Monday, 21 April 2014

Why is oral health a social issue and how do our children fare?

21 April 2014
Why is oral health a social issue and how do our children fare?


“Oral health is an important global public health issue, statistics show disorders and diseases of the teeth and mouth, remain the most common of any of the long-term conditions.  However, these are largely preventable conditions impacting highly on individuals and society and expensive to treat when left.” (Ministry of Health, 2010. p.6) 
Statistics
The surveys reported in the 2009 key findings, were the first comprehensive nationwide surveys in 21 years.  Highlighting the patterns and levels of oral diseases and health since those recorded in 1976 and 1988 (Ministry of Health, 2010).  


Having established historically the two major threats to natural teeth are dental caries and periodontal disease, I now ask why is oral health an issue in New Zealand when the Ministry of Health provides free dental facilities for all children from one year until their eighteenth birthday? (Ministry of Health, 2010).  
Government through its oral health policy  Good Oral Health for All, for Life has invested $116 million in capital expenditure and a further$36 million per annum for operating funds.  To re‑orient child and adolescent oral health services from 2006 to 2013 to promote, improve, maintain and restore good oral health, being proactive in addressing the needs of those at greatest risk of poor oral health (Ministry of Health, 2010).
According to the 2012/13 updated oral health survey, about 30,000 children aged between 1 to 14 years had teeth extracted in the last 12 months due to decay, abscess, infection or gum disease.  These figures calculated from a sample of 4,000 interviewed and examined children, equating to an estimated 675,000 children nationwide in this category.  That is 3.6% of all children in that age group.  Children in the 5 to 9 age bracket are highlighted as most vulnerable to have tooth extractions (Ministry of Health, 2013).  
Approximately 40% of children age 2 to 11 years and 5 to 17 year olds were detected as having untreated coronal decay on 1 or more primary or permanent teeth (Ministry of Health, 2013) .
 16% of children aged 7 to17 years had, had trauma to one or more of their upper six front secondary teeth (Ministry of Health, 2013)
These statistics indicate to me that not enough pre-schoolers are being enrolled, taking advantage of the free health care.  Although the statistics show that 81% of the 1 to 14 age group did receive a dental care check-up, it is the remaining 19% who are potentially at risk of serious ill health and wellbeing.
The New Zealand Herald in 2011 headlines “NZ children’s dental health still among the worst” stating that New Zealand rates are worse than the UK, US and Australia.  These claims are backed up by the key findings of the 2009 and 2012/13 oral health survey particularly when statistics are categorised into ethnic groups, M ori, Pacific and others (Ministry of Health, 2010; Ministry of Health, 2013).
During my research I found the youtube clip below it is very lengthy, (1hr 18 min) however very informative.  Kathryn Fuge from Community Dental Services, Hutt Valley DHB presents a section on “The Oral Health of New Zealand Children” that really took my interest.  Her focus is on early childhood oral health (it is 17 min) but a must view, the scary thing is she is only presenting on her Hutt Valley region although I would imagine representative of most other regions in New Zealand.

Biting into the Oral Health of New Zealand Children




(unfortunately this youtube is too large to import as a video insert so please click on link to view)
   
So now that you have viewed this YouTube clip are you as concerned as I am, to learn that Early Childhood Caries is the most common chronic infectious disease of childhood.  This is having devastating effects on children’s development loosing these primary teeth too soon means they will be unable to carry out normal oral related functions as others their age until their secondary teeth fill the gaps some 10+ years later.


Children’s rights
Under the New Zealand Human Rights Act  children’s rights are said to come under three common categories: provision rights, protection rights and participation rights (Lansdown, 1994). http://www.hrc.co.nz/report/chapters/chapter04/children01.html
Children are vulnerable and dependent on others (parents, care givers, teachers and the State) to honour and exercise their rights to be able to; develop to the fullest, be protected from harmful influences and be able to participate fully in family, cultural and social life.  In a society, that meets the basic rights of its children (to education, health, an adequate standard of living)
Section 8 of the New Zealand Bill of rights Act (1990) gives children the “Right not to be deprived of life.”
New Zealand is currently considering new legislation (the Care of Children Bill) that will amend the Guardianship Act and elements of other legislation. http://www.hrc.co.nz/report/chapters/chapter04/children01.html#english
“Children live, learn and grow, not in isolation, but as part of families, whanau and communities” http://www.hrc.co.nz/report/chapters/chapter04/children01.html        



References
Human Rights in New Zealand Today Ngā Tika Tangata O Te Motu:  Chapter 4: The rights of children and young people Ngā tika o ngā tamariki, rangatahi.  Retrieved from http://www.hrc.co.nz/report/chapters/chapter04/children01.html#english
Lansdown, G. (1994). Children's rights. In B. Mayall (ed.), Children's childhood: Observed and experienced (pp. 33-34). London: The Falmer Press.
Ministry of Health, (2010). Our oral health: Key findings of the 2009 New Zealand oral health survey. Wellington: Ministry of Health
Ministry of Health, (2013). New Zealand health survey: Annual update of key findings 2012/13. Wellington: Ministry of Health
New Zealand Bill of Rights Act (1990) Retrieved from http://www.legislation.govt.nz/act/public/1990/0109/latest/DLM225505.html
The New Zealand Herald  (2011) NZ children’s dental health still among the worst. Retrieved from http://www.nzherald.co.nz/nz/news/article.cfm?c_id=1&objectid=10710408
University of Otago, Wellington, (2013).  Biting into the oral health of New Zealand children. Retrieved from https://www.youtube.com/watch?v=4zPdmuIzglU

 

 



 

 

    

 

 





 

2 comments:

  1. I think this is a great social issue that you have chosen to explore. My mother was a Dental Nurse so I grew up in a family where looking after our teeth was incredibly important. As a result we all had great teeth with barely any fillings. Sadly as we got older and a trip to the Dentist became too costly our teeth no longer fared as well. Now as a mother of two children, I am constantly reminded, thanks to my mum, of the importance of good oral hygiene. However, sometimes that is not enough. Nearly all the food we eat contains sugar, which I believe has contributed hugely to poor oral hygiene in this country.
    My son has good teeth (no fillings yet at age 11) and my daughter (13) has a couple and wears braces. What concerns me is the lack of visits to the Dental Clinic. As I child I can remember going more than once or twice a year to see the Dental Nurse. Now its only once a year if everything is fine. Is it like this in all areas or are children in low socio-economic areas seen more often?

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  2. This is a very interesting social issue that you have chosen to explore Mandy. I was very shocked to read the statistics you have listed around the large number of New Zealand children who are suffering from severe dental caries. I was also alarmed to read that New Zealand children’s dental health is considered to be one of the worst. Reading these cold hard facts leaves me to question the intakes of sugary foods and drinks that our children are consuming within our nation and how it’s taking its toll on their dental health. Lastly this enables me to think about our role as early childhood teacher’s and how we promote children’s dental health within our setting through raising parent’s awareness around the impact dental carries’ have on children’s quality of life and how we support children to recognise the importance of looking after their teeth. I look forward to reading your further posts and finding out more about this issue that is affecting the young children within our nation.

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