Home Print this page Email this page Small font sizeDefault font sizeIncrease font size
Users Online: 26536

 

Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Advertise Contacts Login 
     

ARTICLE
Year : 2010  |  Volume : 51  |  Issue : 3  |  Page : 125-127 Table of Contents     

The role of general dental practitioner in oral health


Faculty of Dentistry, Lagos State University College of Medicine, Ikeja, Nigeria

Date of Web Publication27-Nov-2010

Correspondence Address:
Alagumba L Nwoku
Faculty of Dentistry, Lagos State University College of Medicine, Ikeja
Nigeria
Login to access the Email id

Source of Support: None, Conflict of Interest: None


Rights and PermissionsRights and Permissions
   Abstract 

Although it is widely acclaimed in the recent past that the Nigerian has healthy set of teeth and no oral health problems. Our findings show that over 2.3 million Nigerians between the ages of 3 and 70 years attend dental clinics yearly for treatment. In spite of this, provision of oral health care and services at the local outage is highly deficient.
Just as the eyes may be the window to the soul, the mouth is a window to the body's health. The state of oral health can offer lots of clues about the overall health as these are more closely connected than one might realize. Oral Health is connected to many health conditions beyond the mouth, and indeed, sometimes the first sign of a disease may show up in the mouth. The mouth is normally teeming with bacteria, and some researchers believe that these bacteria and inflammation from the mouth are linked to other health problems including heart disease. Other diseases that affect the oral cavity include, but not limited to caries, infections of the gum and jaws, malformations, benign and malignant tumours, as well as diabetes.
The general dental practitioner therefore has very important duties. These include early recognition and diagnosis of oral health problems, oral health promotion, education and provision of care and services. Dental professionals should make dental patients aware that oral health care can't wait. They should market their practice to increase business and oral health care awareness.

Keywords: oral health, dental practitioner, disease prevention, diagnosis, treatment


How to cite this article:
Nwoku AL. The role of general dental practitioner in oral health. Niger Med J 2010;51:125-7

How to cite this URL:
Nwoku AL. The role of general dental practitioner in oral health. Niger Med J [serial online] 2010 [cited 2024 Mar 28];51:125-7. Available from: https://www.nigeriamedj.com/text.asp?2010/51/3/125/71016


   Introduction Top


Dentistry, sometimes referred to as Dental Surgery may be defined as that branch of Surgical Practice which deals with the diagnosis, surgical and adjunctive treatment of the diseases, injuries and malformations of the human teeth and other associated structures. Dentistry, as a profession, comprises nothing less than fourteen specialities.

The progress achieved in oral Diagnosis and oral Medicine as integral parts of dentistry has greatly improved services in Oral health. This is further enhanced by the innovations in prosthetics, orthodontics and laboratory technology. On the other hand, the parallel developments in general medicine, radiology, aneasthesia and chemotherapy all facilitated the growth of oral and maxillofacial surgery within dentistry.

Health economies studies have differentiated oral health care from general medical care based on uncertainty and asymmetric information[1]. Oral health care is not considered an emergency care except in cases of accidents or toothache. Therefore, unlike general medical treatment, individuals take their time to decide when they would make a dental visit, and sometimes even decide on what dental treatment they should be given. Although, it is widely but erroneously acclaimed in the recent past that the Nigerian has healthy set of teeth and no oral health problems, our findings show that over 2-3 million Nigerians between the ages of 3 and 70 years attend dental clinics. There are numerous reports in the status of oral health in this country dating back over four or five decades[2],[3],[4],[5],[6],[7],[8],[9],[10]. In spite of this, provision of oral health care and services at the local outage is highly deficient.

It must be mentioned that the wider definition of oral health includes not only diseases of the teeth but also, diseases of the gingival, jaw bones, oral mucosa, tongue and lips, and the salivary glands. The incidences of tumorous conditions of the oral cavity have also been studied. Metastatic diseases may also affect the oral cavity, so also some oral manifestations of systemic diseases[10],[11],[12],[13],[14],[15],[16],[17],[18],[19].

