Oral health is a critical component of overall hygiene, yet it remains largely neglected, increasing the risk of not only oral diseases but also other non-communicable diseases (NCDs) such as cancer, diabetes, and cardiovascular diseases. To address this issue, experts call for school-based oral health programmes aimed at educating children on proper oral hygiene from an early age. This was highlighted on Saturday, February 15, during the 4th NCD Alliance Global Forum, in a satellite session led by National Director of SOS Children’s Villages in Rwanda Jean Bosco Kwizera themed “The Influence of Oral Diseases on Other NCDs and Public Health - Inspiration from Rwanda.” In line with this, SOS Children’s Village in Rwanda, in partnership with Dental Health Without Borders, established the ‘Healthy Teeth for Life project ', a school-based oral health programme that seeks to increase awareness among the general public about the importance of oral hygiene. According to Jean-Bosco Kwizera, National Director of SOS Children’s Village in Rwanda, the project began as a pilot programme in three districts before expanding to 15 districts across the country. “We started as a pilot in three districts, that's more than 10 years ago, and then we had a proof of concept, then we expanded to other districts. All districts of Kigali are now covered,” he noted. Kwizera emphasised that maintaining good oral health and managing risk factors can help prevent major NCDs such as cardiovascular diseases, chronic respiratory illnesses, cancer, and diabetes. According to Bo Danielsen, the Vice President of Dental Health Without Borders and Head of the University of Copenhagen said that nearly 3.5 billion people worldwide suffer from oral diseases, making them the most prevalent non-communicable diseases globally. He also highlights that more than 530 million children suffer from tooth decay in primary teeth and that oral cancer is among the ten most common cancers globally, with an estimated 300,000 to 700,000 new cases annually. Following the success of the programme, Kwizera highlighted that they engaged other stakeholders including Rwanda Biomedical Centre, the Ministry of Health, the Ministry of Education, and Rwanda Dental Association to ensure a nationwide scale-up. “We agreed to scale this programme across the country, across all the schools. So to do it we started with the ‘national strategy for oral health’ and then we went to the level of doing a scale-up plan to all the schools.” According to the Ministry of Health, The National Oral Health Strategic Plan (NOHSP 2019-2024) has been developed to provide a strategic approach to prevent, treat, control, and reduce the burden of oral diseases as the most common non-communicable diseases and one of the top ten causes of morbidity in Rwanda. A 2018 study by the University of Rwanda’s School of Dentistry found that 59 per cent of children do not brush their teeth before going to school due to a lack of both toothbrushes and toothpaste, exposing them to dental problems. Kwizera noted that a financial plan has been developed to implement the programme in all schools, but he stressed the need for public-private partnerships to ensure long-term success. “But we feel like a public-private partnership that involves parents will be very critical in ensuring that our young ones are trained and got awareness at an early age and the habit of treating their teeth and oral self-care. So, starting at an early age is very important,” he said. Currently, the programme is active in 15 districts and requires between Rwf 5 million to 6 million to implement in a single school. Given that Rwanda has approximately 38,000 public schools, Kwizera underscored that scaling the programme will require a substantial financial investment. “Our dream is to have this programme implemented in all the schools because we don't want to leave anyone behind. We have an estimation of 38,000 public schools across the country, so you can do the math. If you see a large scale, it really requires a huge amount of money, but we are seeing a stride if we use the public-private partnership,” he noted. According to Dr Irene Bagahirwa, Director of Injuries, Disabilities, Oral Health, and Ear/Hearing at RBC, many Rwandans do not prioritise dental checkups. “We have found that 57 per cent of Rwandans have never received dental care or visited a dentist. And 11 per cent have seen a dentist during the last 12 months,” she said, referring to a 2021 state survey. Among those who do seek dental care, 92 per cent of the interviewed population only visit the dentist when they are already experiencing pain, while just 1 per cent undergo routine dental checkups, she said. “This shows the neglected aspect of oral health. I don't think that is in Rwanda only. I think it is worldwide because if you compare it to the world situation, it's a world threat that we need to combat,” she added. She emphasised the expansion of school-based oral health programmes through collaborative efforts with SOS Children's Village Rwanda, the Ministry of Education, local government, and other stakeholders to scale up the initiative nationwide. She also noted that an ongoing analysis is being conducted to secure funding for the programme's successful implementation across the country. Bagahirwa stressed that poor oral health has far-reaching consequences, including reduced productivity and school absenteeism among children suffering from dental pain. Bagahirwa underscored that in response to these challenges, Rwanda is integrating oral health services into community healthcare programmes. Bagahirwa emphasised that while dental services are currently concentrated in urban areas and district hospitals, access remains a major challenge in rural health centres and communities. “The actual situation is that most of the services of oral health are concentrated in urban areas and especially from district hospitals. But when it comes to health centres and communities, this is still a challenge,” she noted To address this, RBC is training community health workers to incorporate oral health into existing healthcare models, which traditionally focused on conditions such as malaria, maternal and child health, HIV, and tuberculosis. She added that the high costs of dental services discourage many people from seeking care, which is why prevention is the most effective approach. “Implementing this programme is one thing, but there are some kits, oral hygiene kits, like toothpaste, toothbrushes, which need to be owned by the parents,” she added. “That's why we need ownership by the parents and the entire community.” She urged collaborative efforts from the government, private sector, and communities to ensure oral health becomes a national priority. “The development of the school-based oral health promotion programme is our newborn baby, It's a baby that we need to raise together,” she urged. “And we are counting on those children if we are aiming at having a community, future generation, with people who have good health and good oral health.”
