Oral health is at the bottom of Yemeni priorities [Archives:2006/1006/Health]

December 11 2006

Moneer Al-Omari
[email protected]

Qat, shammah (tobacco placed between the lip or cheek and gum), smoking cigarettes, fluoride in water and lack of heath awareness are the main factors damaging Yemeni oral health.

The Yemen Times met Dr. Khalid Al-Dhuree, head of the Mouth and Jaw Surgery Department at Dhamar University's Faculty of Dentistry, who also runs a specialized center for mouth and jaw cosmetic surgery. Al-Dhuree discussed Yemeni health culture, focusing on oral health and the role of local Yemeni habits, which lead to tooth loss.

What can you say about Yemeni health culture?

Health culture in general is absent, if nonexistent. Very few people visit doctors for regular check-ups. Yemenis are among the most ignorant worldwide regarding health. Most lack health education and don't even care. Health is the bottom priority for Yemenis. No one will visit a physician or specialist except when he falls sick. Further, being sick won't lead Yemenis, particularly those in rural areas, to hospitals or medical centers. They'll only make such a decision when they can't move, eat, drink or go about their daily business. They'll remain in bed days or weeks awaiting recovery from above.

How do you see Yemeni culture regarding dental health?

When Yemenis don't care about health in general, in principal, they also won't care about their teeth. Some haven't used a toothbrush in their lifetime – they don't even know what it looks like or how to use it. They won't even use siwak, which is prescribed in Islam and recommended by Mohammed (pbuh). Most of those coming to my center request pulling their bad teeth and don't know anything about cleaning, filling or other techniques nowadays.

Most Yemenis don't bother about their dental health. Further, they don't take any trouble to learn about it or how to protect their teeth. If it only regarded food and drink, the matter would be easy and there would be few problems. Besides the usual habits of eating and drinking, most Yemenis – especially those in the countryside – chew qat for many hours together with cigarettes and shammah.

If a bad tooth hurts, most won't seek a doctor's help, but will try to pull it themselves. If they fail, they'll go to traditional medicine practitioners to extract it using unclean dental tools, which causes many future problems, such as bleeding gums.

They sometimes will pull more than one tooth, caring little about problems that may arise in the future regarding teeth and gums, etc. Lacking the required education, most rural Yemenis pull their teeth whenever they hurt, not knowing anything about filling or treating teeth. They think about their teeth only after they pull all of them and have difficulty eating food or chewing qat, at which point they begin considering dentures.

Describe the effects of shammah, qat and smoking on teeth.

Shammah is one of the primary causes of mouth cancer, as scientifically proven by a Yemeni doctoral student in Germany, who discovered a direct correlation between mouth cancer and using shammah.

Because it's treated with chemical fertilizers, qat causes cancer and further leads to gum erosion, formation of abscesses in the gums and causes problems in the tempromandibular joint from chewing it for long hours.

Irrespective of the smoking effects everyone knows, smoking also causes mouth and tongue cancer.

When combined, using shammah, smoking cigarettes and chewing qat can lead to bad breath and teeth staining.

Do you think Yemen's drinking water has something to do with teeth staining or any other dental problems?

Yemeni drinking water is polluted and has a high percentage of fluoride and salts, which cause Dental Fluorosis and teeth staining, along with other dental problems.

What's your opinion of siwak?

I recommend it because it's been proven that siwak contains bacteria-killing materials, prevents gum inflammation and makes the mouth smell good.

If not apprehended, what effect can dental problems have on the body's other systems?

If not treated, tooth and gum problems can lead to cancer and affect other systems. Further, they can affect victims psychologically. The mouth is the outer gate to the body. Those with stained teeth often are prevented from laughing, which leads them to introversion. Tooth loss can cause indigestion and subsequently, malnutrition and physical weakness. Dental problems would be hazardous to those Medically Compromised Patients.

How do you evaluate the recent Ministry of Health workshop involving dentistry and mouth and jaw surgery?

I believe dental problems will be around as long as qat, shammah and cigarettes exist and the health culture is so weak. However, I pin my hopes on the Nov. 15-16 Ministry of Health workshop, which involved dentists nationwide.

The workshop aimed to establish a dentistry strategy wherein the Ministry of Health will have a specialized dentistry sector with a private budget.

Recommendations involved collaboration between the Health, Higher Education and Education Ministries. The Health Ministry was asked to upgrade dentistry and allocate a special budget for it, while the Ministry of Higher Education and Scientific Research was requested to allocate more scholarships for specialists in dental preventive medicine. Further, the Ministry of Education was asked to include instructional materials on dentistry in schools.

Do you have any final comments?

I implore Yemenis and your readers to give up smoking, chewing qat and using shammah.

Further, they must clean their teeth with a toothbrush and toothpaste three times a day. If there's no toothpaste or toothbrush, they can use siwak, as prescribed in Islam. Finally, they must visit a dental specialist every six months to ensure that there are no problems.

I ask parents to provide more care for their children's teeth and observe their growing up so doctors may intervene at the proper time. They also must help their children get used to a toothbrush and toothpaste because, “Prevention is worth more than cure.”