Why Oral Health Matters

Just as the eyes may be the window to the soul, the mouth is a window to the body's health. The state of oral health can offer lots of clues about the overall health conditions beyond the mouth, and indeed, sometimes the first signs of a disease may be present. Numerous recent scientific studies indicate associations between oral health and a variety of general health conditions, including diabetes and heart disease[16],[20],[21].  Streptococcus mutans Scientific Name Search  to be associated with bacteriemia and infective endocarditis, and recent evidence has indicated an association of periodontitis with cardiovascular diseases.

Too many people mistakenly believe that they need to see a dentist only when they are in pain. But this is the wrong picture. In response to this lack of knowledge, and because poor oral health can lead to numerous health hazards, the World Health Organization (WHO) has integrated oral health into its chronic disease prevention efforts.

The Dental Practitioner's Role

The General Dental Practitioner has an important role to play. In this sub-region, various reports indicate that the oral health knowledge of both Nigerian children and mothers is poor[6],[7],[8],[9]. And in the past, oral health had been discussed out of context of general health. This is misleading as we have seen that the bacteria and inflammation from the mouth are linked to other health problems including heart disease. Other diseases that affect the oral cavity include malformations and tumour of the jaws, diabetes and acquired immune deficiency syndrome (AIDS).

The general dental practitioner therefore has very important duties. These include early recognition and diagnosis of oral health problems, oral health promotion, education and provision of care and services. Dental professionals should make dental patients aware that oral health care can't wait. They should market their practice to increase business and oral health care awareness. The general dental practitioner may be the first health care provider to diagnose an oral lesion. Therefore dentists must be more prevention-oriented rather than a curative approach.

Specifically, their role include, but not limited to, diagnosing oral diseases, promoting oral health and disease prevention, creating treatment plans to maintain or restore oral health of their patients, interpreting radiographs and diagnostic tests, ensuring the safe administration of anaesthetics, monitoring the growth and development of the teeth and jaws, performing surgical procedures on the teeth, bone and soft tissue of the oral cavity and managing oral trauma as well as other emergency situations. In this definition, we immediately see that dentists' areas of care include not only their patients' teeth and gums, but also the muscles of the head, neck and jaws, the tongue, salivary glands, the nervous systems of the head and neck, and other areas. These can show lumps, swellings, dislocation and ulcerations. And when appropriate, they perform procedures such as biopsies, diagnostic test for chronic infectious diseases, salivary gland function, and screening tests for oral cancer and AIDS.

In addition, dentists can spot early warning signs in the mouth that may indicate diseases elsewhere in the body, and when appropriate refer patients to other specialists and physicians. If the general dental practitioners are to carry out this assignment efficiently, the structure of the newly introduced National Health Insurance Scheme (NHIS) in Nigeria, which made physicians the primary provider for dental problems, must be reversed. In this way the general dental practitioners will be able to reach large numbers of families, especially mothers, in order to improve the oral health of the population. Such preventive services will not only reduce caries incidence, but will also provide favourable ratings for oral health.

Education and Clinical Training

Oral health education is an effective means of teaching individuals and communities about how to prevent the occurrence of dental problems[23],[24]. For general dental practitioners to function well, they must possess adequate and accurate knowledge of oral health and preventive measures.

For instance, many general dental practitioners extracts a loose tooth without careful examination of the cause of the tooth mobility, whether it is due to periodontitis, general medical condition such as diabetes, Le Fevre Syndrome, or malignancy. The most important factor for preserving oral health is a well-trained general dentist. The World Health Organization (WHO) recommends that dental surgeons participate actively in global and national oral health prevention and control programmes. By their training, dentists acquire the expertise to examine and diagnose pathological conditions of the teeth and associated structures in the oral cavity. In order to appreciate the role of the dentists and also their concern, one must look into the various systemic diseases that show early signs in the oral cavity. Here also, the early diagnosis of oral manifestations of acquired immune deficiency syndrome (AIDS) may precede the general clinical signs of the disease in Human Immuno Deficiency Syndrome (HIV) - infected persons. The general dental practitioner who sees oral candidiasis, acute necrotizing ulcerative gingivitis and cancrum oris-like lesions in an age group where they do not normally occur may question whether these are not signs of AIDS or HIV-positivity.

