The number of children who've missed their free routine dental check-ups in Auckland has hit a record high and health authorities warn it'll take over a year to catch up.
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The Auckland Regional Dental Service said more than 186,000 primary and intermediate school children are overdue a visit to the dentist - that's two-thirds of all those enrolled.
Parents who can afford it are being encouraged to pay for their kids to see a private dentist.
Paediatric dentist Dr Katie Ayers is worried children's tooth decay is going untreated.
"We know that a significant number of those children will have oral health needs and some of them will have very significant levels of need and until they're seen we don't know what treatment they require and can't schedule that treatment."
Dr Ayers is the New Zealand Dental Association's spokesperson for access to care. She said it was important to pick up problems before they became severe.
But pandemic lockdown restrictions have meant thousands of children have missed out on preventive care, such as x-rays, fissure sealants and fluoride varnishes.
"It might mean more teeth needing to be extracted because the decay has got so bad that the teeth can no longer be restored other ways. It may also mean more children need treatment under general anaesthesia because their needs are so great they can no longer manage it in the dental chair."
Has your child missed their dental check-up? Get in touch with reporter Amy Williams at amy.williams@rnz.co.nz.
The Auckland Regional Dental Service tracks tooth extractions but director Tim Wood said it's too early to tell if there's been an increase.
The service saw 86,000 children last year, that's less than half before the pandemic.
Now the number of children who have missed their routine visit sits at 66 percent of those enrolled, the highest it's been and way above the national target which is less than 10 percent.
Wood said it would take months to catch up.
"On top of the normal work we've got to do in terms of the kids that still need to be seen on on top of those that are in arrears, it's well over a year's work for us to catch up."
He said urgent cases were being prioritised.
"If any child is experiencing any dental discomfort they would get right to the top of the priority list and seen straight away, otherwise we're trying to schedule children in as quickly as we can."
But the backlog is building, at a time when the public dental service is grappling with staff shortages.
He said the mobile dental clinics would focus on seeing children in lower socio-economic areas.
"We're trying to expand our hours and therefore the number of appointments we've got. If people can afford to go and see a dentist privately then they're by all means welcome to do that."
Dr Ayers is also encouraging parents to consider private treatment - something she's aware not all families can afford.
"It's quite a big step for New Zealand families to then consider that they need to fund private dental care for their children but it might be part of the fix of the system that those that can afford it do need to go privately while those who are most in need are prioritised within the free system."
Paediatric dentist Dr Katie Bach works for a private dental clinic and has noticed higher rates of tooth decay since lockdowns.
"We have definitely seen increased demand for our service at present and I think maybe parents are looking into possible other options that are out there in terms of taking their kids to see dentists."
She said parents can check their kids' teeth at home.
"If your child has any pain, any sensitivity, you thought they were avoiding eating on any teeth or a difference in their eating patterns, if you see any brown spots or any marks on the teeth and check the gums do they look healthy or bleeding?"
Bach said children with these symptoms should be seen urgently.