If you want people, especially children, to listen to your advice, don’t give advice that is unrealistic … for example, do not tell children not to eat sweets – trust me, I’m a dentist and the dean of the Faculty of Dentistry at UWC. Not too long ago I embarked on a little experiment. I filled a jar with chocolate bars and a few healthy options and placed it on my desk. It’s the chocolate bars I’ve had to replenish regularly, and I’ve since abandoned the healthy treats.
The point of the experiment? The message we send to people is wrong. We should not tell children or adults not to consume sweets. What we should be telling them is if you control the amount of sugar you consume, then you can indulge and have that chocolate – as long as you brush your teeth and rinse your mouth afterwards.
We are using World Oral Health Day this month at the university to spread that message. The vision is for this faculty to be a global player in teaching, training and research in dentistry. We have a burden of disease, the infrastructure, limited capacity, and the support from the university to play in the big league. What we also need is the collaboration of international partners that will give us the technical tools and some of the funding we need to really drive growth and development in key areas such as teaching and learning, clinical training, research and community-based service learning and research.
This school is the largest in sub-Saharan Africa and what is unique is our joint platform with the Western Cape Department of Health. Almost 77% of all the dental chairs available for treatment lie in the UWC training platform. We run a structured service with a full array of services, and we were the only dental facility in this province open during the Covid lockdown.
Dentistry is one of the most expensive services to deliver at primary care level and one of the most expensive professions to train. Many of the patients in this province cannot afford to go to private practices and their only source of care for oral health is in our Faculty of Dentistry joint training and service platform. Our partnership with the provincial government is crucial for service provision for a significant number of children and adults in the Western Cape.
Many studies have shown that there is a significant link between oral health and general health. The mouth is a good indicator of general health. For example, with HIV, in almost 60% of cases the first symptoms are found in the mouth.
The big problem with dentistry and oral health in particular is the lack of awareness, education and knowledge. There is this notion that because children have primary teeth and they eventually lose them, these are not important to maintain. But if children lose their milk teeth quite early, there’s a significant impact in terms of their growth and development.
Some of the developmental milestones are delayed because of a lack of teeth. In children who lose their milk teeth prematurely, the permanent teeth grow in different directions and that is expensive to treat. The other effect is the inability to chew properly. There are psychological factors too. Children, for example, who lose their teeth are often teased.
What makes dentistry very expensive, especially with children, is that they often won’t sit in the chair and co-operate and so they need to go to theatre. Those with multiple cavities and in a lot of pain often wait six to eight months before they are treated.
You really only understand the importance of dentistry when you’re climbing the walls looking for somebody to help relieve your pain. Imagine a child experiencing this pain and the impact it has on their quality of life.
Children who have dental treatment grow, gain weight and achieve developmental milestones quicker than those that don’t. The evidence is quite clear that if we don’t treat tooth decay it has a fundamental impact, in terms of oral health and general health.
At our faculty, we are introducing cost-effective digital solutions for clinical procedures. We have the facilities for students to train in a First World environment and serve a population that has a Third World disease profile, so they get the best of both worlds. We want out students to be locally responsive but globally competitive when they graduate.
Already we have, for example, students from Oslo, Norway, spending time at our faculty and they are blown away by the kind of patients they see and the kind of techniques we use which they will never be exposed to back home. So many of our undergraduate students are competent in skills students elsewhere in the world only encounter at postgraduate level.
The university is supporting our drive to provide our students with digital equipment for treatment planning. It will have a major impact because we have the biggest dental school in the country – with more than half of the graduates produced annually coming from UWC.
The huge challenge is the perception that all we do is extract teeth. This is far from the truth. We train by international standards. This idea, especially in the Western Cape of the “Passion Gap” (where teeth that can be saved are extracted because of a fad), is certainly not something we promote. On the contrary, at the heart of all of our programmes is good oral health, saving teeth and promoting healthy smiles.
The faculty has seven departments that cover every discipline in dentistry. We have a state-of-the-art mobile clinic serving communities and a genetics clinic that helps medical and forensic colleagues, even in the solving of crimes.
Oral health promotion, prevention, education and awareness are what we do. It’s cheaper to prevent than treat the consequences of tooth decay which need expensive treatment options. Even the richest countries in the world have realised this and there is a focus on huge prevention initiatives to keep peoples’s mouths healthy and free of oral disease. So, have that chocolate. But just one. And clean those teeth afterwards.
* Professor Jeff Yengopal is the dean of the Faculty of Dentistry at UWC. On March 24, to celebrate World Oral Health Day, the faculty will be treating up to 250 patients in its mobile dental clinic on the main campus in Bellville.