By Adekemi Adeniyan
The mouth is a barometer of social inequities — it reflects the injustices in our society. As George Cuvier, an 18th century naturalist said: “Show me your teeth, and I will tell you who you are”. To me, as a dentist, the mouth is like a microscope that reveals more than just tooth decay. It exposes us to a world where people lack access to water, health, quality education and live on low income.
So, when the FDI World Dental Federation unveils a “Be Proud of Your Mouth” campaign for World Oral Health Day (WOHD) 2021 celebrated on March 20, it needs to go beyond encouraging individuals to adopt good oral health routines such as brushing and flossing. It also needs to urge countries, leaders, policymakers and communities to tackle the social inequities that affect the mouth. It starts from addressing the social determinants of oral health.
Research by the World Health Organization shows that the social conditions in which people live have a great influence on their health and has linked increases in oral health diseases to social determinants such as education, income, food, race, and geographical location.
As a rural dentist working with vulnerable and underserved communities in Nigeria, I’ve had first-hand experience working with children at risk of oral health diseases, such as dental caries, Noma, and dental fluorosis. Most of them brush their teeth daily, but they lack access to clean water, nutritious food, and dental care facilities. Their teeth pay the price.
Studies show that 70% of the Nigerian population have a form of periodontal disease and untreated cavities. This is a whopping 140 million people, more than the entire population of the United Kingdom and France combined.
In the heavily populated northwest part of Nigeria, NOMA, a face disfiguring disease often caused by malnutrition, is one of the most prevalent oral health diseases. Between 2011 and 2017, The Nigerian Centre for Disease Control recorded over 37,646 cases. This is a public health crisis for a disease with 90% mortality rate.
Yet, only 15.5 % of the people living in rural parts of Nigeria have access to a dental facility. There is a lack of dental workforce which is an essential component of oral health access for vulnerable and underserved populations. In 2018, only about 850 out of the 4,358 registered dentists in Nigeria work in rural areas.
One patient, a young girl I worked with, had two of her teeth removed due to a defect caused by a vitamin deficiency. She comes from a village with no access to clean water and her family lives on less than US $1 per day. To complicate matters, the nearest dental facility was a two hour walk from where she lived. This is more than the experience of one girl; it is the experience of many living in communities saddled with social inequities.
What then is the way forward for a country like Nigeria? Clearly, there is a need for innovations, commitment of resources, and full engagement to improve oral health.
Since its inception, back in 1964, IPS has believed in the role of information as a precondition for lifting communities out of poverty and marginalization. This belief is reflected in our historic mission: “giving a voice to the voiceless”– acting as a communication channel that privileges the voices and the concerns of the poorest and creates a climate of understanding, accountability and participation around development, promoting a new international information order.
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