Oral Health Care
Especially in the Guatemalan interior, oral health care falls far from top of the list of common daily concerns. Basic daily tasks take much higher priority.
And yet, there are few things more painful than the pain of a toothache, and with so few options as are available, often infection and mouth pain go mostly untreated. Especially in these outer-lying areas, access consists of what the locals call “Tooth Mechanics” where tooth extractions can happen, but most often with less than appropriate tools and virtually no sterilization.
Oral hygiene is undervalued in terms of its effects on patient health and nutrition. Effective oral care reduces infection and promotes health.
The following excerpt from the World Health Organization explains the challenges developing countries such as Guatemala face in addressing oral health issues and costs.
“In some countries, oral diseases are the fourth most expensive diseases to treat. Treating caries, estimated at US$ 3513 per 1000 children, would exceed the total health budget for children of most low-income countries (3). The situation for adults in developing countries is worse, as they suffer from the accumulation of untreated oral diseases. There are few efficient dental care systems to cope with their problems, and where there are, the cost is beyond most people’s means. Millions with untreated caries have cavities and suppuration, yet planners continue to overlook oral diseases, despite their significant impact on cost and quality of life. This oversight will lead to more decay and expensive, ineffective clinical interventions.
Oral health affects people physically and psychologically and influences how they grow, enjoy life, look, speak, chew, taste food and socialize, as well as their feelings of social well-being (4). Severe caries detracts from children’s quality of life: they experience pain, discomfort, disfigurement, acute and chronic infections, and eating and sleep disruption as well as higher risk of hospitalization, high treatment costs and loss of school days with the consequently diminished ability to learn. Caries affects nutrition, growth and weight gain. Children of three years of age with nursing caries weighed about 1 kg less than control children (5) because toothache and infection alter eating and sleeping habits, dietary intake and metabolic processes…”
Poverty has many faces. It is most easily recognized by what is lacking: inadequate housing, lack of money or resources, high unemployment, poor nutrition, etc. Far more insidious is the poverty that you can’t see; social isolation, shame, fear, humiliation, desperation, all working together to erode what many of us take for granted, hope.
When the poverty of hope itself is a way of life, it becomes a communal worldview. Without hope, a community cannot believe in or dream of a better future. We believe this is the most tragic poverty of all; creating negative cultural norms that are ingrained to a point where the idea of change can be can be more daunting than staying put. Where “Status Quo” no matter what it looks like, is simply “Normal.”
Poverty is rarely a single generation phenomenon; the cycle is almost impervious. There are often huge barriers to change, but what’s really lacking is the will to hope for something different.
What if the dentistry was not an end unto itself, but a means, a way in? What if dentistry became an ‘excuse’ to eradicate poverty?
What if we offered a glimpse of a different worldview, planted the idea that things didn’t always have to be this way, or brought an abundance of hope to a community?
Guatemala suffers from a level of inequality and widespread poverty that is extreme even within Latin America. According to the World Bank’s Guatemala Poverty Assessment, many developing countries are poor, multi-ethnic, and overwhelmingly rural. Yet Guatemala stands out for the magnitude of these characteristics.
- 50%+ of Guatemala’s people live below the national poverty line
- 15% is in extreme poverty
- Guatemala ranks 13th in the world for its level of income inequality
- Families struggle to provide basic needs for their families
- Even fewer can afford the expenses associated with school.
- Past 6th grade, high illiteracy rates & low school attendance are very common.
- Access to quality health care and housing is also scarce. Preventable diseases often result in death, malnutrition is common among children, and infant mortality rates are high. All of these issues result in even greater need for dentistry.
- Many homes are made of scavenged materials: Dirt floors, no toilets or drinkable water.
- Guatemala struggles with the after-affects of a 36 year Civil War which ended in 1996.
- All of these issues, coupled with the country’s diverse ethnic heritages (including 23 recognized indigenous languages) makes generalized solutions very difficult. Requiring localized, culturally-sensitive solutions.