Juliet Jacob Ohenje writes that the mouth is a mirror the reflects the overall status of the entire body as oral diseases have a significant impact on an individuals’ health and well-being.
72-year-old Jacob Ochefu has had decades-long battle with teeth problems, beginning with a teenage incident where a friend’s punch cost him a tooth.
He told African Health Report (AHR) in Abuja: “I started experiencing toothaches right from my teenage age. It all started from when i and my friends were playing boxing and one of them mistakenly punched me on my front teeth and one fell off with a lot of blood.
“During my service in the Army, I was always feeling toothache but because of the nature of my job, I didn’t really give my tooth all the attention and dental care it needed,” he said.
Rather than seek proper care by dentists, he said he opted for “local herbal medicine to manage the pain.” And the consequences have been fatal. “After my retirement from the army, my upper front tooth all fell off that I had to replace it with a crown tooth and I go to visit the dentist on every appointment.”
For 15-year-old Nkechinyere Prince, her tooth pain story has been equally harrowing. She narrated: “Two months ago, I started noticing that each time I drank anything cold, I started to feel shock in my tooth. I told my dad about it and he promptly took me to see a dentist.”
Her diagnosis revealed a hole in her teeth which her father requested the dentist to fill but according to Nkechinyere, the treatment only made her condition worse. She said a few days after, “I started feeling serious tooth pain to the point that I couldn’t chew anything or even swallow anything because of the pains.”
At that point, she said her aunt recommended washing the teeth with hot water, salt and lemon solution. Nkechinyere says she has been doing so “but I still feel pains and so my dad is taking me back to see the dentist to have my teeth removed.”
These stories highlight a serious issue – poor dental culture. The World Health Organisation (WHO) Global Oral Health Status Report 2022 report estimates that oral diseases affect close to 3.5 billion people worldwide, with 3 out of 4 affected people living in middle-income countries.
Nigeria’s National Oral Health Policy, 2012, defines oral health as more than just healthy teeth and the absence of disease; it encompasses the overall well-being of the oral cavity, including the dentition and its supporting structures. It involves the ability of individuals to carry out essential functions such as eating and speaking, while contributing fully to society.
Oral Health and Systemic Diseases
Having good oral health depends on various factors, including genetic and environmental predisposition for disease, nutrition and dietary practices, oral self-care behaviors, health beliefs, socio-economic status, as well as dental care. The mouth serves as a gateway to the body, and several systemic diseases, such as Anaemia, Leukaemia, Diabetes mellitus, Osteoporosis, fluorosis, and even HIV infection, often present with oral manifestations. This underscores the importance of oral health extending beyond dental care.
Oral diseases have a significant impact on individuals’ health and well-being, causing pain, increasing morbidity and mortality, and leading to lost school hours and reduced socio-economic activities. Common oral diseases include dental caries, periodontal diseases, malocclusion, dental oro-facial injuries, cleft lip and palate, oral cancer, and Noma. Moreover, links have been established between oral diseases and cardiac infections, coronary artery disease and poor pregnancy outcomes.
The need for Oral Health care in Nigeria is substantial, with periodontal disease and dental caries affecting a significant portion of the population. Despite the reported low prevalence of dental caries, it remains a public health concern due to untreated lesions. Traumatic injuries in the oro-facial region are also common, and there is a rising incidence of oral tumors.
Need For Implementation of Oral Health Policy
For Nigeria to adequately address poor oral health among Nigerians, it requires a coordinated system for collecting Oral Health data. The Nigeria Oral Health Policy 2012 is aimed at achieving optimum oral health for at least 50% of Nigerians through sustainable
awareness creation, strategic research, workforce development, and coordination of oral
health activities, as well as institutionalisation of modern dental practices, and to ensure
effective integration of oral health into national health programmes.
According to the document, its mission is to improve the level of Oral Health of Nigerians through the development and promotion of accessible, effective, efficient and sustainable Oral Health System based on prevention, early detection and prompt treatment of oral diseases, using evidence-based interventions by the year 2015. These goals may not reflect the present realities on ground.
The two personal stories shared above illustrate the importance of dental hygiene in maintaining oral health. While Jacob Ochefu’s toothache journey began with a traumatic incident, Nkechinyere Prince’s experience with teeth pain revealed a hole in her teeth.
Expert Insights on Dental Hygiene
Dental experts like Dr. Morenike Oluwatoyin Ukpong emphasise the significance of good dental hygiene practices. She said in a chat with African Health Report (AHR), that adopting simple routines like brushing the teeth twice a day and daily or flossing can prevent dental problems. Additionally, she continued, diet choices, stress management and avoiding tobacco products are crucial for maintaining oral health.
Dr. Ukpong warned against practices like using wooden toothpicks to remove food particles, which can lead to pockets and caries, saying: ”When you use toothpicks to remove food packs between the teeth, then one has pockets, and caries. That is, holes in the teeth, which becomes a major issue of concern because of the poor growth, development and psychological concerns associated with it.”
She also highlighted the dangers of dental plaque, which she stated, if not removed, can damage teeth and contribute to various systemic disorders. According to www.dentalcare.com plaque is “a sicky film that coats the teeth and contains bacteria”. An advisory on the site warns that If not removed “when its soft it hardens and becomes difficult to remove. According to the advisory, “dental plaque can damage a teeth and lead to tooth decay or tooth loss.”
Dr Ukong agrees, adding that “plaque is also associated with a number of systemic disorders such as low birth weight and preterm births for pregnant women, it increases the risk for diabetes mellitus and also the risk for cardiovascular diseases.”
She also warned that neglecting plaque removal can result in tooth decay, tooth loss and even systemic health issues like diabetes, cardiovascular diseases and Alzheimer’s disease. Her insights shed light on the profound impact of oral health on overall well-being, emphasising the importance of cultivating good dental habits.
“Studies by researchers have also associated plaque with other anomalies like low sperm counts, Alzheimer’s disease, arthritis. These links are associated to the inflammation that plaque sets up from the mouth and linked to the body. I can attest to the arthritis and oral inflammatory link because of my past experience,” she stated.
The doctor noted these sad experiences with dental problems are prevalent in Nigeria due to poor hygiene but with dietary changes like reduction of “consumption of refined carbohydrates like cake, biscuits, sweets, sodas and the likes during meal times” and “taking it in-between meals as it significantly increases the risk for holes in the teeth especially when it is taken in between meals up to three times a day or more,” there will be significant improvement.
The dentist added: “If you play contact sports or grind your teeth at night, consider wearing a mouthguard to protect your teeth from injury or damage. Manage stress. Stress can contribute to teeth grinding (bruxism), which can lead to dental problems. Practice stress-reduction techniques to minimise its impact on your oral health.”
She said Nigerians must begin to be conscious of other healthy oral habits like “once daily flossing to clean between the teeth, brushing of the tongue daily and avoiding the use of tobacco products – both smoking and use of smokeless tobacco,” to maintain a healthy dental life.
