Children on general anaesthesia waiting list akin to abuse, says dentist

children-on-general-anaesthesia-waiting-list-akin-to-abuse,-says-dentist

A Taranaki dentist has warned that wait times for children requiring dental treatment under general anaesthetic are tantamount to child abuse.

cropped shot of dentist with instruments examining teeth of little child

Stock photo. Photo: 123rf.com

Dr Mary Anne Costelloe says about 100 children in the region are waiting up to a year for treatment, often while in chronic pain.

Dr Costelloe said the number of children suffering advanced tooth decay had grown since the removal of fluoride from the New Plymouth water supply in 2011.

“There is a need for advanced dental care for children in Taranaki especially since flouridation was removed, but the GA service for children has not increased since then and the waiting list has and it has now extended to over a year for a child to wait in pain on that list.”

The Stratford-based dentist said if a child had more than two broken teeth or widespread decay in they were referred to the district health board for treatment under general anaesthetic.

Children requiring this level of care were often in pain.

“They are often crying at night and they limit their diet because food gets stuck between their teeth. So, they tend to eat mainly softer food which doesn’t help the decay rate in their mouth and they are generally unsocialable and are a stress in the household which is often already stress because of other issues. And it often occurs in more deprived households.”

Dr Costelloe believed cost was behind the delays and she worried policy changes around the use of minimal sedation would force dentists to refer even more children to DHBs for treatment instead of doing the work themselves.

She said if the proposed changes go ahead, her practice alone would refer 50 more children a year to the general anaesthesia waiting list in Taranaki.

Taranaki dentist Dr Mary Anne Costelloe

Dr Mary Anne Costelloe. Photo: RNZ / Robin Martin

In statement, Taranaki DHB Director of Allied Health, Katy Sheffield, confirmed there were 101 children on its waiting list for dental treatment under GA and that they would generally wait 4-8 months for treatment, except for acute cases which were brought forward.

Sheffield said it was difficult to say what effect the lack of fluoridation in New Plymouth water supply had had on the numbers because other factors were also an influence.

“These other significant factors affecting children’s oral health include diet and lifestyle choices, a national community oral health staffing shortage, and most recently Covid-19 service restrictions.”

She said in-patient dentistry was not specifically funded for general anaesthesia and there was no ring-fenced funding for children.

Sheffield said the DHB was changing its policies on general anaesthetic for dental treatment of children and young people, but it did not know what effect it would have on wait times.

The minimal sedation contract with two providers is being aligned to best practice standards to ensure safe services are delivered in the community.

“This may mean that more children and adolescents will be treated under GA. However, we are exploring options to mitigate the risk that this may increase wait times.”

That’s cold comfort for Dr Costelloe who said being made to wait so long amounted to neglect.

“And neglect in children is often seen as a form of abuse and the neglect of children on these lists I don’t think is acceptable.”

The Ministry of Health said nationally there were 3537 children aged 0-14 waiting for dental treatment in a hospital – typically under general anaesthetic.

It said it was aware of DHB plans to develop national guidelines for oral health treatment of children under general anaesthetic, but that they had not yet been finalised.

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