When Dr Rob Beaglehole moved from Wellington to Nelson, he was shocked at the number of children with tooth decay.
The primary difference: Wellington had fluoridated water; Nelson did not.
“It wasn’t uncommon to be removing 10 teeth from children as young as 18 months,” Beaglehole said.
A new study from University of Canterbury (UC) researchers has again highlighted the benefits of fluoridated water for oral health.
The study, published in the International Journal of Epidemiology, showed community fluoridation was related to reduced dental hospitalisations in children aged 0 to 4 and 5 to 12.
The greatest benefit was for children living in the most deprived areas around the country, UC senior lecturer in public health and study author Dr Matt Hobbs said.
The study, which drew on several years of national hospitalisation data, compared the difference in dental-related hospital admissions between fluoridated and non-fluoridated areas across different deprivation bands.
“In the least deprived areas it didn’t actually seem to make too much of a difference. It was the most deprived areas where this difference was occurring,” Hobbs said.
Poverty was the number one risk factor for poor oral health, Beaglehole said. People were less likely to access dental care, and more likely not to be following a healthy diet. “More coke, more junk food, those sorts of things.”
About 54 per cent of the New Zealand population receives fluoridated water, according to a 2017 health committee report. The Ministry of Health says water fluoridation is a proven public health measure to reduce tooth decay.
According to ministry statistics, in 2017-18 there were about 8700 hospital admissions for young people aged up to 18 for dental care under general anaesthetic, or 23 a day. Children and youth receive hospital-level dental care for several reasons, not just to extract teeth.
Beaglehole, spokesperson for the New Zealand Dental Association (NZDA), left his role as a clinical dentist at Nelson Hospital this year. During his career he could “see on a day-to-day basis the pain and suffering that tooth decay causes”, he said.
“Also, the needless suffering of children living in non-fluoridated areas.”
NZDA president and specialist paediatric dentist Dr Katie Ayers on Thursday treated six children under general anaesthetic at a private hospital in Hamilton.
One of her patients was a 2-year-old boy who had eight teeth removed due to tooth decay. His family chose to take him private because of a possible year-long wait in the public system, Ayers said.
Seeing young children with severe tooth decay was “heartbreaking”, she said.
“It’s terrible, because they can’t eat and then if they can’t eat well they can’t sleep well.”
Canterbury District Health Board community dental health clinical director Dr Martin Lee said about 750 children a year in Canterbury were admitted to hospital for dental care under general anaesthetic.
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Examples in Christchurch in the past few weeks included a 4-year-old who had three teeth removed and another child who had nine teeth removed due to tooth decay.
Water fluoridation was an equity issue, Lee said.
“Well-off people don’t have dental problems, but people who are disadvantaged do. And water fluoridation is a really easy, cheap and safe way of tilting the scales back.”
It comes as a bill that would transfer decision-making powers over water fluoridation from territorial authorities to district health boards (DHBs) appears to be floundering.
The bill was introduced in 2016 and passed its first reading that year with broad support. New Zealand First opposed it. There has been no progress since a health select committee report came back in 2017.
Beaglehole said he understood there was a lack of agreement between the Government parties, adding the NZDA was disappointed it had become a political issue.
The association hoped the bill would pass under urgency in the next term, he said. “The reason being is it would dramatically reduce the pain and suffering of our young children.”
In a statement issued on Wednesday, before he resigned as Health Minister, David Clark said the bill was “part of our legislative agenda”.
“New Zealand First is not responsible for progressing nor delaying this legislation,” a spokeswoman for the party said.