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Dental health care takes root in Kenya

NAIROBI, Kenya, November 14 – In the marketplace of a medieval town square, a magnificently dressed charlatan boasts that he can extract teeth painlessly.
 
His accomplice, pretending reluctance, steps forward, and the tooth puller fakes an extraction, holding up a bloodstained molar for all to see. Toothache sufferers are soon encouraged to part with their money and their teeth.
 
Drums and trumpets and the oohs and aahs of the crowd drown out their screams so as not to dissuade others. Within days, dangerous cases of sepsis sometimes appear, but by then the charlatan is long gone.

Few victims of toothache have to resort to the services of such rogues today since modern dentists can now cure toothache and often prevent tooth loss.

Dr. Chris Wagaiyo who practices at the Nairobi Hospital says that the Dental practice has undergone a revolution which makes it less painful to patients.

“Previously, dental treatment was painful mainly due to the anesthetics that were being used. They were not effective but the drugs we have now are effective, they can numb the gums and the teeth,” he states.

“There is also general anesthetic that can be used in some situations so dental treatment should not be painful at all.”

Before anesthetics were discovered, dental procedures caused agony to patients. Dentists gouged out sensitive, decayed teeth with sharp instruments and then pounded hot metal into the cavity as a filling.

Since they did not have any other treatment, they would cauterize a tooth that had infected pulp by pushing a red-hot iron rod into the root canal.

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Before special tools and anesthetics were developed, an extraction was also a grim experience. People submitted to such torture only because living with toothache was even worse.

Dr. Wagaiyo says that despite the advancement in technology, there is need to observe strict dental hygiene to avoid such complications.

He emphasises the need to brush one’s teeth on a regular basis in a bid to minimize tooth decay and bad breath.

“If you do not have a good Dental hygiene, the most obvious is bad breathe. People will start avoiding you because your mouth smells,” he observes.

“Over and above that, you can get a lot of pain from cavities, gum disease and eventual loss of the teeth,” he adds.

According to Dr. Wagaiyo, tooth decay is not merely a modern disease but mankind’s second most common, after the common cold.

In ancient times, although Elizabeth I was queen of England, she could not escape toothache. A visitor who observed her black teeth said that it was a defect that the English seem subject to, from their great use of sugar.

At one particular time, a toothache tormented the queen day and night. Her physicians recommended that the diseased tooth be pulled out, but she refused, possibly in fear of the pain it would cause.

To encourage her, bishop of London, John Aylmer had one of his own teeth, perhaps one that had decayed, extracted before her, a gallant act, since the old man had few teeth to spare.

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At that time, commoners who needed a tooth pulled went to a barber or even a blacksmith. But when more people became able to afford sugar, toothache increased as did the demand for skilled pullers.

Thus, some physicians and surgeons began taking an interest in the treatment of diseased teeth. However, they had to teach themselves, since experts jealously guarded their trade secrets and there were also few books on the subject.

Breaking the custom of guarding trade secrets, in 1728, Fauchard wrote a book in which he passed on all the procedures he knew. As a result, he came to be called “the Father of Dentistry.” He was the first to seat patients in a dentist’s chair rather than on the floor.

For decades dentists wondered about the cause of mottled teeth. Finally, an excess of fluoride in the water supply was found to be the cause. But while studying that local problem, researchers stumbled across a fact of worldwide importance for the prevention of toothache: People raised where drinking water contains inadequate fluoride have more tooth decay.

Dr. Wagaiyo says that fluoride, which many water supplies contain naturally, is an ingredient of tooth enamel. When people who lack fluoride in their water supply are provided with the ideal amount, the incidence of tooth decay drops by as much as 65 percent.

There is also need for the regulation of the practice to prevent quacks from taking advantage of patients for their own good.

The Medical and Dental Practitioners Board says that it is taking all the necessary steps to ensure that all doctors are legally qualified to practice.

Chairman Daniel Yumbya states that the Medical Act also needs to be reviewed so as to make professionals more effective.

He points out that some of the penalties provided by the act are too lenient and this encourages malpractice.

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He says that currently 470 cases of malpractice have currently been reported and of this, 220 have been determined and concluded. 
 
“The penalties that we give need review because the doctor or Dentist can be warned and the case is concluded and the practitioner may also be placed on probation fro a period of not more than 12 months,” he stresses

The practitioner can also be ordered to go for remedial training and all this is not enough.”

He further adds that it’s important to involve the public in the review of the Act to get an all rounded input.

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