By The Surgeowriter
Reproduction and nutrition are the two biggest drivers of evolution. You need to be there and have a means of energy to fuel your metabolic processes. Your mouth ensures proper nutrition and serves as the gateway to your body. Our mouths matter. The ability to feed without difficulty matters as much as the food itself. Good nutrition is our means to the future and optimised evolution.
However, your body system must be protected from the bugs in your mouth, which are accumulated from exogenous sources. Those microorganisms are deadly and work synergistically to break through your defences, turning your head and neck muscles into a malodorous, slurry black paste. In some cases, it just chokes you out of your breath when your neck is expanding dangerously in a condition called Ludwig’s angina. You literally bask on the brink of death, experiencing intense anxiety and palpitations. You cannot swallow anything, even your own saliva, for days. You are dehydrated, sweating, hungry, cannot lie down and do not have the energy to stand. That is worse than misery. It will strip you of your dignity and comfort. It will rob you of your hope and end your life and dreams without warning.
I have seen how demeaned and almost crazy patients with dental pulpitis can be. They come to hospital at 5 am when their tolerance is stretched taut, and their fuse of rationality is totally blown out. When they see anyone with a white coat, they want the tooth extracted. No amount of convincing about saving it works. Ask anyone who has had real dental pain about their experiences and they will run out of adjectives trying to describe the pain felt. Some women say it is worse than labour pains of childbirth. I don’t think they were trying to be poetic; rather, they were trying to characterise the pain’s demeaning nature.
As a maxillofacial surgeon, I struggle to block the gate to death for patients with such serious and advanced maxillofacial infections. I often feel like the last ditch of hope. However, I feel like a porous goalkeeper because, in this strange football, too many balls are shot at my goal, to the point of being overwhelmed. To clarify the metaphor, each goal scored represents a life lost due to a preventable cause. The team players are working hard, but the controller (financier of public oral health) is absent without apology. He is our strongest player and our fortress, and his absence is as deflating as it is devastating.
Each goal scored represents a life lost due to a preventable cause.
I often leave the theatre with a smell of rottenness that lingers for almost two days despite a purging antiseptic shower. I don’t mind because that is my battle, my calling and the hope for my patient. Half of such patients do not get out alive. Those who make it need immense resources, which may include ICU care. They need protracted daily wound management and sometimes many theatre episodes, first to control the disease and second to resurface the wounds and skin lost to it. Sometimes pus enters the chest cavity, and a chest tube is needed to remove it. Imagine a crushing force on your windpipe and a third load restricting your lungs to take in oxygen.
What is concerning is that the deaths from such severe infections are preventable. Almost all of those infections are odontogenic, coming from decayed teeth and periodontitis. By the time such cases get to me, we are almost more inclined to faith and superstition than science. When your doctor tells you about God openly, your bleak fate is almost assured. Such is the anticlimactic experience for the patient, relatives and the doctor. We don’t need to overburden God with what we can do through our common sense. Kenyan dentists and oral health care workers have world-class training, which any human resource can dream of, but they lack the simple inclusion of oral health financing platforms, including inclusion in SHA packages.
It is not a rationalization of resources. It is a definite trivialisation of collective human effort. Oral health cannot be shelved for years and years without solid justification. It is simple and lazy exclusion. Sadly, I have witnessed intense lobbying by healthcare across political offices to gain attention. The fragmentation of the body is appalling. Sadly, health cannot be politicized. It can only be understood and acted on. Even a small tax increase for people, with a genuine plan to protect them, is still better than leaving them to known danger.
Please fund the Kenyan public oral healthcare with taxpayers’ money. Kenyans own both their teeth and the money. Fortunately, money can help solve their dental problems. Thank you.
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Fund Oral Healthcare With Taxpayers’ Money (PDF, 2 pages)
About the author
The Surgeowriter is a maxillofacial surgeon writing on oral health and health financing in Kenya.
The views expressed in this article are those of the author.