Dire child dental statistics have been keeping some Auckland DHB members awake at night, as major change is signalled.
More than 2000 children, many in pain, were waiting up to eight months for specialist dental work in the city, while 60 percent were overdue for their regular appointments.
About 17,000 had not been seen at all in two years.
A DHB committee met to discuss the situation yesterday, with the Child Health manager Ruth Bijl admitting the statistics did not make for happy reading.
The city's dental care system was more than 20 years old and it was time for change, she said.
Board member Michael Quirke said the problems had literally kept him awake at night.
While those working in it were doing their best, more needed to be done to help the children affected, he said.
Chief executive Ailsa Claire said $650,000 had been put aside to clear the 2000 children waiting to see a specialist or for care under general anaesthetic by June.
But there was much more work to do to fix the wider problems that led to that, she said.
"We need to tackle the fact that we have a waiting list, that there are kids in pain, but we also need to look at the whole system," she told the meeting.
The large system covered the whole Auckland region, with Waitematā DHB overseeing routine dental care, and Auckland DHB looking after specialist care or dental operations.
"We can't keep going like this. A whole lot of things don't make sense," she said.
It might be better to work with smaller communities to tailor the care to what worked for them, Claire said.
Change looked likely to be slow.
The DHB should not "jump to the conclusion" about what the solution was, she said.
RNZ has been asking to interview someone from the DHB about the dental care situation for five weeks and has been repeatedly refused, including a request after the meeting.