Access Crisis: Not Only A British Problem

Access Crisis: Not Only A British Problem

With constant news coverage of the UK’s dental access crisis it would be easy to conclude that this is a particularly British problem. Dentaid, the charity that began by providing assistance in Ukraine and Malawi, now runs programmes in Britain. But it appears that Brexit, the NHS and austerity are not essential requirements for a developed nation to have serious problems with dental services.

A recent report from the WHO concludes that the status of global oral health is alarming and it requires urgent action. This may not be a surprise, but some of its content may be less expected. 16/% of the global total of those suffering from oral diseases live in high income countries. One section reveals that in the USA, 30% of elementary school students in the state of Maryland, had untreated caries. In the USA as a whole, 26% of adults have untreated caries, with 46% of those over 30, showing signs of periodontal disease.

Meanwhile all is not well in New Zealand. A recent paper from the Journal of the Royal Society of New Zealand showed that dental decay was the most prevalent non-communicable childhood disease nationally. The paper’s lead, paedodontist Dr Dorothy Boyd, said that, “Despite the hard work of dental professionals in the midst of the early childhood caries tsunami, every part of the oral health care system is stressed, with long waiting lists, inconsistent collaboration between primary, secondary and tertiary care, and inconsistent access to, and types of, care offered across the country.” Referring to regional and social factors affecting access she said that “The entire oral healthcare workforce is under-resourced, and Māori and Pasifika are under-represented in it.”

The high cost of care and resulting lack of access is not a new feature of life in New Zealand. In 2020  special care dentist Juliet Gray, commented that she had a patient, “nearly every day who has attempted to dig their own teeth out using, most commonly, screwdrivers and knives.”

“We are appalling, we are shameful in New Zealand, shameful,’’ said Gray. ‘’Only about a third of New Zealanders regularly access dental care. Most people can’t afford it.’’ She went on to compare her country unfavourably to others, including England.

Closer to home, France has a serious dental workforce problem.  Figures from France’s health ministry, published in November 2021, revealed that there were on average 62 dentists for every 100,000 people, lower than the equivalent figure in the 1990’s. Again, in common with the UK, there are major regional variations with some of France’s departments having less than 40 dentists per 100,000 population. 

A French village had to resort to an unusual approach to recruit a new dentist.  The village of Champlitte, near Dijon, had four doctors, two nurses and an assistant nurse, three physiotherapists, a speech therapist, a psychologist, a podiatrist, and a dietician.  Despite this it was set to be left with no dentist, with the only one in the village retiring. After a meeting the village decided to try an unusual approach with its advertisement on Facebook. Alongside a picture showing a woman who might benefit from dental care, the post described the village as being “very agreeable” and at “the centre du monde – or at least the centre of Bourgogne-Franche-Comté anyway”. 

The same article in The Connection concluded with a story that, apart from a change of place names, would fit in very well in the UK, about a person living in Quimper (Brittany) who reported phoning 65 different dentists without being able to get a single appointment.

Toothbrush Image Credit

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