Two in five kids have teeth cavities by age five
12 April 2019
A new University of Auckland study shows two in five (41 percent) children living in Auckland and Northland have one or more decayed, missing or filled tooth when they start school.
The rate is higher still in Asian, Māori, Pacific children (44 percent, 59 percent and 65 per cent respectively), children from very deprived neighbourhoods (60 percent) and those living in Northland (54 percent). This compares to rates of 25 percent in England, 35 percent in Wales, and 34 percent in Queensland, Australia in a similar age group.
The new study, published in the New Zealand Medical Journal, analysed records from school-entry dental exams of 27,333 children in 2014-2015. It also revealed that children who had been hospitalised for an injury at least once had a higher chance of rotten teeth at school entry.
Researchers say their findings underline the urgent need for society-wide actions to improve oral health in young children and tackle inequalities, including water fluoridation, measures such as a tax and health warnings to reduce consumption of sugary drinks, and oral health promotion that is meaningful in communities where children currently experience poorer oral health.
It is distressing to see children who have painful, eroded teeth when caries
[tooth decay and cavities] are so preventable
“Oral health is so important for the wellbeing of children. As a doctor, it is distressing to see children who have painful, eroded teeth when caries [tooth decay and cavities] are so preventable,” says researcher Dr Tim Jelleyman, an academic at the Faculty of Medical and Health Sciences and community paediatrician at Waitakere Hospital.
“It causes sleepless nights, loss of appetite, and general misery. And the bugs that set up in our mouths early in life probably impact the later health of our permanent teeth.”
Previous overseas studies linked several other childhood medical conditions and infectious diseases, such as asthma and middle ear infections, to a raised risk of tooth decay and cavities. The Auckland researchers were the first to check for these kind of associations in Aotearoa New Zealand by analysing dental records alongside hospital records.
Co-researcher Dr Sandar Tin Tin, a senior research fellow in the University’s School of Population Health, says they found no evidence that being hospitalised for avoidable medical conditions went hand in hand with a greater likelihood of tooth disease, once other known risk factors were taken into account.
“Instead, we found that children who had been hospitalised for injuries at least once had a 17 percent higher chance of caries at school entry.”
The reasons for this link are not known, but may partly reflect living conditions. There is a practical implication though, the researchers say.
Dr Jelleyman: “When we see children with injuries and other illness, probably we should be checking their mouths and discussing good care of teeth with them and their whanau/families.”
The issue calls for action on many levels, he adds, including caring for the teeth of mothers. “Good oral health in mothers during pregnancy will set their babies up for good oral health, too.”
Researchers say the higher rates in Northland could reflect in part the lack of community water fluoridation in the region. More broadly, they point to a shortage of dentists, and minimal regulation on the availability and promotion of sugary foods and drinks in this country.
“Ideally, we want to make water the first drink choice at home, early childhood centres and school, but this kind of shift takes time,” says Dr Jelleyman. “Avoiding sweet snacks between meals and providing water instead of sugary drinks in places where children play and learn would be worthwhile steps in this direction.”
The study’s other authors were former masters student Yan Myo Aung and Professor Shanthi Ameratunga.
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