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Dentists concerned about oral health of young Pasifika

Dentists say they’re concerned about the dental health of young Pasifika, after a recent report showed they were disproportionately more likely to have tooth decay than others.

Dentist (file picture). Source: istock.com

Figures from Bula Sautu: Pacific health in the year of Covid-19 found 36 per cent of five-year-old Pasifika were free of tooth decay. For non-Māori, non-Pacific five-year-olds, that figure is 69 per cent. 

The report said that for children under four years of age, 83 per cent were enrolled in a community oral health service, compared to 98 per cent for non-Māori, non-Pacific for the same age group. Pacific children under 14 were also twice as likely to have had teeth removed in the past 12 months because of decay, abscess, or gum disease. 

Dr Fanakava Misa, a Canterbury DHB dentist and a New Zealand Dental Association spokesperson, said the findings were “heart-breaking”, but not surprising. 

Misa told 1 NEWS she recently saw a five-year-old Pasifika girl in her practice whose family lived rurally. After checking her teeth, Misa found she needed to have about seven of them taken out because of decay. 

“This child has waited two years [to see a dentist]. And the reason why it took two years is because her parent was working shift work. And every time that they were trying to come in, something came up so they couldn’t really take time off work to travel.”

She said she’d seen other cases where children had to be put under general anaesthetic because of the significant work that needed to be done on their teeth. 

While dental care for young people under 18 is free in New Zealand, Misa said that didn’t always play out in reality. 

“When we say that it’s free, there are people out there who aren’t able to come in because of shift hours or they prioritise other things. Because, of course, if I was just making ends meet, I would prioritise having bread and milk rather than having a toothbrush.”

She said Pasifika were also more likely to have poorer health outcomes, which were linked to socio-economic status, lifestyle and diet. 

“These kids have [cavities] not just because they are not practicing good behaviours to help prevent it, like brushing twice daily with fluoride toothpaste, it’s also the food they are having. 

“It doesn’t really help if the cheapest food they can get access to and is available and what they can afford is high in sugar.”

Severe oral health issues affected a child’s sleep, their overall health, how well they did at school, and their families, she said. 

“It’s really sad because it's a right for each person to be able to enjoy good oral health. It’s not a privilege.”

Misa said she wanted to see water fluoridated and clearer labelling of sugary foods to help improve all young people’s dental health. 

Having more Pasifika enter dentistry would also help, she added. Being of Tongan descent, Misa said she was able to better communicate with the family of the five-year-old.

Māori dental health also a concern

The report highlights that young Māori also tend to have poorer oral health outcomes. 

Data on the Ministry of Health’s website from 2013, first published in 2018, showed Māori children under five were more likely to have missing teeth or have fillings than other children. 

Dr Pauline Koopu (Te Whānāu-a-Apanui, Ngāti Konohi, Ngāti Kahu) is a public health dentistry specialist in Auckland DHB and the former chair of the Māori Dental Association. 

Koopu said because free dental care was available for people under 18, there is a lot of data about young Māori which showed they were disproportionately more likely to have cavities or decay. However, less was known about Māori adults and kaumatua. 

The high cost of dental care for adults was also an issue, she said. 

Publicly-funded services, especially community oral health providers, were also still playing “catch up” with patients after the Covid-19 lockdowns, she said.

Those with the most severe cases of tooth decay are referred to Koopu.

“Every week, I work under general anaesthetic on children aged between two up to about the age of nine. And an average case would involve several fillings or stainless steel crowns, and several extractions as well. 

“It’s not uncommon to have to extract up to 10 baby teeth in three and four-year-olds unfortunately.”  

She said education for whānau, such as in schools or public health campaigns, was important so they could make better choices about their oral health.

“As a Māori clinician, it’s quite a heart-breaking thing, the level of disease that we're still seeing, coming through both children and adults and particularly in Māori and Pasifika.”