Dentists aim to dispel oral health misconceptions
Professionals say some teens have already started wearing dentures due to poor habits. By Onnucha Hutasingh
'Bad dental health, poor appetite" is an old saying by King Rama IX which may sound very general yet well reflects the dental health situation of people in rural areas observed by the late King on his visits to the provinces.
The situation has not much improved considering the presence of a common habit that has been impeding Thailand's efforts to improve people's dental and oral health -- that Thais visit a dental clinic only when they get a toothache.
Recent surveys and studies have found that many Thais still have this die-hard habit.
"This attitude has been unintentionally fostered when parents tried to make their children behave by threatening to take them to a dental clinic for a jab, which created a scary perception of the clinic and discouraged them from visiting," Adisak Jarasmatawit, a dentist at Bung Khla Hospital in Bueng Kan, said half-jokingly.
In principle, everyone should visit a dental clinic twice a year at least to have their overall dental and oral health checked by a dentist so that any progressing problems could be fixed in time, he said.
At the very least, regular teeth cleaning is needed to maintain gum health, he said.
Poor dental care habits have led to poor dental health, which often ends up with the need to wear dentures when it is too late to save real teeth.
"The problem occurs even sooner these days. Many people in their teens now need to wear dentures and the culprit is those sugary candies advertised to be mouth fresheners," said the dentist.
Aside from the bad habit of visiting a dental clinic only when toothache strikes, the fact that most dental problems require multiple visits to complete a lengthy treatment and care process is another critical factor, he said.
In most cases, these teens require dentures to replace their missing front teeth, he said.
Bung Khla district has a population of about 12,000 while there are only two dentists and four dental nurses and dental health officers, which undoubtedly isn't enough to take care of everyone living in the border district.
One effective strategy is preventing them from developing dental health problems, starting with young children at day care centres around the district, said the dentist.
Health volunteers have been assigned to teach these children to learn to take care of their dental and oral hygiene, while prohibiting sweetened milk from being sold to them, he said.
"Two years have passed now since the launch of this dental health promotion project and the results are good. No child at the daycare centres is found to have a decayed tooth," he said.
As for students at all 11 prathom primary schools and mathayom high schools, he said, appointments are made for them to take turns to visit the hospital's dental department regularly for checks and training on how to brush their teeth properly and take good care of their gums.
In older groups, the working age population usually has no problems visiting a dentist for regular dental care and check-ups, but the elderly people have.
A recent study carried out by the hospital found that the wrong and negative attitudes about dentures kept many elderly people from visiting a dental clinic, he said.
Among the many common misconceptions about wearing dentures is that they believe they still could chew food with their bare gums, it's inconvenient to have to clean dentures regularly, wearing dentures isn't comfortable and it will cost a lot of money to ask for dentures, he said.
The fact is the provision of dentures under the National Health Security Office (NHSO)'s universal health scheme is free of charge.
A full set of 4,400 baht and a piece of between 1,300 baht and 1,500 baht are all covered under the healthcare scheme.
However, each patient is required to visit a hospital at least five times, two to four weeks apart, in a standard process of making a set of dentures and fitting it into his or her mouth which may discourage some to complete it and end up giving up in between, he said.
Fitting dentures into the patient's mouth isn't always the final step as some patients still require adjustment of their dentures while using them in daily life.
"Uncomfortable, too tight and painful," said a 95-year-old patient in describing how he was feeling when wearing a given set of dentures, which discouraged him from continuing to wear them.
The man agreed to revisit his hospital's dental clinic only after a health volunteer kept visiting him at his home and encouraging him to see his dentist to have his dentures checked and fine-tuned, said Mr Adisak.
However, not all elderly people have a negative attitude toward wearing dentures.
Thongdi Sichan, 92, for one, has been wearing the same set of dentures for more than 25 years. He is meticulous about taking good care of his dentures, cleaning them up every time after a meal, which explains why the set is still in good condition.
Twenty-five years ago, dentures sold by a denture craftsman in Mr Thongdi's village weren't very good and were expensive, said Mukda Sichan, Mr Thongdi's daughter.
The very set of dentures her father has been using for 25 years was provided under a denture project sponsored by Princess Srinagarindra, the late Princess Mother of His Majesty King Bhumibol Adulyadej The Great, said the daughter.
"My dad is still healthy physically and mentally because he eats well and is happy anytime he eats," said Ms Mukda.
Mr Thongdi, however, admitted that the dentures on his lower jaw have begun to loosen, saying sometimes that when he laughed heartily, he felt like they might fall out of his mouth.
He laughed aloud after saying so.
Each set of dentures provided under the healthcare scheme is intended for use for five years at the most, during which time free fixes will be provided if partially broken, said Atthaporn Limpanyalert, secretary-general of the NHSO.
In most cases, patients usually have a problem with their gums on the lower jaw which become shrunken and too flat as a result of the pressure applied during food chewing with the gums, said Physicspong Buengmoom, another dentist at Bung Khla Hospital.
As the shrunken and flat gums fail to hold the dentures well, patients wearing them feel uncomfortable with the loosening artificial teeth and unhappy about wearing them, said the dentist.
The only remaining option, therefore, is the dental implant, he said.
With at least two artificial tooth roots fixed firmly either on the upper and lower jaws to allow a set of dentures to be fitted to them, the dentures won't move or loosen ever again, he said.
The costs of a dental implant surgery vary depending on where the artificial tooth root comes from, he said.
A set of artificial tooth roots made in Europe costs about 70,000 baht to 80,000 baht while one produced in Asia costs about 20,000 baht to 30,000 baht, he said, adding that the NHSO provides a set costing about 24,200 baht.
Aside from the high prices of the artificial tooth root, another important limitation is that only a dentist who has been trained specifically on dental implanting can perform the task.
"Yes, in the entire province, I'm the only dentist who has been trained on dental implanting, unfortunately," said Mr Physicspong.
In conclusion, he said, good dental and oral health is something that can be achieved only when both the dentist and the patient are committed to being patient and working well together toward this very goal.