth, requiring extractions or "very significant restorative procedures".