Kiwi pre-schoolers losing teeth to preventable tooth decay
Canterbury District Health Board and University of Canterbury media release: 28th July 2020
Kiwi kids are suffering unnecessarily from severe tooth decay that could be prevented according to research published today in JAMA Paediatrics - the highest-ranking journal of Paediatrics, Perinatology and Child Health in the world.
The nation-wide study - evaluating the link between community water fluoridation and the experience of severe tooth decay in four-year-old New Zealand children - analysed the B4 School Check screening programme data of 275,000 children over a five-year period from 2011 to 2016.
The findings show children who didn’t have a fluoridated water supply were 20 percent more likely to have severe tooth decay.
“Modern dentistry can only do so much to tackle this issue and by the time children receive dental care it’s often too late to save their baby teeth, which then affects the development of adult teeth,” says Dr Martin Lee, Canterbury’s Community Dental Service Clinical Director. “Community water fluoridation is the safest and most cost-effective preventative strategy we have to protect the teeth of all Kiwi kids, and the teeth of all New Zealanders generally.”
Nearly one in seven (15 percent) of four-year-olds who had had a B4 School Check were found to be severely affected by tooth decay. The rates of severe decay were much higher for Māori and Pacific children and children living in deprived areas, but no-one was immune. 7 percent of NZ/European children and children living in the least deprived areas had severe tooth decay.
Four-year-olds with severe decay frequently need a general anaesthetic for their dental treatment and many of those on hospital waiting lists have chronic toothache and abscesses.
New Zealand has a long-term national policy supporting community water fluoridation, yet only 54 percent of the population currently receives it. A Bill proposing moving responsibility for this from Councils to District Health Boards - introduced in 2016 - has not been progressed since a health select committee report in 2017.
Lead author of the study, Philip Schluter, Professor of Population Health at the University of Canterbury (UC), says the burden on the dental health of Kiwi kids is not shared equally across the country.
“The research shows the current lack of widespread community water fluoridation disproportionately affects children living in the most deprived areas, with Māori and Pacific children more likely to experience worse oral health than pakeha, even after accounting for key sociodemographic factors,” says Professor Schluter.
“We hope that the real-world evidence provided in this research will be used in evidence-based policy-making to combat the woeful oral health burdens and neglect carried unnecessarily by so many children in New Zealand.”
The research was undertaken by a team of legal, public health, dental, water quality, and geospatial specialists:
- Professor Philip Schluter (Population Health expert at the University of Canterbury);
- Dr Martin Lee (Canterbury DHB’s Community Dental Service Clinical Director);
- Helen Atkins (Director of Atkins Holm Majurey - New Zealand’s leading specialist environmental law firm and President-elect of Water New Zealand);
- Mr Barry Mattingley (Senior Scientist in drinking water quality at ESR - a New Zealand Crown Research Institute);
- Dr Matthew Hobbs, (Senior Lecturer in Public Health at the University of Canterbury with specialist geospatial expertise).
Key points/ findings of the research
The study of 275,000 Kiwi children over a five-year period (2011 to 2016) found:
- Children in areas without a fluoridated water supply were 20 percent more likely to have severe tooth decay.
- Māori and Pacific children living in the most deprived areas were 8 and 12 times (respectively) to have severe tooth decay.
- 7 percent of NZ/European children and children living in the least deprived areas had severe tooth decay.
- Nearly one in seven (15 percent) of four-year-olds who had had a B4 School Check were found to be severely affected by tooth decay.
New Zealand has a long-term national policy supporting community water fluoridation, yet only 54 percent of the population receives it.
A Bill proposing moving responsibility for community water fluoridation from Councils to District Health Boards, introduced in 2016, has not been progressed since a health select committee report in 2017.