COMMENTARY: Dominica’s oral health plan

Dominicans should be encouraged by government’s proposed National Strategic Plan on Oral Health for 2010 to 2019 to take the necessary steps to improve oral health in Dominica. This is critical because oral health is an integral and very important aspect of general health. Therefore, if one does not have good oral health, invariably, he/she does not have good general health.

But good oral (dental) health can be achieved and oral diseases are largely preventable. The bold steps which were underlined by the Minister of Health and Chief Medical officer towards the creation of a national Oral Health policy should be applauded and supported. But In order for this goal to have a chance of succeeding, some realignment and a new sense of order of doing things health-wise in Dominica may be a need to be realized.

Due to the fact that there are just a few practicing dental providers on the island, non-dental health care providers (MD, Nurses, and others) need to play a greater role in oral health care by providing diagnostic dental services, referring patients to local dentists, and educating children and their parents about the importance of oral health.

The government should incorporate training on oral health issues for primary care providers, pediatricians, nurses and others in the field to improve early diagnostic screening. This can be realized through a national program that trains primary care providers in oral health care prevention with clear pre and post assessment and evaluation goals. At least 10 hours per year of continuing dental education should be required of every licensed non-dental health care provider and professional.

The Ministry of Education should be an important partner the formation of an effective oral health policy. Schools are important partners in promoting good oral health practices and preventing oral disease. Poor oral health is an often overlooked but critical impediment to student learning and achievement. Students will be more confident, better prepared to learn and succeed if the school’s environment, policies, and personnel are aligned to help them maintain their oral health. One could say, ‘A brighter results in a brighter and better future.’

Promotion of preventive and awareness of good oral hygiene habits practice is a cost-effective and efficient way to improve children’s oral health. There should be a national effort and pledge to increase the number preventive school oral health programs.

These programs will conduct oral health education, teeth cleanings, fluoride rinses and dental sealant application. Dental sealants are plastic coatings which are placed on vulnerable molars to help prevent decay. In the U.S, a Center for Disease Control (CDC) review shows that school-based dental sealant programs effectively prevent and decrease decay for children and adolescents by 60 percent.

Dental health is often overlooked among the numerous health needs in pregnancy and early childhood. Dental disease in pregnant women is associated with pre-term birth, low birth weight, and gestational diabetes, all of which can harm the baby and may result in a more costly pregnancy. Dental care is safe throughout pregnancy. In addition to the consequences of dental health problems during pregnancy, a woman’s oral health can affect her children. Children should have should have their first dental visit by age 1 average 40 percent lower over a five-year period than for children who do not.

Regarding Oral Cancer prevention and mitigation objectives and protocols, the government and communities can reverse the rise in oral cancer prevalence by employing a few cost-effective protocols. One measure is to initiate a robust and vibrant health oral promotion and education campaign to reduce cigarette smoking and alcohol consumption, especially among young people. Primary care providers and dentists should routinely advise smoking cessation and provide assistance and follow-up for all of their tobacco-using patients.

These providers should screen for alcohol and other drug use problems and provide counseling and referral as needed.

In order for this national strategic oral health plan to work and be effective, the Ministry of Health will have to collaborate with all the stakeholders, and create sustainable government-public-private and community-based partnerships.