The UDA carried out a successful outreach to Kitalya Mini Max Prison on the 26th Of October 2021. This is the commencement of our 60 years of dentistry- anniversary celebration. We were pleased to reach out to this community of underserved individuals and offer them much needed dental care. Like most populations that are cordoned off from the general public, there is a great need for improved dental service availability on a regular basis. Having a population of 3200 inmates, the prison is unfortunate to receive the services of a dentist only once every 3 months. The dental officers attached to the prison are required to serve so many other prisons. This further exacerbates the dire situation.
We noted that the most prevalent conditions were dental caries and periodontal disease. Periodontal disease is a silent killer. It is usually painless and slowly progressive, but almost always results in loss of multiple teeth. It begins from poor oral hygiene which allows buildup of harmful plaque and eventually calculus deposits on the teeth. It is these deposits, yellow/green in color, commonly known as Kaboole, that initiate the destruction of structures that anchor the teeth firmly in the mouth. Over time, teeth become mobile( shaking) to the point that they could even fall out on their own while someone is eating. Many of the cases we saw were at an advanced stage where the only thing that could be done for the patient was to extract the tooth. We noted multiple cases of advanced dental caries( holes in the teeth); so advanced that some teeth were too broken to be used for chewing anymore. Similarly, the best thing that could be done in this instances was extraction to prevent the infection from spreading further. Three learning points are raised here; first, the importance of good oral hygiene. Brushing twice daily should be commonplace. In addition to tooth brushing, regular dental cleanings are called for. More than half of the general population will need a cleaning done at least once a year. This professional cleaning removes accumulated calculus deposits, therefore protecting the teeth and gums from the effects of periodontitis. Secondly, regular dental checkups should be emphasized, among children and adults alike. Early detection of caries leads to early resolution ( such as fillings, root canal treatment) which are aimed at ensuring the tooth stays in the mouth and is able to function normally.
Finally, oral health education should be embraced within schools, prisons, nursing care homes and all other secluded communities. People should know how best to look after their teeth and the consequences of falling short of proper oral care.
The bigger question is how do we ensure continuity of dental care provision year in year out in environments that are cut off from the normal way of life of the general public? The UDA used this as a pilot project and we intend to scale it up in 2022 and onwards, taking dental care services to other prisons all over the country. The Commisioner for health, Uganda Prisons was in full agreement concerning scaling up this activity in the coming years. Ambitious as this sounds, it is necessary that as professionals, we give back to the communities we serve.
Dr Trevor Kwagala
The writer is a Dental Surgeon at Basil’s Dental Clinic and General Secretary of the Uganda Dental Association.