By Enyeribe Ejiogu
Don’t you feel warm when somebody displays a fine set of teeth in a smile? You can then imagine how unpleasant a sight it would be if the person’s mouth had no teeth or bad teeth. Primarily to avoid this, medical director of Divine Dental Home, Isolo, Lagos, Dr. Olukayode Segun Adeyanju, a dentist with close to 30 years of practice sheds light on what you need to do. Please read on…and enlighten yourself.
Would you say that Nigerians recognize the need to go to see dentists on a regular basis?
No. From my close to three decades of practice as a dentist, I have found that awareness about dental care is very, very low in the country. The low awareness is a function of culture. The truth is that we are just trying to graduate from the traditional to the Western practice of medical and dental care. What people still adopt is the traditional way or do-it-yourself (the well-known doctor-at-home practice).
People still don’t value professionalism when it comes to seeking healthcare. Dental care is a highly specialized care and it doesn’t come to the fore, when people begin to consider healthcare needs and options.
Could this be attributed to cost?
Yeah that is possible. Because it is a specialist care, it is expensive. It is more expensive to treat toothache than to treat malaria. You can get to the average hospital and treat malaria at an affordable cost, but this is not so with dental care, because it is a specialized practice. Traditionally, people hold this belief that it is expensive and prohibitive, so they never give going to see a dentist a thought.
Secondly, most people go to a dentist when the situation is bad, when they are in pain. And for that reason, people have come to associate dental care with pain, and thereby rarely desire to go to a dentist. That is a very bad perception that people need to overcome and drop. Dental procedures are also not too friendly as our instruments and equipment scare people off. Drilling, chiseling and all that, strike fear in people. So in essence, cost, pain and the dental care environment all make people uncomfortable about dental care.
But these days, dental procedures are absolutely painless because modern equipment have changed the face of dental care. Now there are different anaesthesia that are involved in dental care practice.
What are the things that people do wrong when it comes to dental care?
Number one is the choice of toothbrush. Most people feel, and wrongly too, that the harder the brush, the better. That is a big fallacy. People brush their teeth in the wrong way and with the wrong brush.
Two, the way or manner most people brush, involves the exertion of energy. What is more important is deploying the right brushing skill than energy. In fact people tend to ‘punish’ their teeth, as it were, rather cleaning them with the brush.
Three, people overuse toothpaste. What you need is just a pea-size amount of toothpaste. It is used moderately, just a pea-size, so that it can be used effectively and adequately. But you find that people put so much of the toothpaste on the bristles, covering the bristles from one end to the other.
Four, when people have toothache, they do bizarre things to their teeth. People have told me that somebody advised them to drop a little acid on the aching tooth to burn it. Some people would tell you that they went to see one mallam in Idi Araba area of Lagos. Simply put, people do all sorts of terrible things to their teeth. All these often lead to complications. When the complications begin to manifest, that’s when they come to seek solutions to problems, which would not have arisen in the first place if they had bothered to see a dentist beforehand.
What are the implications of not doing the right things?
The tooth is the strongest tissue in the body. It is stronger than bone; that is why the teeth can crush the bone. It has the enamel layer, which is the outermost and strongest part of the tooth. The tooth has nerves and blood vessels underneath the dentine. But when the enamel is over-abused, of course, it becomes damaged as it is worn down. At some point, the nerves and blood vessels underneath become exposed and that’s when you begin to feel excruciating pain. After the enamel is the dentine, which is softer than the enamel. When the dentine becomes compromised, it gives way and the nerves are then exposed.
What causes dental caries?
Basically, sweet things like cake, chocolate, soft drinks and any food that is naturally sweet and sticky. And particularly if you don’t brush at night before going to bed and after eating various things during the day.
We are having children that are exposed to a lot of sweet things from a very early life.
What is your advice to parents?
We are going to have a generation of Nigerians, when the dental care industry will experience a big boost. There will be more dental care patients and this will create a need for dental care specialists, but we don’t have enough dentists. We are not producing enough dentists. So in some years to come, all these children that eating a lot of sweet things will become dental patients. That is why you should expose children from early life to dental care. That way any potential problem can be identified early and treated before it becomes a major problem.
Parents should encourage their children to develop a culture of seeing a dentist, by taking them to visit the dentist, even if it is just to interact and chat. The dentist will check their teeth, even though there may be no problem at all. That is one way of making children feel free and comfortable around dentists. You must have seen that some parents put their children’s teeth in braces to align the teeth and give the dentition an appealing look. Such treatment and the process help children develop a culture of dental care. Proper brushing ‘seminars’ and other dental care awareness programnmes can be organized for schools. All these go a long way to neutralize the phobia of dental care. In essence, parents should not wait until problems develop before they take their children to see dentists. If a child begins to see a dentist as he/she goes through the milestone ages, namely, five, seven, 10, 12, 15, 18, then the chances of developing major dental problems later in life will be reduced as any manifestations can be picked up early and resolved before they become dental problems. With that practice of seeing dentists ingrained in children, they lose the phobia, such that they can walk into a dental clinic and get appropriate care without fear, because they already feel at home and friendly with the dentist. In situations where this practice was not started early, the child can still start at 10 years.
In what other ways can people care for their teeth?
You need to use the right toothpaste, which must contain fluoride and perhaps bicarbonate. The bicarbonate creates an alkaline environment in the mouth and makes the bacteria less potent. Again, we also recommend any toothpaste that has herbal component. You should also adopt a practice of using dental floss to clean between the teeth after brushing. The reason is the bristles of the brush cannot get between the teeth. Again, after eating a meal, use both a toothpick and dental floss. You should also have a tongue scraper and use it every morning after brushing, to remove bacteria from the surface of the tongue. The bed of the tongue is like a carpet of bacteria, because bacteria accumulate on the surface of the tongue to a high degree.
Then at the policy level of government, scaling and polishing should be offered to Nigerians as a component of the primary healthcare programme of the country. Unfortunately, dental care is not covered under the primary healthcare part of the Nigeria Health Insurance Scheme.
Statistics show that gum disease is one of the most prevalent diseases affecting mankind around the world. The problem is also prevalent in Nigeria. The government needs to revisit this and include dental care under primary health care.
In developed countries, dental care is offered as primary health care. Nigeria can do no less.
The current thinking whereby dental care is seen as secondary care is very wrong. The belief is that until there is a problem then there is no problem. We must recognize that a stitch in time saves nine. Doing regular check on the teeth should necessarily be included in primary healthcare. You shouldn’t go to see a dentist only when there is pain. Unfortunately, in Nigeria, that is only when people go to see a dentist. This needs to change.