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Importance of regular dental check-ups |01 December 2017

The dental department of the Ministry of Health has been providing dental care services for many years. It has been observed that there is an imbalance in terms of how patients access the service. Considerably more patients report to dental clinics for relief of pain compared to preventive dental check-ups, despite numerous efforts to promote prevention and early visits.

This pattern is more common among the adult population. The latest dental statistics reveal that a total of 20,460 adult patients attended government dental clinics on Mahé, Praslin and La Digue for the period of January to August 2017, the bulk of which (84.5%) was made up of symptomatic dental visits. There is also the concurrent issue of patients not attending their appointments, which amounted to 1,894 missed dental appointments for the same period, which could have been allocated to other patients in need.

In a bid to further educate the public and raise awareness, the dental department spoke to the Seychelles NATION to explain the importance of regular dental visits.

 

What does a regular dental visit entail?

In Seychelles, dental check-ups are performed by dental therapists and dentists. Dental therapists attend to children from 0 to 16 years of age and dentists take over from 16 years onwards.

A dental check-up starts off with a short interview, whereby the dental therapist/dentist talks to the patient or parents, if the patient is still a child, to obtain relevant demographic and health information. Following this, the dental therapist/dentist thoroughly examines the patient’s teeth, gums, tongue and other areas of the mouth and records all clinical findings in their dental charts. If the patient requires any specific treatment, they are informed and treatment or referral to a hygienist/specialist is issued.

 

What is the importance of regular dental visits and what are the consequences of missing these visits?

Oral health is part of general health. Regular dental visits serve as a continuous opportunity to not only assess the status of the mouth but also the rest of the body. Sometimes, certain medical conditions, e.g. diabetes, can also manifest and are pre-detected through initial changes which occur in the mouth.

Regular check-ups allow for early detection and treatment of dental diseases. In Seychelles, common dental diseases include tooth decay, gum disease and mouth cancer. While the prevalence of mouth cancer is on the increase, tooth decay remains the most prevalent one.

All three conditions occur on a continuum from early pain-free stages to advanced stages associated with severe pain and discomfort. It is usually during these late stages that most people report to the dentist, whereby treatment can be complicated and not what the patient desires.

For instance, advanced decay extending into the tooth nerve and blood supply requires total tooth removal or a complex treatment called root canal therapy. The latter requires multiple follow-up appointments and can sometimes be unsuccessful, ultimately leading to tooth loss.

Patients reporting with advanced gum disease and obvious tooth mobility often have no other choice but to lose that tooth. It has also been observed that many patients welcome the proposition of having a tooth removed when in severe pain, without taking into account the forthcoming implications of tooth removal.

Tooth loss can de-stabilize the way a person’s teeth fit together and affects their ability to chew food properly, ultimately impacting on the digestive process. Furthermore, the replacement of natural teeth with artificial ones may pose additional discomfort and social limitations. Similarly, most mouth cancer cases in Seychelles are detected when the cancer is far advanced with poor prognosis and high mortality risk. Regular dental visits can not only reduce these complications but can also prevent unnecessary pain and discomfort.

Dental check-ups also enable the detection and monitoring of different kinds of abnormalities of the mouth. For children transitioning from primary to permanent teeth, it is only through regular visits that the dental therapist can detect cases of incorrect tooth alignment and refer on time for specialised orthodontic treatment. Failure to address these cases early may signify more lengthily or unsuccessful treatment due to missed development growth spurt.

 

What is the procedure for regular dental check-ups?

All patients are advised to undergo a dental check-up appointment once every year, unless they have been instructed otherwise by their dental care provider to attend more frequently because of increased risk of dental problems.

Patients are advised to contact their respective dental clinics personally, or by phone to book an appointment, and in the event that they are unable to attend, they also have to notify the clinic in advance so that the appointment slot can be allocated to another patient.

 

What are the implications for the dental unit when patients do not attend regular check-ups?

This exerts tremendous pressure on most dental clinics with a large influx of patients early in the morning, wanting to be seen as soon as possible, which is even more problematic for clinics staffed with only one dentist.

Symptomatic dental visits carry greater financial implications than regular dental check-ups. This is because patients reporting with advanced dental problems require more complex treatments associated with expensive materials and instrument cost. Patients attending a routine dental check-up , may just end up having a scaling and polishing procedure and one-surface tooth restoration while another patient who presents with severe toothache may require a diagnostic radiograph, medications, a first stage root canal procedure followed by multiple visits whereby additional materials will be used. Widespread symptomatic dental visits in all clinics also have greater economic implications for the country, in that these signify more time away from work for our workforce and disrupted learning for the child patients.

 

What challenges are faced by the dental unit which may deter patients from attending regular check-ups?

Recently, the dental department has improved in terms of infrastructure and service expansion, with the provision of an additional dentist at the newly re-opened Les Mamelles and Anse Royale dental clinics on specific days.

However, the department is still in need of more dentists to cater for the population. There are issues about long waiting times and availability of appointments, which are partly due to the shortage of dentists and also large volumes of patients presenting all at once in the mornings.

Additionally, complex dental procedures such as root canal therapy take up more appointment slots. Having more young Seychellois joining this noble profession will be a positive boost and will definitely help to overcome these constraints.

 

What is your advice for patients to help ease the challenges you mention above?

All patients are advised to attend their appointments. Additionally, patients need to understand that if following their initial dental visit, they no longer have any symptoms, they still have to abide by the dentist’s advice and attend their follow-up appointments. This is because some treatments provided for relief of pain, e.g. temporary filling, is not the final treatment and may eventually fail and cause even more severe pain if not attended to in the follow-up appointment.

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