Tuesday, March 9, 2021

 













Entry in cd magazine

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.