The density of Nigerian dentists is slowly increasing in recent years, but dental contact frequency per capita has remained low. A better understanding of the intensive academic and clinical education that dentists undergo, their role in delivering oral health care, and most importantly, the degree to which oral disease is almost entirely preventable, should stimulate the policy makers to ensure that more Nigerians enjoy lifelong benefits of good oral health through education.

Improving the Nation's Oral Health

Despite all we know about the importance of oral health to overall health, to people's self-esteem and to their employability, the State and Federal policies continually sell oral health care short. In 1981, the World Health Organization (WHO) and Federation Dentaire Internationale (FDI) proposed the global goals of oral health for 2000[25],[26]. The WHO, among other things, made concrete recommendations for Oral Health. Again the new global goals for oral health presented by the FDI, WHO and the International Association for Dental Research (IADR) in 2003 augmented a systemic review of oral health systems, which gained importance in terms of clinical applications and cost effectiveness. Since then, policy makers and dental professionals worldwide have acted consciously according to those indicators. However, the situation in Nigeria is different. In order to improve the nation's oral health, one must concede that social class should not be important in determining access to health care services as this would adversely impact on the decision to visit the general dentist.

In conclusion, the following recommendations could be made.

  • Professional preventive oral health care could be made free.
  • Flouride application programmes as a part of public health care should be provided.
  • The general dentist should shift from a treatment-oriented model to a prevention-oriented model under the cost-concentrated policy.
  • Pressure should be put on policies to shift towards remodeling statutory dental health insurance schemes towards a cost-effective model. Therefore, the scheme should strategically allocate dental expenditure between public and private sectors.
  • General dental practitioners all over the country must prepare themselves to deliver oral health care to all patients of all ages, promote oral health across the population including children, adolescents and older people in both low and socially disadvantaged groups.
  • Research in oral health should not be a left out.
  • It is our recommendation that dental visits to the general dental practitioner begin not later than a child's first birthday to establish a "dental home". Dentists can provide guidance to children and parents, and diagnose and treat dental diseases in its earliest stages. This will help both children and adults to maintain optimal oral health throughout their lifetimes.
[27]

 
   References Top

1.Sintonen H., Linnosmaa I. Economics of Dental Services. In: Culyer A. J., Newhouse J. P. ed. Handbook of Health Economics Vol. 1B Amsterdam: Elsevier Science; 2000 pp 1251-96.   Back to cited text no. 1
    
2.Enwonwu C. O. Socio-economic factors in dental caries prevalence and frequency in Nigerians. An Epidemiological Study. Caries Res 1974; 8: 155-71.   Back to cited text no. 2
    
3.Enwonwu C. O., Edozien J. C. Epidemiology of Periondontal Disease in Western Nigerians in relation to Socio-Economic Status. Arch Oral Biol 1970; 15: 1231-44.   Back to cited text no. 3
    
4.Akpata ES. The Prevalence and Distribution of Dental Caries and Gingivitis in the Primary Dentitions of 6-year old Lagos Children. J Int Dent Child 1979; 10: 3-9.   Back to cited text no. 4
    
5.Enwonwu C. O., Review of Oral Diseases in Africa and the influence of Socio-Economic factors. Int Dent J 1981; 31: 29-38.   Back to cited text no. 5
    
6.Jeboda S. O., Salako N. O., Bamgboye P. O. Dental Health Awareness Among Nigerian Mothers . Odont Stom Trop 1984; 4: 184-94.   Back to cited text no. 6
    
7.Aderinokun G. A., Arowojolu M. O., Arowojolu A. O. Perception of Oral Health needs by Antenatal Clinic Attenders in Ibadan, Nigeria. Afr J med Med Sci 1998; 28: 229-32.   Back to cited text no. 7
    
8.Orenuga O. O., Sofola O. O. A survey of the knowledge, attitude and practices of antenatal mothers in Lagos Nigeria about the primary teeth. Afr J. Med Med Sci 2005; 34: 285-91.   Back to cited text no. 8
    
