A Lack of Oral Health Care: Its Impact on Children and Educational Outcomes

Created for Brighter Tanzania Foundation

On a wall in our pediatric dentist’s office is a patchwork of photographs, each capturing the smiling round face of the practice’s newest patients as they sit in the dentist’s chair for their first appointment. Some look as if they are barely out of the crib.

In fact, the American Academy of Pediatric Dentists recommends that children should visit a dentist when a first tooth appears and no later than the first birthday. This begins a lifetime of biannual appointments to prevent cavities, ensure a proper level of fluoride treatment, and correct or prevent other issues and diseases.

This diligence in oral health care is in stark contrast to 70% of the world’s population which has no access to basic oral care. (2)

Oral Health Care in Tanzania

Fewer than 500 dentists practice in Tanzania, a country of over 45 million people. (4) Dentists in Tanzanian rural areas are particularly difficult to find. With only one dentist per 400,000 people, few, if any receive dental care.

Urban areas are a bit better off, but many still lack basic care. In a 2007 survey of the oral health behavior of 310 twelve-year-olds in Dar-es-Salaam, 76% had never visited a dentist. The students did, however, appear to be somewhat educated on oral health with 71% recognizing that sugary snacks and drinks are a main cause of cavities. In addition, 92% brushed their teeth once per day, and 71% used toothpaste. (1)

When Tanzanians are able to access dental care, the visit is often corrective rather than preventive. One of the common procedures is tooth extraction. Teeth that have become diseased or rotted need to be removed to avoid the spread of infection. (3) Rural Tanzanians on average suffer with tooth pain for two years before remedying the problem. They will then often pull the teeth themselves or pay a local witch doctor to do it. (2)

How a Lack of Dental Care Impacts Children

Oral health has both a direct and indirect impact on children and their ability to succeed in school. The mouth is an entry point for infections which can spread throughout the body. Chronic oral infection can lead to many other issues including heart and lung disease, stroke, low birth weight and premature birth. Poor oral health and accompanying issues can lead to lost days of school. Tooth pain alone might keep a student home from school or unable to focus while in school.

While poor diet and nutrition can certainly lead to tooth pain or tooth loss because of decay, the inverse is also true. Tooth pain or loss might prevent a child from getting proper nutrition. Poor nutrition then impacts a student’s ability to learn. A student may lose the ability to concentrate, and behavioral problems may emerge.

Untreated cavities can also impact a child’s psychological well being and social connectedness. A child’s self image and confidence can be damaged. In addition, with pain or tooth loss, communication skills might be hindered.

During a 2012 mission trip, dental professionals and students from the Arizona School of Dentistry and Oral Health experienced first hand how a lack of oral health care can impact a child’s self image. The group traveled to a rural Tanzanian school and orphanage in Moshi, Tanzania. In addition to treating cavities and extracting teeth, the dentists also treated a condition called Fluorosis which results from too much fluoride in a child’s diet. The condition leads to discoloration or spots on the enamel. The children were given cosmetic treatment, and the dentists were rewarded with newly found smiles. (4)

One Child’s Need for Dental Care

Shedrack, a student at Saving Grace School, also epitomizes the problem. At seven years old, he is now one of the oldest students, but when he arrived a few years ago, he suffered from Rickets, a softening of the bones due to malnutrition. Secondary complications included knock knees and missing front teeth. Shedrack was embarrassed by his missing teeth, so he kept his mouth closed whenever possible, never smiling. He was withdrawn and didn’t participate in class activities.

With surgery for his knocked knees and better and consistent nutrition at school, Shedrack has grown into a happier and healthier boy. His teeth have grown in, he has improved academically, and he smiles! For more details on Shedrack, read another of our blog posts: https://www.brighter-tz-fund.org/Blog/5275457

Sources:

1.https://www.ajol.info/index.php/tdj/article/viewFile/37563/6963

2.https://www.telegraph.co.uk/news/health/expat-health/8572455/Africa-the-place-where-a-toothache-can-kill.html

3.https://www.regencymedicalcentre.com/dental-clinic/

4.http://www.asdablog.com/providing-dentistry-to-underprivileged-children-in-tanzania/

5.http://bora.uib.no/bitstream/handle/1956/6187/94922681.pdf

6.http://www.health.gov.au/internet/publications/publishing.nsf/Content/report_nacdh~report_nacdh_ch1~report_nacdh_out

7.ttps://www.mouthhealthy.org/en/nutrition/food-tips?utm_source=mouthhealthyorg&utm_medium=mhnutritionrotator&utm_content=food-tips