Dental concerns in children as world marks Oral Health Day

On March 20, Rwanda will join the rest of the world to mark Oral Health Day, under the theme ‘a lifelong smile.’ It will see national dental associations, dentists, dental students and the general public carry out several activities to promote oral health awareness and teach good oral hygiene. The latest World Health Organisation (WHO) statistics show that 60 – 90 percent of school children and nearly all adults have dental cavities. It further points out that severe gum disease affect 15 – 20 percent of middle-aged adults who are between 35 - 44 years old. Above all, it is estimated that about three in every 10 people aged 65 – 74 have no natural teeth. Yet oral disease in children and adults is higher among poor and disadvantaged groups. Local efforts The government has put some efforts to ensure easier access to oral health care services by rolling out health insurance coverage to over 75 percent of the population. The government’s commitment towards fostering oral health among the population was also witnessed when it convened an international oral health conference, the first of its kind, with the aim of sharing scientific knowledge, skills and experience, in March 2013. The two-day conference attracted oral health experts and other professionals from DR Congo, Belgium, Kenya, Tanzania and France, According to Dr Alphonsine Mukandoli, the head of Oral and Maxillofacial Surgery Services at the University Teaching Hospital of Kigali (CHUK) a five-year National Strategic Plan that will see every health centre have a dental therapist and a surgeon is in the offing. Dr Mukandoli, vice-chairperson of the Rwanda Dental Surgeons Association, said that though there was no national survey on dental ailments, there are indications that it is an area that needs attention. “According to a study carried out in 2004 on children between five and 12 years of age in seven primary schools across the country, it was found that dental infection was common. At CHUK, for instance, we handle at least 50 cases daily, yet we are only three dental surgeons, and three dental therapists,” she said. Mukandoli says that the country has 18 qualified dental surgeons while 15 are undergoing training. “Only four public hospitals countrywide can handle complex dental ailments, so there is need to increase capacity countrywide,” she said. Mukandoli said the biggest challenge was patients who delay to seek medical care. “The good thing is that Mutuelle de Sante (a community based health insurance scheme) covers dental health. This, therefore, should be motivation for people to seek dental care services,” she said. Dr Brian Swann, an oral physician from Harvard School of Dental Medicine in Boston but on a working visit here, said dental cavities among children are the most prevalent. “Most Rwandans have healthy teeth, perhaps because they were not exposed to a lot of sugary foods during their childhood. However, there is a challenge of failure to access adequate health care by those with dental infections,” Swann said. “There are less than 30 dental surgeons in the country, serving 11 million people yet in the US, one dental provider serves just 2,000 people,” he added. “While dental cavities are commonest among young people, gum inflammation was found to be a common oral ailment for adults,” said Frank Rwema, a dentist working with the Rwanda Military Hospital. Stephen Kalisa, a fifth year student of dental therapy at the University of Rwanda’s College of Medicine and Health Sciences, said there was need to increase funding for dental health. “Starting a private clinic is difficult since equipment is expensive. One, for instance, requires at least Rwf2m just to acquire a dental chair unit,” he said.

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Dental concerns in children as world marks Oral Health Day