Dental Tribune UK Edition, October 25-3, 2010, No.26 Vol.4

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Latex Free Nitrile Supersoft Flexible Powder-Free Gloves Promotional Price from £3.50 per box • The micro-textured surface ensures a good grip on instruments. • The gloves contain no Natural Rubber Latex proteins to ensure that no Type 1 Immediate hypersensitivity reactions occur in individuals who are sensitised to Natural Rubber Latex. Supersoft Flexible Tribune_feb10:Precision 12/2/10 15:31 Page 1 O ver the past couple of years, you will no doubt have read numerous articles outlining some of the day-to-day failures seen within the NHS (some even by myself, perhaps). While the difficulties have been much publicised, many of the things we get right are often forgotten and, dare I say it, taken for granted. The advantages of the NHS are even more noticeable when looking at developing countries, where a lack of basic provisions often results in the spread of disease considered eradicated in the west. Reaching out Let me turn your attention to the work of Christian dental charity Mercy Ships, who pro- vide free medical and dental care for countries who are not fortunate enough to have a sys- tem like the NHS. Mercy Ships comprises of a fleet of hospital ships, which have been visiting develop- ing nations since 1978 and are crewed by volunteers offering healthcare and other profes- sional services free of charge. Many people in developing countries have never had the opportunity to see a dentist. Den- tal care is almost non-existent in much of West Africa, as well as many of the other areas Mercy Ships visits. In common with many industrialised countries worldwide, the most frequently seen oral diseases are dental caries and periodontal disease. However, unlike many coun- tries, thousands of people suf- fer from dental pain for weeks, months, sometimes even years, because of the lack of available dental care. Although difficulties access- ing NHS services can lead to difficulties for some patients in some areas, in the UK we rarely hear of death as a result of un- treated dental infections. Con- sultant oral and maxillofacial surgeon Mr Leo Cheng, who regularly volunteers onboard Mercy Ships, informs us that in third-world countries dental in- fection can and does kill. For example, because of a direct lack of healthcare, one patient required life-saving emergency treatment as a result of a spreading dental infection. Drains were inserted in all fa- cial spaces in his neck and floor of mouth and regular irrigation through the drains with anti- septics (for example, betadine, hydrogen peroxide, etc) was necessary to wash out abscess cavities within his chest. There- after, this patient was intubated in ITU and was kept in ITU for three days before extubation. He continued to receive irrigation of his mediastinal abscesses for another two weeks before his in- fection was under control. First-class dentistry for the third world Onboard, the volunteer dentists, nurses and hygienists play an important role in the prevention of dental diseases and help edu- cate patients by showing simple oral hygiene tips, as well as by introducing fluoride to the oral cavity. While many patients have to undergo procedures such as the extraction of teeth and roots, dentists are also able to restore teeth with composite fillings. Mr Cheng also informs us that when at one point den- tal students had come on board to observe Mercy Ships in ac- tion, in the short time they were there, they ended up extracting more than 90 roots and teeth, more than required for their en- tire dental training! Deformities in developing nations For the poor in developing na- tions, accessing necessary medical and surgical care is extremely difficult, due to their remote location, lack of medi- cal facilities and financial con- straints. Conditions that would be treated in the early stages in developed nations grow to the point of being life threatening in undeveloped nations; the conse- quence for many is a lifetime of disability and rejection. Cleft lip and/or palate is a condition easily repaired in the developed world; however, cleft lip babies born in developing countries are often malnour- ished because they cannot feed properly. Children who do sur- vive are often rejected because of their deformity. The statistics tell us that cleft lip and palate is the number one facial birth defect and the fourth most com- mon birth defect overall, affect- ing 1 in 700-1,000 live births (WHO). In the UK, cleft lip and/or palate is routinely treated at a young age, however, in West Af- rica it can be left untreated. In West Africa, superstition also plays an important role in how children with facial deformities are treated. I am informed that many children with this condi- tion are kept hidden from view, rejected by friends and family, stoned if they appear in public and in some cases have been buried alive. Superstitious practices The lack of healthcare provision and education has meant that in many cases, witch doctors or village chiefs are often the first port of call for many local villagers. Unfortunately, the ad- vice given can have disastrous consequences for those affected. Rather than recognising these conditions as defects, which may be corrected through surgery, often the cause is put down to the devil or to evil spirits. Much of the advice given is based on local superstition and a real lack of healthcare access means that, for many, there is no option other than to take this advice. In a recent report by the BBC, Humphrey Hawksley reported that, while billions of dollars of aid have been invested in pro- grammes to modernise Africa Putting things into perspective Neel Kothari talks to Leo Cheng about the work of Christian dental charity Mercy Ships and how it’s providing many West African communities with much-needed dental care page 8DTà ‘Thousands of people suffer from dental pain for weeks, months, sometimes even years, because of the lack of available dental care’ 7FeatureOctober 25-31, 2010United Kingdom Edition 7United Kingdom Edition