The medical neglect of the African mouth
A recent article reminded me of the sorry state of dental research, practice and policy in Africa. When health care systems are compromised by poverty and civil conflict, dentistry is regarded as a luxury and treated accordingly. The article is focused on Swaziland: a country of 1.2 million persons served by nine private dentists, along with another 15 public dental practitioners, although the latter do not have the specialized skills to conduct root canal procedures or the fitting of dentures. What's worse is that the diet of Swaziland (like much of Africa) is becoming more 'Westernized', i.e. more processed and sugary foods are hitting the markets, leading to cavities unlikely to be filled. A rise of a neo-Medieval practice of tooth extraction is likely to accompany the change in food habits.
While oral conditions are not typically life-threatening, anyone with a toothache (or other dental conditions) can attest to their negative impact on quality of life. And quality of life, on that level, anything but a luxury. Given the track record on affordable and equitable access to primary health care on the continent, as well as the traditional subservient position of dentistry within the culture of medicine, the road to better dental health and dental practice in Africa looks to be long, hard and bumpy.