Dr. Olurotimi Olojede is the former President of the Nigerian Dental Association (NDA) and the Secretary General of the African Regional Organisagion of World Dental Federation. In this interview with APPOLONIA ADEYEMI, he discusses factors fueling tooth decay, mouth odour, teeth extraction and measures to improve oral health generally
What are the common tooth problems in Nigeria?
Basically, in Nigeria, we have two major tooth problems. One has to do with the hard tooth structure and the second is the soft tissue. The hard tooth structure has to do with any disease that will affect the enamel. We call it cavity conformation or dental caries and we have the disease of the soft tissues or supporting structures of the teeth. It may be the gum, which is the periodontal disease and other parts of the tooth.
Race and environmental factors tend to affect the prevalence or occurrence of these dental problems at a particular point in time in different environments.
There is also oral cancer. Some may be benign while some are malignant.
Are they very common?
They are common; the only challenge we have is that patients don’t come to the hospital because some of the oral cancers are not painful at the onset and the swelling is gradual.
Some people carry the swelling for between eight to ten years and sometimes fifteen years until when they start to have deformation or cosmetic embarrassment. That’s when they seek medical advice and by that time it’s almost late. In fact, a very serious damage must have been done and surgery to correct that is very expensive.
What is the burden of dental caries in terms of available data?
If we are to look at available data, we will be talking about 25 per cent to 30 per cent of our population that comes down with dental caries.
Dental caries or cavities, which are also known as tooth decay, is a breakdown of teeth due to acids made by bacteria.
The cavities may be a number of different colours from yellow to black. Symptoms may include pain and difficulty with eating.
It’s a cross-sectional thing; it cuts across male, female, children and adults. If children takes things that will lead to it, it will happen. If adults, too take some of those things that will lead to it, adults too will develop it.
Specifically, what are the causes?
The four major things interplay in the development of dental caries; if one is missing out of those four major things, dental caries will not occur.
Number one is that it is not the quantity, but the frequency of the intake of refined sugar that is behind it.
Secondly, a susceptible tooth could also develop caries; that is to say that some teeth are made to have caries because of some things happening in them.
Then, the immunity of the patients is also very important and finally, bacteria in the saliva is another major problem leading to caries. All of us have bacteria in our saliva. So, when there are those enabling environment in the patient’s mouth, the patient will develop caries. We all have different species of bacteria in our mouth. Those four factors are very germane to the development of caries.
How can people prevent developing caries?
That’s why I said, it is not the quantity of refined sugars consumed that causes it, but the frequency. Even if you are taking it in small quantity, but also taking it frequently, the refined sugar will increase your risk of developing tooth decay. If you engage in taking refined sugar from morning till night, under one month, you will develop carries. Whereas, I might just sit down before my wife’s refrigerator before my lunch and take all the cakes there. You will realize that I will not have dental caries while someone taking tom-tom on regular basis throughout the day will have dental caries.
So, it’s the frequency of the intake of sugary diet that fuels tooth decay. For example, if before you leave your house in the morning, you drank tea or coffee with sugar and milk; When you get to work, you had another coffee or at meeting, they served you meat pie and soft drinks.
Thereafter in the afternoon you say, “Oh!, I’m really hungry. Can I have soft drinks,” which also contains refined sugar. Similarly, before you go to bed, you say, “Oh! You must give me my coffee” with milk and sugar. Before you know it, you have challenged your mouth regularly, eight to twelve hours with sugary substances.
Therefore, if you do that consistently for one month, you will have to get a good deal with your dentist.
One paramount method of prevention is, whether there is complaint or not, you must make sure you see your dentist every six months or twice a year.
You must also brush your teeth twice a day, first thing in the morning and last thing before you go to bed at night.
Similarly, you must make sure that you avoid what is called ‘in-between’ meals. You have taken breakfast, then you see somebody taking chin-chin, you take a little; someone is eating When you’ve taken your breakfast, you should relax. When you want to take snacks, take snacks and rinse your mouth and end it there.
Much more than that, you ought to involve in principles of hygiene; it’s very important and that is why I said that you shouldn’t wait until you a have a complaint before you visit your dentist.
In addition, you should use what is called medium toothbrush. In the market, there are trademarks, showing types of toothbrush; we have soft, medium and hard brushes.
Look on the packet, you will see medium for adults and then, you ask your dentist to teach you how to brush your teeth. It’s very important; we call it oral hygiene instruction.
If you do all that, you can keep your teeth for a lifetime, except you have trauma.
National hospital receives 2nd cancer treatment machine
The National Hospital, has taken delivery of the second Radiotherapy machine for Cancer treatment, in Abuja on Monday. The Elekta machine for Linear Accelerator (LINAC) is made up of several components to be coupled and installed soon.
Speaking in a brief interview at the hospital, the Chief Medical Director (CMD), National Hospital, Dr. Jeff Momoh, said the Abuja Radiotherapy centre would be the only centre in West Africa running two Linear accelerators at the same time. This, the CMD explained, was to avoid running down the 1st machine which has currently treated over 200 patients.
Describing the arrival of the 2nd machine as a major breakthrough for the country, the CMD said its installation would further check medical tourism as patients who travelled abroad for cancer treatment would return home to receive treatment at the centre.
