Raising
standard of oral health in children and helping humanity in the process.
I all
started back in 1990 when in Romania there were appalling newspaper reports
about the abandoned children after the fall of the dictator there. I went off
armed with a suitcase of drugs to a village called Tatari north of Bucharest
and set about restoring an orphanage of 400 totally abandoned children which
expanded into more visits, some dental orientated ones, a container of new beds
and other support taken via my lorries and is now a leading model self
sufficient with equipment for a cottage industry making wooden toys to sell in
Romania.
I am sure we
have all witnessed the serious decay rates in some young children who have been
allowed free access to some form of sugar solution whether this be sweetened
feeds as a baby or the sugar comforter placed in the mouth of the infant to
subdue a tendency to cry .
The result
being total erosion of the primary teeth and subsequent early loss and further on a serious rate of decay
of the first molars.
To address
this issue and to improve the dmf rates in the world’s children is a real
challenge when the diet pattern is high
frequency of sugar consumption.
To this end
I determined to visit such communities and try and introduce some simple oral
health messages.. cut the frequency of consumption of sugary drinks and foods
such as biscuits and impress on the children the importance of applying a
fluoride containing toothpaste on cleaning the tooth surfaces of their mouth at
the most critical moment.. using a very small measure of toothpaste and
refraining from actually rinsing out their mouth to leave their teeth
acceptably clean before they went to sleep at night.
Research
shows that getting a group of children to adopt this routine can reduce the
rates of dental decay by a good 30% without the active intervention of applying
dentistry. Decay will arrest giving the mouth the chance to slow down the
damage .
How to get
over this message? Gathering an assembly of children and demonstrating a bass
technique of tooth cleaning, coupled with a spiel on diet restraint.. followed
by a very quick dental exam counting the dmf rates and showing the worst cases
to their teachers and so recruit them into the repeat game for the message to
change the diet and tooth cleaning routine for the children.
There is a
marked difference in some countries. Countries such as Zimbabwe where there is
a high rate of breast feeding of infants showed a marked lower rate of dmf
incidence, while a country such as Pakistan where drinks such as coco cola and
lemonade as a drink are quite common and indulgent grandparents who care for
the young children showed a markedly higher rate of dental decay and incidence
of dental decay. Other countries such as Nepal are somewhere in between..
I managed to
do these IOH sessions at a rate of about 5 schools and colleges a day often with an audience numbering over a
thousand at a time.
Purchasing
toothbrushes and toothpaste at a rate of around 30p complete from the
wholesalers , it was possible to target those
with a high decay rate .
This was
repeated in the same schools about twice a year for a two or three years and
the dmf rates certainly improved markedly. Hopefully their school teachers
carry on the message and incorporate the message in their lessons. Obviously a
step up is supervised tooth cleaning sessions as part of the daily routine for
the children but time was limited to set this up.
one area
that struck me as one hospital was geared to offer cleft lip and palate surgery
repair using visiting plastic surgeons from many parts of the world,, and so
funded by ‘smile train’. Here the operation is charged up at around $250 a case
but did not include any pre operation assessment of oral health or any IOH to
either the patient or the family. This seemed to be a total disaster as we know
that a high standard of oral care is essential contribution to the longer term
success of the surgery and the final cosmetic result.
I raised
this issue with the international medical advisory committee of ‘smile train’ which is based in USA and
has reps in many countries where ‘smile train’ operate.
I managed to
get a direct telephone dialogue with the management of ‘smile train’ with also
the support from a number of very august bodies here in UK such as the royal
college of surgeons with the support of Professor Bedi here in UK who was very
supportive and who carries great weight in his international reputation. Some
progress was made and acknowledgement on the importance of assessing oral
health as part of the care of cleft lip and palate patients.
The most
important message is that dental disease is totally preventable and just needs
the simple message to be given and
reinforced as part of the child’s education on how to look after themselves.. a
high sugar diet is a factor in the early development of type 2 diabetes and coronary
heart disease.
The history
of this mission started in 1998 with a visit to an abandoned orphanage in
Tatari in Romania. This was a dreadful site with 400 cot bound children hardly
fed with little care who needed some serious aid required. Over a series of
visits we restored their conditions, installed music and TV to stimulate,
looked after their oral health and introduced a wooden toy factory to provide
and income as these were sold in Country.
Then the war
in the Balkans stimulated a aid convoy phase with over 15 convoys to Serbia and
repulica Srpska , moving over 400 tons of aid via my lorries, having to obtain
an HGV licence which was unusual as a dentist, especially when parking a 40ton
lorry outside the practice ! I learnt how to obtain UN certification and the
special medical permits from New York to allow passage across into Serbia with
medicines and supplies to an isolated community, again taking dental equipment
to try and deal with the zugboljia ( toothache) requests in the refugee camps visited.
After the
Balkans came the issues of the conflict between parts of Kashmir. I had a friend who has a house in Kashmir in
the Bhimber district of Kashmir and so made a number of visits there installing
a dental surgery and treating patients
there in another hospital in Gurjarat again going round many local schools and military establishments delivering an IOH
message and distributing toothpaste and brushes ( which only cost 30p for brush
and paste complete.
I made a number of visits to many schools in
Kashmir where either they had no toilets, water
or had suffered earthquake damage.
These were
delivered and now the schools with earthquake damage have been rebuilt.
I also helped and visited a school site in Harare Zimbabwe where we
have managed to build and establish a new primary school for over 80 children
and have a support network here in UK as the school is expanding and caters for
children who cannot afford to attend school. While in Zimbabwe we distributed via a lorry large amounts of food parcels to
give to those villages that were exceptionally poor.
I always
made the point that I come here as a Christian to a Muslim Country as an act of
helping humanity.. no bias toward any one group of religion.
The future
beckons to return to Kashmir to build another new school and return to Zimbabwe
to see that new school expand, install more water wells and new toilets for the
children and of course pursue the IOH lectures to try and reduce the caries
level and suffering of all those child dental patients.. just where opportunity
and God directs my efforts.
