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Water Fluoridation, sugar and dental problems: Modern Foods, New Epidemic


Modern Foods, New Epidemic
The Nation (Nairobi)

June 7, 2004
Posted to the web June 7, 2004 Source:

Jeff Otieno

Dental problems will increase sharply in Kenya in the next decade due drastic changes in diet, the dental association has warned.

Research done by the umbrella dentists body has discovered that the complaints, also referred to as oral health problems, are the result of an increased consumption of sugary foods and drinks.

Consumption of sugar in recent years has risen threefold as Western foods, which are full of refined sugars, replace the otherwise nutritious traditional dishes.

Leading the pack is tooth decay, which affects people as young as three years in both the rural and the urban areas.

"This is not only concentrated in the urban areas, but has also become a major problem in rural areas where three-quarters of the country's poor live," says Dr Tom Ochola, the chairman of the Kenya Dental Association.

He argues that consumption of sweets, biscuits and cakes among the young is worrying as over 70 per cent of them suffer from tooth decay.

"How will the children of our children be if the current situation continues unabated?" the medic wonders.

Tooth decay results in tooth loss and reduces one's ability to eat a varied diet. In fact, it is the organic acids formed by bacteria in the dental plaque through the anaerobic metabolism of sugars derived from diet that demineralises the hard tissues of the teeth.

Many young children visit dentists every month to have their temporary teeth removed following massive decay.

But tooth decay is not the only headache the association has to grapple with. According to Dr Ochola, the gum disease, mainly among adults, is another major problem.

"Almost every Kenyan suffers from the gum disease at one stage or another. However, the difference is the severity," he adds.

The medic says that approximately 90 per cent of Kenyan adults suffer from one form of gum disease or another.

"But since most of them are not painful, people don't see the need to seek medication and only consult the doctor when the pain becomes unbearable," Dr Ochola says.

Fluorosis, which is caused by excessive intakes of fluoride, is another common dental problem in the country.

Scientifically known as clinical dental fluorosis, it is characterised by staining and pitting of the teeth. In the more severe cases, all the enamel may be damaged.

"The teeth lose their natural white colour and completely turn brown, and this might affect one's psychological well-being as many sufferers are made fun of and looked down up," says Dr Ochola.

The problem is common in the Rift Valley area where ground water has a fluoride content higher than the recommended World Health Organisation figure of 1.5 milligrammes per litre.

"Most people in Kiambu, Ruiru, Muranga and Baringo have brown teeth because the fluoride content in the ground water is much higher than the recommended WHO figure."

But what is more worrying is the increase in oral cancer cases, currently representing two per cent of all body cancers.

The association says that dentists are receiving more patients now than in the past.

Research done by the association has found out a direct relation between oral cancer and tobacco usage.

"Tobacco chewing and sniffing and reverse cigarette smoking, where the burning end is placed inside the mouth, are to blame for the new phenomenon," Dr Ochola says.

The chewing of bitten nuts which is common among Asians, is also another major cause of oral cancer. Dr Ochola advises people aged 50 and above who notice unhealing wounds and swellings in their mouths to seek early treatment.

The task to ensure disease-free teeth and gums will not be easy as the burden in the African countries is bound to continue to rise.

"As a result of lack of awareness, people do not value oral health and still see it as a cosmetic issue," adds Dr Ochola.

The argument stands in health insurance where many schemes lack packages for dental treatment.

In Kenya, sky-rocketing dental costs is not only the issue hindering the people from developing a culture of healthy teeth.

Besides, there is severe shortage of dentists- only 600 in a country of 30 million people.

"This means that there is only one doctor for every 50,000, a figure which is far below the WHO-recommended figure of one for 5,000," says Dr Ochola.

As a result of the problems bedevilling the African countries, WHO wants the governments to increase budgetary allocations to oral health programmes.

"We foresee a situation where dental problems will be a heavy burden for the African countries unless dental health is taken seriously," says Dr Erick Petersen, a WHO dental expert.

Dr Petersen adds that the marginalisation of oral health is hampering programmes aimed at combating the diseases. "The budgetary allocations must be increased if Africa is to win the war on oral health," he says.

Health minister Charity Ngilu supports the sentiments: "It is true budgetary allocations of the African countries to oral health programmes has all along been minimal."

She argues that education on oral health and prevention programmes in many African countries have also been minimal.

In Kenya, Mrs Ngilu says, the allocation for dental healthcare is only 0.0016 per cent of the total health budget, which is Sh14 billion.

"Indeed, the orientation of dental practice in Africa has been more towards curative rather than preventive care," the minister says.

The importance of oral health in general health programmes, she urges, should not be underestimated.

According to Dr Petersen, the global health body is concerned about the sweeping dietary changes taking place in Africa among, not only the affluent, but also the poor.

For many years oral health problems were minimal in many African countries, but due to the increased consumption of refined sugar foods, they are emerging as a major sources of worry, he adds.

He says that Africa is currently one of the leading continents on which the people do not have the full set of teeth due extractions caused by decay.

WHO also wants governments to step up campaigns to raise awareness on dental health and nutrition.

Dr Petersen urges countries with a low intake of sugars not to increase their consumption. "When the sugar intake is between 15 and 20 kg per year, or represents 6 per cent to 10 per cent of the energy intake, dental problems are low."

To WHO, oral means more than just good teeth as it is integral to health and essential to a person's general well-being. This implies being free of chronic oro-facial pain, oral and pharyngeal (throat) cancer, oral tissue lesions, birth defects such as a cleft lip and palate and other diseases and disorders that affect the oral, dental and craniofacial tissues.

To improve private-public participation, Prof Denis Bourgeois, a France-based dental expert, proposes the establishment of micro-insurance organisations to help the poor to acquire quality healthcare.

He says that such organisations can cushion the African poor who pay more for healthcare than the rich.

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