In his words, “A cancer patient has returned from India for treatment at the centre and we will soon see patients from other sub-regions receiving cancer treatment in the hospital because with the state of the art equipment available, it will be the best Cancer treatment centre in West Africa”
Commending the Minister of Health, Professor Isaac Adewole, for seeing to the delivery of the machine, Dr. Momoh informed that the procurement of the second machine was made possible by the unflinching commitment of the minister who had earlier made a pledge to the hospital in that regards.
According to Momoh, similar machines would soon be installed in each of the six geopolitical zones in the country.
On the maintenance and optimum functionality of the Cancer machine, the CMD said the Hospital has fully trained the First set of Nigerians on the maintenance and supervision of the Linear Accelerator under the supervision of Engr. Ikede John, a Deputy Director in the National Hospital, Abuja, to ensure its proper use.
To ensure safe delivery of the machine was, the representative of its manufacturer, JNC International Ltd, Engr. Wale Akinola.
UNICEF says world is failing newborn babies
Global deaths of newborn babies remain alarmingly high, particularly among the world’s poorest countries, UNICEF said today in a new report on newborn mortality.
Every year, 2.6 million newborns around the world do not survive their first month of life. One million of them die the day they are born.
Globally, in low-income countries, the average newborn mortality rate is 27 deaths per 1,000 births, the report said. In high-income countries, that rate is three deaths per 1,000.
“While we have more than halved the number of deaths among children under the age of five in the last quarter century, we have not made similar progress in ending deaths among children less than one month old,” said Henrietta H. Fore, UNICEF’s Executive Director.
“Given that the majority of these deaths are preventable, clearly, we are failing the world’s poorest babies.”
The report notes that eight of the 10 most dangerous places to be born are in sub-Saharan Africa, where pregnant women are much less likely to receive assistance during delivery due to poverty, conflict and weak institutions. With the newborn mortality rate of 29 deaths per 1,000 births, the global estimates rank Nigeria as the 11th highest on newborn deaths.
In the recent Multiple Indicator Cluster Survey (MICS) conducted by the Government of Nigeria in 2016/17, the rate of newborn deaths per 1000 births is 37. This national average hides the differences between the 36 states and the slow progress in some of them.
“A fair chance in life begins with a strong, healthy start. Unfortunately, many children in Nigeria are still deprived of this,” said Mohamed M Fall, UNICEF Nigeria’s Representative. “MICS data tells us that the trend is improving but urgent action needs to be taken for Nigeria to reach the Sustainable Development Goals (SDGs). It cannot afford to fail its newborns today.”
More than 80 per cent of newborn deaths are due to prematurity, asphyxia, complications during birth or infections such as pneumonia and sepsis.
These deaths can be prevented with access to well-trained midwives during antenatal and postnatal visits as well as delivery at a health facility, along with proven solutions like clean water, disinfectants, breastfeeding within the first hour, skin-to-skin contact, proper cord care, and good nutrition.
However, a shortage of well-trained health workers and midwives means that thousands don’t receive the life-saving support they need to survive.
This month, UNICEF is launching Every Child ALIVE, a global campaign to demand and deliver solutions on behalf of the world’s newborns. Through the campaign, UNICEF is issuing an urgent appeal to governments, health care providers, donors, the private sector, families and businesses to keep every child alive by:
Recruiting, training, retaining and managing sufficient numbers of doctors, nurses and midwives with expertise in maternal and newborn care;
Guaranteeing clean, functional health facilities equipped with water, soap and electricity, within the reach of every mother and baby;
Making it a priority to provide every mother and baby with the life-saving drugs and equipment needed for a healthy start in life; and
Empowering adolescent girls, mothers and families to demand and receive quality care.
New blood test shows promise for early autism detection
Scientists yesterday said a new blood and urine test that could detect autism early in children’s urine and blood, was underway.
The researchers from the University of Warwick, United Kingdom (UK), said their test could lead to earlier diagnosis of autism spectrum disorders (ASD), a major factor that was key in the management of children living with the condition.
A new study, which unveiled this development, was published in the Molecular Autism journal. Autism, or ASD, refers to a range of conditions characterised by challenges with social skills, repetitive behaviours, speech and non-verbal communication, as well as by unique strengths and differences.
Diagnosing autism over the years, especially in developing countries including Nigeria, has been a difficult task and this, in addition to poor awareness about the condition, poverty and stigma, had contributed to make many cases go undiagnosed until very late when affected children had become adults.
However, scientific evidence showed that early detection of autism and medical intervention, often resulted in good treatment outcomes, enabling many autistic children achieve independent living. Currently, there were no biological tests that can spot autism, which was often diagnosed through behavioural assessments by clinicians.
Often the personnel and equipment for conducting these tests were available in mainly health facilities located mostly in urban centres, leaving thousands of autistic kids from poor background in rural farto- reach communities, unable to access the therapy. In the new study, researchers tested children with and without autism and found higher levels of protein damage in those with the disorder.
They looked for chemical differences in the blood and urine of 38 autistic children and 31 children without the condition, all aged between five and 12. In those with autism they found higher levels of protein damage, particularly in the blood plasma, which they said were associated with illhealth.
Dr. Naila Rabbani from the University of Warwick, who led the study, said the tests could ultimately be used by doctors to diagnose autism earlier in childhood by detecting these markers. Rabbani added that she hoped the tests could also eventually reveal some of the factors that cause autism and improve its diagnosis.
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