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Aotearoa New Zealand (NZ) has a long tradition of providing publicly funded oral health care for children and young people; however, substantial inequities in child oral health remain. Dental caries is the most prevalent non-communicable childhood disease in NZ, with Māori and Pasifika, those from low socio-economic backgrounds, and those without access to community water fluoridation most affected. Children and whānau with dental caries suffer consequences that seriously affect their day-to-day lives; it is critical not to underestimate the disease or fail to include it when considering children’s overall health. Dental caries is a complex disease, as is its prevention. This is particularly so in the current social context of child poverty, our food environment, the exploitation of children in advertising of non-healthy foods and drinks, and the immense challenges of meeting demand for oral health care in primary, secondary and tertiary care within current constraints. We review children’s oral health in NZ and make recommendations for change among oral health professionals, all health professionals, health services and society. Further research in oral health services will be an essential part of improving oral health, recognising that there is an urgent need for a shift towards much greater prevention of caries. Glossary of Māori terms:  Aotearoa: New Zealand; He Korowai Oranga: New Zealand Māori Health Strategy; Hui: meeting; Manaakitanga: hospitality, kindness, generosity and support; Mana Motuhake: self-determination; Māori: the indigenous people of Aotearoa New Zealand; Mātauranga Māori: Māori knowledge; Rangatahi: adolescents; Tamariki: children; Te Ao Māori: the Māori worldview; Te Kauae Parāoa: Division of Health Sciences Policy on Admissions; Te reo Māori: the indigenous Māori language; Te Tiriti o Waitangi: Māori language version of the Treaty of Waitangi; Tikanga: customs; Whānau: family; Whakamaua: Māori Health Action Plan 2020-2025; Whakawhanaungatanga: the process of establishing relationships and relating well to others

Oral health of children in Aotearoa New Zealand–time for change