By Dr. Samuel Awosolu
Health care delivery has its teething problems and limitations. There is the ideal of healthcare delivery being affordable accessible and without any prejudice to health, race, gender etc.
In equality on the other hand is not acceptable ideally in the delivery of health care services and indeed oral health care.
This brings the discuss to the crux of the matter, it is believed by many school of thought that the oral health care status of the individual indeed reflects on the general well being of the individual. This does not resonate well with the majority of the populace. This is easily attributable to the level of awareness /education/perception. A sizeable majority of the population feel that the teeth is not as important as other organ systems , heart, lungs , kidney etc.
The reverse is actually easy to actualise as the oral cavity is the inroad to the innermost parts of the body; it is then subjected to a lot of wear and tear.
It is easier to pay a medical doctor or physician a couple f thousands in consultative and treatment fees as the other may request for some tests from laboratory obtain blood etc then he prescribes medication.
In contrast most people that visit the dentist come at the terminal stage of tooth decay and any other debilitating disease , so the treatment is often not conservative, A lot of people then have the misinformed notion dentistry is all about extraction, However far from dentistry just being an extraction of the teeth. Dentistry however is more than that there are restorative procedures, dietary advice, advice on cessation on smoking etc.
It is necessary to inform that most pre-requisite to set up a private dental surgery are quite more extensive, expensive than a medical consulting room. The machinery have to be shipped from overseas, similarly consumables are to be shipped from overseas very rarely are things used in dentistry, manufactured locally. With the exchange rate unfavourably skewed against the Nigerian currency, the naira… Rotary instruments need to be maintained with parts from overseas and engineers hard to source even locally. Then there is the attendant epileptic power supply so incurring costs of generating sets , inverters or solar energies, Other complimentary equipment , x-ray machine, panorex x ray machines, annual licence fees, professional staff bills , rent, regular continuing education as the professional field is rapidly changing and new innovations and techniques and materials the dentist then needs to update himself and move with the times. Local Government fees, taxes and rates. In government hospitals these fees are highly subsidised.
This brings the decision to set dental fees up, the overheads are important to view and sometimes the dentists are realistic about the initial profit. It might be necessary to set achievable profit levels. The foregoing makes dental services likely to be a little on the above average cost.
Dentists and most professionals are not helped with their inability to access soft cushioned loans from the banks who in turn inform of the myriad of banking regulations placed on them by the apex banks, a sort of catch 22 situations.
Dental problems are massive and under reported in the general population as in most developing countries, yet access and affordability prevents the problem from abating, bearing in mind that preventive oral health is cheaper than the curative aspect in most occasions.
Diet as we all know impairs on general health and indeed oral health most especially , the drawback is that whilst dietary styles in the western world is changing for the better that in the developing world seems to have progressed to the poor level that caused oral health problems in the developed nations. Whilst there are no clear cut statistics to determine this accurately it becomes clear that the reportage of those in the treatment theatre or front line I mean the dentist is one of increasing worsening oral health status of the average citizen. This can be extrapolated to be a general reflection of the population as a whole.
In the United Kingdom for example The NHS National Health Service was created to tackle this inequality to access health care and oral health care inclusive.
It is worth mentioning that no health care is perfect no matter the best intentions , however they are to be seen in trying to address teething health issues for example Obama care was derided by the opposition parties as being socialist , communist and of poor quality even by Ben Carson one of the foremost neuro surgeons known for hemi spherectomies that is dividing the brain into two in a living person whilst the person survived. There are different schemes for dental health worldwide from capitation where a monthly contribution is paid by the patient and passed to the dentist or general practitioner minus the administration fees.
The treatment that can be provided by the dentist are clearly specified, some may be excluded like laboratory fees, specialist treatment etc.
There are medical insurance schemes where costs of the treatment are reimbursed to the dentist. Corporate dental schemes for parastatals , banks and oil companies covering their staff and relations and the ones of course for office holders up to a dastardly and stupendous amount of 100 million naira ,” hmmmm there is God oh “.
There are saving schemes done usually with the dentist consent for more specialised treatment where orthodontics, straightening of crooked teeth is involved.