9.Jeboda S. O., Adeniyi A.A., Ogunbodede E. O. Assessment of Preventive Oral health Knowledge and Practices among Rural and Urban Mothers in Lagos State. Nig Postgrad Med J 2009; 16: 239- 44   Back to cited text no. 9
    
10. Henshaw N. E., Adenubi J. O. The Increase in Dental Disease in the Northern States of Nigeria and its manpower implications. J Dent 1975; 3: 243-50.   Back to cited text no. 10
    
11.Nwoku AL. Resection and Reconstruction of mandible with Iliac Crest Transplant. Nig Dent J 1980; 1: 23-27.   Back to cited text no. 11
    
12.Sawyer D. R., Mosadomi H. A., Nwoku A. L. Adenomatoid Odontogenic Tumour in Lagos Nigeria. Nig Dent J 1980; 1: 40-45   Back to cited text no. 12
    
13.Nwoku A. L., Sawyer D. R. Burkitts Lymphoma in Africa: case report. Virginia Medical 1981; 108: 138-41.   Back to cited text no. 13
    
14.Sawyer D. R., Nwoku A. L., Mosadomi H. A. Recurrent Amelolelastic Fibroma: Report of two cases Oral Surg Oral Path Oral Med 1982; 53: 19-23.   Back to cited text no. 14
    
15.Sawyer D. R., Mosadomi H. A., Nwoku A. L., Calcifying Odontogenic Cyst. Report of four cases. Central African J. of med 1983; 29: 196-99.   Back to cited text no. 15
    
16.Sawyer D. R., Nwoku A. L., Mosadomi H. A., Kekere-Ekun T. Odontogenic Calcinoma with Dentinoid. Int J Oral Maxillofac Surg 1986; 15: 105-7.   Back to cited text no. 16
    
17.Sawyer D. R., Nwoku A. L. Malnutrition and Oral Health of Children in Ogbomoso, Nigeria J Dent Child 1985; 52: 141-45.   Back to cited text no. 17
    
18.Akinwande J. A., Odukoya O., Nwoku A. L., Taiwo E. O. Burkitts's Lymphoma of the Jaws in Lagos. A ten-year review. J max yac surg 1986; 14: 323-28.   Back to cited text no. 18
    
19.Sawyer D. R., Nwoku A. L., Leunert J. F. Facial and Oral Manifestations of Leprosy: An Evaluation of 104 cases. J. Oral Med 1987; 143-49.   Back to cited text no. 19
    
20.Nwoku A. L., Sawyer D. R. Cancrum Oris Mortality in Lagos Nigeria. Virginia Dental J. 1980; 22-25.   Back to cited text no. 20
    
21.Sawyer D. R., Nwoku A. L., Rotimi V. O., Hagen J. C. Comparison of Oral Microflora between well-nourished and mal-nourished Nigerian Children. J Dent child 1986; 53: 439- 443   Back to cited text no. 21
    
22.Scannapieco F. A., Bush R. B., Paju S. Association between Periodontal Disease and Risk for Atherosderosis, Cardiovascular Disease, and Stroke. A Systematic Review. Ann Periodontol 2003; 8: 38-53.   Back to cited text no. 22
    
23.Pihlstrom B. L., Michalowicz B. S., Johnson N. W. Periodontal Diseases. Lancet 2005; 366: 1809-20.   Back to cited text no. 23
    
24.Blinkhorn A. S. Dental Health Education. What lessons have we ignored? Brit Dent J. 1998; 184: 58-9.   Back to cited text no. 24
    
25.Frazier PJ, Horowitz AM. Oral Health Education and Promotion in Maternal and Child Health: a position paper J Public Health Dent 1989; 50(6): 390-5.   Back to cited text no. 25
    
26.Federation Dentaire Internationale. Global goals for Oral Health in year 2000 Int. Dent. J 1982; 32: 74-7.   Back to cited text no. 26
    
27.FDI World Dental Federation. Report of the Global and Oral Health Planning Workshop. FDI Press Lowestoft, UK 2005; 13-15.  Back to cited text no. 27
    




 

Top
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    Abstract
    Introduction
    References

 Article Access Statistics
    Viewed7514    
    Printed317    
    Emailed0    
    PDF Downloaded197    
    Comments [Add]    

Recommend this journal