The “underfunded, understaffed, overwhelmed” school dental service is where the crisis is in dental care, says Dental Association president Dr Bill O’Connor.

O’Connor said too many kids with rotten teeth showed the DHB-delivered community oral health service was failing children and he called on the Government to get ‘serious about dental care for our children’, in his opening address to last week’s New Zealand Dental Association conference. Also that retention of dental therapists in the public service needed to be a priority.

He said 96,000 children were overdue their recalls with a dental therapist and 29,000 Kiwi children had decayed teeth extracted last year – about 120 each working day. “Why have they not been treated before they got to this point?” he asked.  He added that the large number of children being enrolled with the service seemed at odds with the large numbers of school-aged children that have untreated tooth decay.

O’Connor said children deserve to have first world dental treatment available when they need it and to be seen for regular check-ups and prevention of these “terrible dental problems”.

“The young children of New Zealand don’t get to choose what they eat or drink, they don’t choose to have rotten teeth and the pain and suffering that comes with that. They don’t choose to live in areas that are woefully unable to meet the treatment needs of their population.”

Retaining therapists in system a priority

He said his speech was not intended to be negative about dental therapists, as dentists knew how hard their job was.

“Retention of therapists already in the system must be a priority, along with attraction of new ones. The working environment must be made attractive to prevent the loss of therapists from the public system,” said O’Connor.

“Money alone is not the answer, but it is essential therapists are paid sufficiently to work in the public sector and their working conditions enable them to be fulfilled in their role.”

He said children deserve to have motivated, skilled professionals caring for their oral health and to be the number one priority for the available resources.

“Underfunded, understaffed, overwhelmed school dental services are where the crisis is.”

He said to stop the ‘rot’ that the current system needed a complete review and overhaul to meet current and future needs and called on the Minister to make this a priority for the Government.

Health Minister David Clark has responded to the Association’s concerns by acknowledging major unmet needs in dental care.He also said he had been told that 85 per cent of children were being seen on time by DHB community oral health services and the ministry was working with DHBs on reducing the level of overdue appointments.

O’Connor also told the conference that the sector should not get “distracted by the agendas of others” as the country’s children deserve a fair go.

His comments follows calls in the past year by New Zealand Dental and Oral Health Therapists Association (NZDOHTA) chair Arish Naresh for suitably qualified dental and oral health therapists to be able to work with people beyond the current cut-off of age 18 to help meet the unmet need in adult dental care. The Dental Association has responded by saying many DHBs were already having trouble recruiting and retaining dental or oral health therapists to work with pre-school and school-age children and the greatest need for therapists was to focus on children’s unmet dental treatment needs.

Therapists’ respond

Naresh, a dental therapist who is also the Director of Allied Health and Technical for Hauora Tairawhiti (Tairawhiti District Health Board), said he welcomed NZDA’s call to further resource community oral health services.

“NZDOHTA is encouraged by NZDA’s support for kids oral health, and dental and oral health therapists are going to support our dentistry colleagues in future by using adult scopes to reduce the burden of oral disease in adult populations. This is a good example on how NZDOHTA and NZDA can support each other to improve oral health for all New Zealanders.”

He added that the major reason why new graduate oral health therapists chose not to work in the public sector was because they were not able to practice to their full scope of practice.

“It is like training pilots to fly airbuses but then once they graduate, restricting them to flying kites. It is time the public sector ensured that oral health therapists are better utilised and this will need more resourcing from central government.”


  1. This makes no sense. If, as the NZDA says, correctly, that an underfunded service has allowed thousands of children’s disease to go untreated, their basic needs unmet, then how on earth will it help if the therapists trained to provide this treatment are taken away from children’s dentistry to provide treatment for adults, no matter how deserving?

  2. Public health dentistry must base provision of care based on evidence, not politics. We have learned that the School Dental Service was not responsive for our high risk children. We have learned that providing treatment for children who return home to parents with oral disease, poor diet and poor oral hygiene, also doesn’t work.
    Providing a preventive model of care for all communities regardless of age is working e.g. Victoria, Australia.
    It’s time New Zealand lead the world again with evidence-based care. The growing disparity between those who can’t afford dental care and those who can is unacceptable and severely impacts on general health and well being. Too many New Zealanders suffer, with a huge burden on DHB funding when tertiary health care is needed due to poor oral health.

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