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Oral Health


Oral Health the general condition of the mouth, mouth cavity, teeth, and associated structures. In Bangladesh more than 80 percent of the population have at least one or more oral and dental diseases. Many suffer from periodontitis, gingivitis, dental caries, pulpitis, alveolar abscess etc. Dental cysts, carcinoma of the oral cavity are also common oral health problems in Bangladesh. The people of rural areas are comparatively much ignorant regarding their oral hygiene. They normally use neem sticks, ashes, etc to clean their teeth in the morning. As there is no facility for dental treatment in villages, dental patients have to report to the nearby upazila health complexes for their emergency treatment. With the existing treatment facilities, it is really difficult to provide conservative and prosthetic dental treatment to the village people. So, after the loss of teeth, they mostly live without artificial denture.

Most parents in Bangladesh usually do not give proper attention to the care and conservative treatment of milk or baby teeth on the plea that these teeth are temporary and will be replaced by permanent set of teeth. If there is any early loss of milk teeth due to disease, then the child feels difficulty in mastication.

Babies who take sugar mixed milk by bottle especially at night usually suffer from rampant caries, that is, most of their teeth are affected by caries. Due to lack of qualified dental service, there was an unfortunate growth of quack dental practice in the country. These quacks are uneducated, unskilled, and do not possess the professional knowledge. They have no idea about the use of medicine. Medical and Dental Act was introduced in 1980. It is clearly mentioned in Articles 30 of that Act that no one can practice medicine or dentistry without registration of the council. It means indigenous medical or dental practice is totally prohibited in the country and any body violating it, is liable to punishment. In article 15(3) of the Act there is a provision for granting registration by a tribunal to those nonqualified dental practitioners who practiced dentistry at least for five years before 1980.

The number of dentists in relation to the population is one of the lowest in Bangladesh. Actually there is one dental surgeon for every 0.2 million people. Oral health care delivery system in Bangladesh is conducted by the Dental Surgeons in the district hospitals. In such places a dental unit is provided to carry out minor surgical, periodontal and conservative treatment like extraction of teeth, scaling, filling, etc. There is also one dental hospital attached to the Dhaka Dental College. It renders all sorts of free dental treatment to patients. Besides, there are private dental clinics where dental treatment is done on payment.

The large industrial and business organisations have their own dental surgeons. In rural areas there is no facility available for regular dental treatment except voluntary dental camps at some places. The line of treatment in such temporary camps are usually minor extractions, scaling and temporary restoration. In several areas there are indigenous dental practitioners.

Quite a good number of people in Bangladesh are in the habit of chewing betel leaf and nut without knowing its ill-effects. It is therefore of much importance to know about the effects of betel leaf on human body, and the orodental system. Other ingredients, such as jarda, khaer, tamak pata (tobacco leaf), etc are also mixed with betel leaf, nuts and lime to make the betel leaf eating tasty. The different ingredients of betel leaf have their respective reactions, of these the most important one is the betel nut. In betel nuts, there are aricolin, tannin, alkaliod, etc. Aricolin is almost like the nicotine in cigarette. It irritates the mucous membrane of mouth and intensifies the respiration. The tanins in the betel nut slightly shrinks the cells. Lime is used with betel leaf, which breaks down the alkaloid in the betel nut by metablism. The acid juice secreted from the stomach due to chewing betel leaf makes the broken alcaloid active. The etheric oil present in the betel leaf makes the tongue less sensitive. On the whole, eating of betel leaf acts as somewhat stimulant. Those who take betel leaf for the first time may suffer from vertigo.

Regular and excessive eating of betel leaf decreases the taste of the mouth. Certain reactions are found on teeth and oral health due to eating of betel leaf. Tartars are formed at teeth roots of those who take betel leaf regularly, and suffer from gum troubles. The gum decays and in many cases the bone which holds tooth root in jaws gradually decays. As a result, the teeth become unsteady and there is an early loss of teeth. Besides, attrition occurs in the enamel as a result of excessive chewing of betel leaf. In certain cases, the dentin is found to be exposed due to attrition of enamel. This results tingling sensation in teeth and various sorts of troubles occur. There is evidence that the habit of taking betel leaf induce cancer in the mouth.

Many superstitions among the people exist in Bangladesh regarding various sorts of diseases and their treatment. Many people still believe that worms grow in the decayed teeth causing pain in the teeth. The publicity of the 'Bedenees' is the root of this belief. Due to this wrong belief, many persons for relief of their dental pain take recourse to the Bedenees. They show worm by exorcism to take money from the patient. Two major causes viz, inflammation of dental pulp, and diseases relating to gum are responsible for toothache. When the teeth are decayed small holes known as dental caries are formed in them. When this decay causes inflammation in the dental pulp, the victim experiences severe pain. [M Ashraf Hussain]