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Dentists plead for fluoridation and pain relief service as infections increase

More people are suffering potentially life-threatening brain, lung and heart infections as a result of severe and untreated tooth decay, dentists say.

Christchurch Hospital special needs dentist Juliet Gray said she had received 33 referrals for patients hospitalised with lung, brain and heart infections caused by bacteria from decayed teeth in the last year. The year before she received 18 such referrals.

Gray provides dental care for adult patients with complex health needs, including severe mental illness and disability.

However, she was increasingly treating people on low incomes with “remote site infections” caused by dental disease and bacteria spreading to other parts of the body.

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A remote infection in the heart could be fatal, or require cardio-thoracic surgery, Gray said.

Lung, brain and spine infections required at least six weeks of intravenous antibiotics and often surgery as well.

Christchurch Hospital's emergency department sees about five people a day for toothache caused by dental disease.

Christchurch Hospital’s emergency department sees about five people a day for toothache caused by dental disease.

Christchurch Hospital emergency department (ED) staff were seeing about five people with dental problems – and sometimes up to 10 – every day, consultant emergency physician Dr Scott Pearson said.

Occasionally patients developed significant facial swelling related to a dental abscess that, when severe, could restrict their breathing.

Gray said as demand increased for complex patients there was less capacity to treat people who needed pain relief for toothache.

“Everybody thinks if you can’t afford to have dental treatment you can go to the hospital to get it done and that’s increasingly not true because we’re seeing more and more medically complex people.”

Often patients reported their own efforts to extract a painful tooth – most often with a screwdriver, Gray said.

“If someone’s in absolutely agonising pain and they try and dig their own tooth out they increase the risks of infection, they increase the risks from bleeding – they are literally self-harming.”

Some people who were denied treatment became aggressive, she said.

Some patients report their own efforts to extract a painful tooth – most often with a screwdriver.

John Bisset/Stuff

Some patients report their own efforts to extract a painful tooth – most often with a screwdriver.

“We see increased agitation and violent behaviour, and we quite often see people who are incredibly distressed when they attend ED.”

A relief of pain service, which operates on week days, was only available to people on a benefit.

Many employed people who sought support from the service became distressed when they were declined, Gray said.

Others overdosed on painkillers while trying to self-treat their tooth pain.

Gray and fellow dentists Abbey Corbet and Susan Gorrie were so concerned about the state of dental care they met with Ilam Gerry Brownlee in May last year to discuss legislation to fluoridate water supplies.

At the time Brownlee, who is now National’s deputy leader, was the party’s caucus chair.

The Fluoridation Amendment Bill, designed to give district health boards responsibility for fluoridating community water supplies, was introduced by the former National Government and rolled over with the Labour Government’s succession in 2017.

Stuff understands New Zealand First would not support it, believing the bill should be put to a referendum.

Brownlee said he had personally been against fluoridating Canterbury’s water supply before he met with Gray, Corbett and Gorrie.

Ilam MP and National Party deputy leader Gerry Brownlee says a presentation by dentists in his electorate convinced him of the effectiveness of fluoridation for preventing dental disease.

Stuff

Ilam MP and National Party deputy leader Gerry Brownlee says a presentation by dentists in his electorate convinced him of the effectiveness of fluoridation for preventing dental disease.

“I had a degree of hesitancy about it but their argument was just too compelling.”

Gray said she wanted to prevention and funding for wider access to dental treatment.

“Prevention and treatment go hand in hand – and so you can’t just treat a disease, fill the holes and then wait for more holes to come. It’s hopeless. The treatment won’t be successful unless there’s prevention.”

They asked Brownlee to take up the cause to get the bill passed.

Brownlee said Labour did not bring the bill to a weekly business committee attended by all parties, as was the convention, so there was no opportunity to support it.

A spokesman for Health Minister Chris Hipkins said Labour could not get the assurance it needed from National to be certain the bill would pass.

Gray said she felt ashamed about the lack of action on treating and preventing tooth decay.

“What are we saying to people? That they’re not valued, that they don’t matter.”

She wanted more funding for adult dental care.

“Even if it was just urgent dental care, a relief of pain service would be a great starting point.”

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