24 Sep 2020

New Zealand's adult dental health needs are dire

From Lately, 10:30 pm on 24 September 2020

One adult a week is being admitted to the intensive care unit at Christchurch Hospital because of serious dental infection, a specialist hospital dentist says.

Juliet Gray and her colleagues face with people whose dental health has deteriorated so severely that they are being admitted with infections that have spread to their heart, lungs and spine - at times unintentionally overdosing to manage agonising dental pain.

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Photo: 123RF

“In New Zealand as soon as you turn 18 the funding for dental care stops and you are expected, if you need any treatment that’s managing decay or gum disease or even any preventive care to prevent decay or gum disease you need to pay for it yourself and in the private sector,” she told Karyn Hay.

The funding that does exist is inadequate and piecemeal compared with going to the GP, Gray says.

There is a little bit of funding for hospital care and a little bit of funding for WINZ clients, she says.

Hospital dentists are providers of last resort, she says, and they are seeing presentations of people whose dental problems are causing critical problems and require specialist care.

An infected nerve in a tooth can cause serious problems, she says.

“That infection can spread, so then there’s people coming into hospital with big swollen faces and a compromised airway and they need very specialist care from maxillofacial surgeons.”

These people need time in ICU and time in theatre.

The clinical director of maxillofacial surgery at Canterbury DHB, Jason Erasmus, is collecting statistics on hospital admissions caused by preventable dental problems, she says.

And is “watching with horror as this trend is increasing.”

Maori, Pasifika and males are over represented in hospital admissions, she says.

“They come in in desperate pain and ED doctors are only able to prescribe antibiotics and analgesics and this barely touches the sides of this and it doesn’t solve the problem because the nerve has got to be removed.

“People go round in circles and unfortunately some of them end up in ICU with terrible swellings and dental infections.”

New Zealand has been ignoring the problems of dental care for adults for a very long time, she says.

“I was so disappointed that the Ministry of Health made the decision that adult dental care isn’t funded in New Zealand. It’s not logical.”

She wants to see widespread fluridisation and a sugar tax.

“And feel confident that any New Zealander of any age who has an agonising toothache or a facial infection related to dental care can access dental treatment.”

The mouth is part of the body but is not funded as a problem elsewhere would be, she says.

“What is it going to take for us all to realise that the mouth is part of our body? It’s not separate. The bugs in your mouth can move anywhere in your body.”