Auckland's public dental service has failed to clear a backlog of nearly 2000 children waiting for urgent dental treatment, many of them in pain.
Auckland District Health Board (ADHB) vowed in November to fix the problem, with one board member saying it was keeping him awake at night.
It committed $650,000 to clear the waiting list of 2157 children by June but the latest figures, to be tabled at a meeting today, show there are 1999 children on the list.
Most of the children were waiting to see a specialist dentist for work that could not be done by a dental therapist, with about 630 waiting for treatment under a general anaesthetic.
Some of the children on the original list will have been treated - but more were being added all the time.
Dental Association president Katie Ayers said there were not enough theatres - or people to staff them - to keep up with children who needed care under general anaesthetic.
Dr Ayers, who is a paediatric dentist in Hamilton, said the problem was not limited to Auckland.
"It's heartbreaking. I'm seeing this every day in my practice, children that have been waiting at least six months on a waiting list with ongoing pain. The parents are absolutely beside themselves."
More needed to be done to sort the "ambulance at the bottom of the cliff" urgent care, but funding was also needed to prevent future problems, Dr Ayers said.
That included fluoridated water, more education about diet and tooth brushing, and making sure all children had access to proper toothpaste and brushes, she said.
In a paper, ADHB, which runs the specialist service for the city's three district health boards, said it had long-term projects underway.
They included a workforce development plan and a redesign of the way its entire system operates.
The Covid-19 pandemic had exacerbated an already existing problem, it said.
Dr Ayers said it would always have been a tough ask to clear the entire backlog and, in many ways, the dental service had done well to shorten the list, which had previously been growing.
More than 173,000 of Auckland children were still overdue for routine dental clinic check-up - 60 percent of the population.
Māori and Pacific children were over represented in both delayed groups, something the district health boards say they are working to fix.