“I have never been to the dentist.” Precious, Student.
“I don’t go to the dentist. I won’t deceive you.” Simon, Entrepreneur.
“I saw a dentist 10 years ago. I had a tooth that was about to fall out so, I had no choice.” Michael, Youth Corper.
Beyond regular teeth brushing, a good number of Nigerians hardly prioritise oral health, except in severe conditions such as pain or discomfort. Even then, some prefer to numb the pain with painkillers and would only visit the dentist as a last resort. The Global Burden of Disease Study 2019 estimated that oral diseases affect close to 3.5 billion people worldwide, with caries of permanent teeth being the most common condition. As a result of the high prevalence rate, oral health conditions were made a priority on the non-communicable disease list, especially as they share common risk factors with other NCDs such as diabetes, cardiovascular diseases and cancer.
There isn’t a great deal of data on oral health in Nigeria however, available data reveals that dental caries (tooth decay) affects about 6–23% of Nigerians with about 90% of these cases going untreated; while gum diseases affect 15–58% of the population, aged 15 years and above. This information was taken from the national oral health policy developed in 2012 and might therefore, not be representative of current conditions. According to Dr Eze Chinemeogo, a dental resident at the National Hospital, Abuja, dental caries is the most common oral health condition in Nigeria.
Making oral health a priority
At present, Nigeria has no oral health policy as the existing one expired in 2015. There is therefore an urgent need to develop a new oral health policy, one which is tailored to reflect updated research on the prevalence and burden of oral health problems in Nigeria. In 2019, the Federal Ministry of Health announced that a new policy — the 2020 National Oral Health Policy — had been developed. The new policy was said to address the current burden of oral diseases in the country and was to be released in June 2020.
In 2021, the World Health Assembly (WHA) approved a Resolution on oral health. The Resolution highlighted the importance of oral health and interventions with a life course approach from the mother’s gestation and the birth of the children, and in addressing shared risk factors. It then went on to recommend promoting oral health within the family, schools and workplaces, and included timely, comprehensive and inclusive care within the primary healthcare system. It affirms that oral health should be firmly embedded within the non-communicable disease agenda and that oral healthcare interventions should be included in universal health coverage programs.
What is good oral health?
Sunday, March 20 was World Oral Health Day, a day observed annually to empower people with the knowledge, tools and confidence to secure good oral health. The date serves as a reminder of what good oral health is: seniors must have a total of 20 natural teeth at the end of their life to be considered healthy; children should possess 20 baby teeth and, healthy adults must have a total of 32 teeth and 0 dental cavities. This is translated as 3/20 and therefore, March 20.
In 2021, the FDI World Dental Federation launched a 3-year campaign theme: Be Proud of Your Mouth, and the 2022 focus highlights how a healthy mouth is important for overall well-being and happiness.
Oral health and pregnancy
Oral health is essential to general health and wellbeing across a person’s lifespan therefore, Oral Health Day is as good a day as any to discuss the important and often neglected component of oral healthcare that a woman should receive during pregnancy and after childbirth. Due to increased hormonal levels, during pregnancy, women may be more susceptible to oral lesions such as caries and gingivitis. Women who have a lot of cavity-causing bacteria during pregnancy and after delivery could transmit these bacteria to their babies through the mouth. According to the Centre for Disease Control (CDC), early contact with these bacteria and other sugars, from frequent snacking or taking a bottle to bed, can lead to early childhood cavities and the need for extensive dental care at a young age.
Aisha, who is a nurse with maternal and child health experience, said oral health service delivery is not something she is familiar with. “I have worked with pregnant women during the ante natal period and the aftercare when they put to bed and taken care of their babies. Oral health screening or counselling is not something we do”.
Ummu, a mother of two said, she never had any form of oral screening during both pregnancies, neither was she taught oral hygiene measures for her babies. “I had toothache while I was pregnant with my first child, but nobody mentioned anything about my oral health during my routine checkup, luckily my husband is a doctor and when I told him, he took me to the dentist. Nobody told me the proper way of cleaning my children’s teeth or how regularly I should be taking them to the dentist, I had to learn myself”.
A mother’s oral health status is a strong indicator of her child’s oral health status. So, if a parent practices good oral health seeking behaviour and makes it a habit of visiting the dentist for routine checks, they will most certainly take their children along with them.
Creating an oral health-friendly environment
Like every other condition that affects a person’s total wellbeing, poor oral health, apart from pain and discomfort, leads to absenteeism at school and the workplace and ultimately productivity losses. To improve its citizen’s oral health, government should use the WHA Resolution to create an oral health-friendly environment, ensure that the country’s oral health care system is of assured quality and raise public awareness of the needs and benefits of maintaining a healthy mouth. Every Nigerian deserves to have oral care that is affordable, accessible and of good quality.
But beyond the government, every individual needs to prioritise and take ownership of their oral health. To attain optimum oral health, here are some of the things you can do:
- Brush your teeth for 2 minutes, 2 times a day with fluoridated toothpaste and don’t forget to include children and the elderly in the process
- Get a new toothbrush every 3 months
- Visit your dentist every 6 months for routine checks and cleaning
- Swap refined sugars for healthier options
Have you ever been to a dentist? If so, when was your last visit? If you have children, do you take them to the dentist? Share your experience, we would love to hear from you.