Tooth Decay Ravaging Cameroonian Children

By *Leo Achembong Ndiangang

The average Cameroonian child is presently facing a challenge that past generations did not have. Dental caries is ravaging Cameroonian children, much as it did in the developed world prior to the emphasis on the use of fluoride and dental hygiene. 

This situation has come about due to a number of factors. The increasing popularity of highly refined foods and the neglect of hygiene instruction in primary schools are two contributors. In general, fluoride toothpaste is not affordable or is probably not on the list of priorities for many Cameroonian families. Basic oral hygiene knowledge and awareness of its importance is lacking. 

In addition, there is inadequate infrastructure in the few available dental clinics and a dearth of dental personnel in Cameroon. There are currently about 150 practicing dentists serving 19 million Cameroonians, 80 percent of whom are located in Yaounde and Douala, the two largest cities, where most dentists are in private practice, out of reach of the ordinary Cameroonian. The ordinary Cameroonian has no access to dental care because of the costs involved and the absence of dental providers in most parts of Cameroon. 

Presently there is no dental school, no dental hygiene school, and no government or public health emphasis on oral health. There is also no reliable data on the prevalence of dental caries. Hopefully, stake holders involved with the proposed dental school at the University of Buea will engage in oral health research and start doing research to show the evidence of the enormity of dental diseases in Cameroon.

Oral health in Western Europe and North America was probably at a similar level to where we are today in Cameroon fifty to sixty years ago. There is evidence showing that these countries embarked on aggressive campaigns in which fluoride was incorporated in to pipe borne water and the importance of fluoride toothpastes and regular dental checkups was emphasized. 

The consumption of sugary diets has increased in these populations over the years, but the prevalence of dental caries has been on the decline. Evidence suggests that this can be attributed to these aggressive efforts. Educating children and parents on the basics of dental hygiene will enable children to grow up with a lifelong habit of proper oral hygiene practices. 

Cameroon does not have the infrastructure and resources to embark on some of the preventive measures that have worked in developed countries. However, we can educate children and parents and encourage every Cameroonian to brush twice a day with fluoride toothpaste and endeavor to see the nearest dentists when tooth problems start instead of waiting until there is tremendous pain or indulging in fake concoctions to relieve toothache. 

Incorporating oral health in to primary health care is definitely the answer to the huge problems we face in oral health in Cameroon today. We are many years away from having dental clinics in every nook and cranny of Cameroon. Even if we were to train several dentists within the next five years they will end up in the two biggest cities, Yaounde and Douala were private practice thrives. 

 Mid level dental personnel and community oral health workers who could be trained to focus principally on preventive aspects is no doubt our best strategy at this time. This will be a cost effective, doable and manageable route to take for a low income country. Mid level dental professionals will need just one to two years of basic dental training of high school graduates. Community oral health workers will do a short training of at most six months to learn some basics in oral hygiene instruction and pass it down to children in schools, rural areas, and other vulnerable positions. Mid level dental personnel could be trained to do simple fillings, extractions, and sealants. They can perform good, modern dentistry in resource deprived settings without using the sophistication of dentistry. 

In their oral health program for elementary schools, the Cameroon Baptist Convention Health Board (CBCHB) is definitely doing the sort of affordable intervention that could increase oral health knowledge among the youth and bring down the prevalence of dental caries. The CBCHB is running tooth brushing programs in eleven elementary schools in northwest Cameroon. Teachers supervise daily tooth brushing with fluoride toothpaste and the kids receive oral health education regularly from CBCHB dental workers. Children who have dental problems are treated on their school premises using evidenced based, low-cost methods approved by the World Health Organization. The ultimate goal is to educate children with life long habits in oral hygiene, treat those with dental problems early and prevent dental decay. 

The cost of a 75g tube of toothpaste is 500 FRS CFA (approx. $1 US). Many Cameroonian parents spend more than 500 FRS CFA every day on alcohol. Avoiding purchasing alcohol which is a daily habit for many Cameroonian parents and channeling the money in to buying toothpaste could help improve children’s oral hygiene. 

 The government could take a cue from the CBCHB and institute oral health programs across the country in elementary schools. The CBCHB has been able to mobilize resources to buy toothpastes and supervise tooth brushing every day in eleven schools involving 3700 children. The cost has been affordable and there are indications that tremendous progress has been made in improving oral health awareness amongst these kids plus preventing dental diseases. There has been a reduction in missed school days and better application to doing homework. 

The Ministry of Basic Education can combine forces with the Ministry of Public Health and Parent-Teacher Associations to institute such programs and avert the problems of toothache, and dental abscesses. A Cameroonian child who is free of toothaches will definitely study better, eat well, have good self esteem and avoid other systemic problems that may arise from tooth decay. Bad teeth will prevent chewing, pain will prevent the kids from studying, and healthy teeth will enable kids to smile and interact with their peers.

*Leo Achembong Ndiangang worked as a dentist in Cameroon at centres run by the Cameroon Baptist Convention (CBC). He is currently a student at the University of Washington in Seattle, USA. 

Comments

[Magnus]

Thanks for sharing this Leo, I get really angry reading this because there are several government well paid bureaucrats who are responsible for pushing through small but important changes in our country. This is someones job and sadly nobody can hold him responsible for not doing enough. I understand that we are 100 years behind the west but I encourage Cameroonians to start holding their local representatives accountable for every little thing, they need to understannd their job description. Change can only come when the greater majority will understand that health services such as dental hygiene have been paid for by the tax payer. The baptist mission is doing a great job but then the government needs to have a much broader program and it will not surprise me if the government hass billion of AID money allocated to such projects.

[emergency dental care]

It's a social issue that needs to be addressed. There are various domestic programs that should be implemented.

[dentist]

Instead of just sending dentists, they should learn how to take care of their own. It may be involved with cultural ideas that outsiders can't comprehend.