A GNA feature by Linda Asante Agyei

Accra, Aug. 24, GNA - It was a standard and common practice during the days of yore to see anxious and duty conscious teachers inspecting the teeth of pupils every Monday to enforce oral health in schools. This meticulous process was not the responsibility of teachers alone. Every child growing up knew well that to avoid a few lashes and the extracting tool of a dentist he or she must resort to the use of chewing stick or 93sponge=94 to be able to portray in public spotless white teeth without the slur of decay.

Parents also cultivated the habit of visiting dentists regularly with their children.

With time these sound oral health practices have faded. Now people only visit the dentist when they are afflicted by tooth decay or want a painful health problem rectified through extraction. Dr David Oppong-Mensah, Chief Dentist at the Ministry of Health, is not amused with this changing trend, saying the oral health of Ghana is now very appalling.

He says untreated tooth decay; chronic gum infections; premature loss of permanent teeth; untreated cleft lip and palate; poorly aligned teeth and jaws that disfigure the face and fractured teeth and jaws caused by trauma are widespread.

Dr Oppong-Mensah says three out of every 10 school children in Ghana have tooth decay and 95 per cent have poor oral hygiene. Eight out of 10 adults have chronic gum diseases and associated bad breath and only 500,000 Ghanaians visit a dentist once in a year.

Whose responsibility is it to ensure that the teeth of children are healthy and in good shape? Is it the parents or the children themselves? Dr Oppong-Mensah says all children under-12 years of age have experienced toothache once their lifetime. Many adults of 30 years have had cavities in their teeth while people over 45 years have lost a proportion of their permanent teeth.

He attributes the present situation to lack of fluoride, which is the main source for oral disease prevention.

There are children as young as two years who visit the dentist with either toothache or tooth decay. The question is: Will these children grow and still have their teeth or will grow up having almost all of their permanent teeth extracted and fixed with artificial teeth? Eating of sweets and toffee contributes to the bad oral health of children. Some parents these days give their children too many sweets and they have no idea the harm that they are causing to their children's oral health.

Dr Chloris Adadevoh, Former President of the Ghana Dental Association (GDA), during her term of office, called on beverage manufacturing companies to reduce the sugar content in their products. She said the sugar content of soft drinks and sweets on the market were so high that they contributed to the bad oral health and tooth decay of the people, especially children. As to whether this call has been adhered to, no one knows.

Brushing the teeth with toothpaste containing fluoride, according the Chief Dentist, is the safest and only source for the promotion of oral health.

Though fluoride promotes oral health, it is dangerous when used in large quantities. It is poisonous when toddlers swallow large quantities of toothpaste containing fluoride while brushing their teeth instead of spiting it out.

Signs and symptoms of fluoride poisoning include nausea, vomiting, diarrhoea, abdominal pains and increased salivating. It also reduces calcium in the body and in some cases death may occur if treatment is delayed.

Dr Oppong-Mensah notes that the people in Bongo District in the Upper East Region have excessive fluoride in their borehole water saying this is not very good for their health.

The people in this District had cried for water for so many years and now that they have been provided with water, they have excessive fluoride, which is poisonous to their health.

Fluoride can also be found in water; milk; salt; tablets and clinical preparations for professional use and mouth-wash. These are in abundance on the market and affordable to an average Ghanaian. But the sad aspect of it is that our drinking water contains low fluoride levels and less than 0.1 per part million (PPM). The recommended level for the Tropics is between 0.7ppm and 0.8ppm and 1ppm to 1.2ppm for the Temperate Zone.

Dr Oppong-Mensah, however, allays the fear of people that though Ghana's level of fluoride in water is less than 0.1pmm there is no cause for alarm.

Of the over 61 different types of toothpaste on the market, 62 per cent have fluoride levels as required by the standard range of 1,000ppm to 15,000ppm while 38 per cent do not have the required standard of fluoride, which sounds worrying.

The Chief Dentist says a study is under way to determine the level of fluoride in the toothpaste on the Ghanaian market. Acute shortage of dentists and auxiliary personnel coupled with low coverage of services, low utilisation of limited services and poor oral hygiene especially among children are also compounding the problem of poor oral health.

Ghana has 140 registered dentists most of whom are due for retirement. The present dental surgeon to patient ratio is 1:128,000, which the Ghana Dental Association says, is quite a distance from the World Health Organisation's recommended ratio of 1:80,000. This, the Association says, is putting immense pressure and strain on the few facilities available.

Most dental surgeons are centred in Accra and regional capitals, which is unfortunate as those in the districts and rural areas are deprived of such services.

To ensure that quality dental services reach every part of the country, the Ministry of Health has, as a policy, ordered all new health facilities in the districts to have equipped dental clinics to provide dental services to the people.

For effective take-off, the Ministry is establishing new dental facilities and equipping existing ones with the requisite manpower and logistics to improve access.

Mr Awuah Siaw, Head of Institutional Care of the Ministry of Health, says oral health care should start from the home and asks mothers to supervise their children when they are brushing their teeth. The correct way to brush the teeth is to place a small amount of fluoride toothpaste to cover a quarter of the head of a brush. For toddlers and children under-six years, only a pea-sized amount of the paste should be used.

Slowly spread the paste on the teeth with light touches of the brush, systematically brush the teeth starting from one side of the jaw to the other and move to the other jaw.

Make sure all surfaces of the teeth are brushed moving from top to down. Spit out if mouth is full but do not rinse with water to allow the fluoride to perform its job. Brush teeth twice a day. People should also always buy toothpaste that contains fluoride for it is the only source of fluoride to prevent tooth decay and gum infections. The mouth is the first entry point to the inner body and must be in good health to ensure the full health of the body. Let us all show interest in our oral health. 24 Aug. 06