Dialogue: Hundreds of children miss out on basic dental care

As you are brushing your teeth tonight, I want you to think about their importance.

They are not just cosmetic. Those bright enamel-coated chompers are an essential part of your body. Their good condition allows you to eat a wide variety of food, talk clearly, provide you with confidence and fill out your face.

Then imagine your teeth aren't in good condition. Imagine they constantly hurt, you have infections, your face is swollen, you can't eat.

Then imagine you are facing those problems as a child and you are doomed to grow old with a distorted face and suffer the consequences for the rest of your life. That is the reality for hundreds of children in Northland.

Toddlers, babies and young children are being forced to live in excruciating pain day after day here while their general health deteriorates and they become sick and malnourished because their teeth are rotten.

Children in Northland, in particular Maori children, have the highest average number of fillings in the country.

Northland has only 23 dental therapists trying to look after 30,000 children in an area which stretches from Mangawhai and Ruawai in the south to Te Hapua in the north.

Only 5 per cent of the population in that area receive a fluoridated water supply, and many live in isolated and poverty stricken conditions with poorly educated parents who are just as likely to give them a bottle full of soft drink as a bottle of milk.

At the moment, the Northland District Health Board is trying to convince the Ministry of Health that a flat annual dental funding rate of $64 a child is failing thousands of children in its area.

Children in Remuera receive the same amount of funding as those who live in the Hokianga - or Raetihi or Ashburton for that matter.

Although that may seem fair on the surface, investigation soon reveals it isn't.

It seems bizarre that while almost every other system of funding or allocation seems to be targeted, rightly or wrongly, at what colour a person is, how wealthy they are or where they live, the funding for children's teeth doesn't take any of those factors into account.

Children living in affluent or urban areas have fluoridated water to drink, thereby immediately lowering the risk of dental disease.

They also have easy access to dental therapists and most likely have their own toothbrush and parents who make sure they use it.

But many children in Northland, especially in the parts coloured red on a deprivation map, don't have these.

Dental therapists have to trek long distances to get to them maybe once a year, if the children are lucky, and then are faced with problems so horrific that they have to refer them to specialists, whose work has to be funded through the mainstream health system.

These children's parents are usually on the breadline or worse and many don't realise the importance of keeping their children's teeth clean or see the worth of buying them a toothbrush. And, at $64 a child, Northland District Health can't afford the programmes to educate parents otherwise.

Whangarei dental surgeon David Stallworthy has to deal every day with the consequences of the lack of funding, lack of education and lack of resources.

He has spent hours up to his elbows in pus and rotten teeth while trying to give children a better chance of living normal lives.

Each week he operates on babies, toddlers and children whose faces are swollen and distorted because their rotten teeth have been infected and abscessed.

In the past three months he has operated on more than 100 children who needed a general anaesthetic to get them through the ordeal.

One of his worst cases recently was that of a 3-year-old boy whose entire top row of teeth had to be removed, along with two teeth from the bottom.

The child had been hospitalised after the infection from his teeth caused his face to swell and his eye to close over.

"The teeth I took out were abscessed and the tops of them had rotted away," said Dr Stallworthy. "Pus had also formed and gotten into the bone."

The situation is becoming increasingly common and Dr Stallworthy said the waiting list for similar operations was growing.

"It's heartbreaking."