Health & beauty

Dental care for children

Updated 05 Jan 2009
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Introduction

Healthy teeth are important at all ages. We explain the care options for babies through to teenagers.

Children are entitled to receive free dental care from birth until the age of 18. We outline their rights to receive dental care, explain how to keep kids' teeth clean and tell you where to go for more help.

Children's dental services

Pre-school

Toddler

You should enrol your child with a dental therapist early, before their first birthday.

Call the dental clinic at your local school or Plunket, or ask your family doctor to find out how and when to enrol your child. Your pre-schooler should be seen at least once a year, more often if there are serious problems.

Primary school

When your child starts primary or intermediate school, the dental therapist attached to the school usually organises the enrolment.

Traditionally, dental therapists worked in clinics on school grounds, but now less than half have an on-site dental clinic. Children from the remaining schools attend by appointment at the on-site clinics at other schools and some DHBs use mobile clinics.

If problems are severe - for example if root canal work is required - the dental therapist may refer your child to a dentist. Treatment is free if the dentist is providing care under the Combined Dental Agreement; if not, you'll have to pay for the treatment. However, the Combined Dental Agreement doesn't include orthodontic work.

Your child can also receive free emergency treatment if the school dental clinic is shut, but you'll need to check that the dentist provides care under the scheme.

Teenagers

Teenagers

You can get free dental care for your teenage children if your dentist is signed up to the Combined Dental Agreement.

This provides free examinations, extractions and fillings (but you may have to pay for large tooth-coloured fillings in the back teeth). Preventive services, such as fissure sealant and fluoride treatment, are also provided free.

To enrol your teenager for free dental care you can pick up a form from a dental therapist, a dentist or your local district health board (DHB). Your DHB will have a list of dentists enrolled in the benefit schemes.

Tooth decay

This child's pain and swollen face are the result of untreated tooth decay.

Who is at risk of getting dental decay? Good dental health is partly inherited and partly the result of lifestyle.

Some children are born with stronger teeth that are less prone to decay. But diet, regular brushing with fluoride toothpaste, and drinking fluoridated water are major factors in determining whether children have good teeth.

Fluoride

Regardless of ethnicity or wealth, living in areas where the water is fluoridated decreases your risk of dental decay throughout your life. The New Zealand Dental Association actively promotes the addition of fluoride to water supplies as a proven method of preventing cavities.

Despite this, fluoride remains controversial because of claims that it can cause cancer and osteoporosis, particularly if it's in the water supply. The Ministry of Health rejects these claims. It says that despite extensive international research there is no evidence of a link between fluoride in the water supply (at the levels set in New Zealand) and bone or other cancer, or any increased risk of osteoporosis.

The Ministry says putting fluoride in drinking water is the most effective and efficient way to prevent dental decay.

Keeping teeth healthy

Babies

Dental care should begin as soon as the baby teeth appear. Many parents think decay in the early years isn't a problem because baby teeth fall out and are replaced by permanent teeth.

But research has clearly shown that children who develop early cavities go on to have higher rates of decay in permanent teeth.

Babies

When first teeth come through, wipe them gently with a damp clean cloth. At about age one you can use a small soft toothbrush. Start with one of the low-fluoride toothpastes specially formulated for small children and use just a tiny smear.

Children

Make sure kids brush at least twice a day - before bed and in the morning. Bedtime is the most important time to brush. A smear of toothpaste is all that is required. Have them spit out the toothpaste but not rinse with water. Leave the rest of the toothpaste so the fluoride can keep working to protect the teeth.

Diet advice

  • Restrict sweet drinks and foods. Fruit juice and fizzy drinks contain a lot of sugar and are high in acidity, which increases the susceptibility of the enamel to decay. Sipping a bottle of juice or slowly working through a handful of lollies is worse than a short sweet feast, as the teeth get well and truly coated in sugar.
  • Night-time snacks are particularly damaging because the saliva flow, which helps clean the teeth, switches off at night. That's why night-time brushing is so important.
  • Be wary of so-called "healthy" snacks such as muesli bars, dried fruit and even some crackers. The sugar content can be surprisingly high.
  • Food or snacks served with dairy products are usually less damaging than those without. Milk, even flavoured milk, is less damaging than cordial or juices. Plain water is best.
  • Sugar-free chewing gums are good, once children are old enough, as they stimulate saliva flow, which helps to clean teeth.
Emergencies

  • If your child breaks a tooth or gets toothache at the weekend or at any other time you can't contact their usual dental service, look for a dentist who is contracted to provide free care. Otherwise you may have to pay.
  • If your child has severely decayed teeth, they may be referred to a public hospital dental unit for treatment or extraction under general anaesthetic.
  • You may have to wait up to several months for treatment. You may also have to pay a part-charge. You can opt for private treatment by a dentist, or possibly an oral surgeon and anaesthetist, but you will have to pay normal private rates.

More information


Report by Bev Frederikson.