The Tanzania Dental Association (TDA), says TDA President, Dr Ambege Mwakatobe, must ensure, maintain and safeguard the interests, privileges and welfare of its members.
But TDA members can only help patients when they have tools and equipment to do the job. For a long time hospitals have been lacking doctors, tools and equipment to enable them treat patients with ease. Now the situation is changing for the better.
In an interview this week with Correspondent PETER KEASI, Dr Mwakatobe expresses TDA’s gratitude to the government for its recent allocation of funds to secure dental equipment in 28 public hospitals and its approval to have 1,000 young doctors employed. Excerpts:
QUESTION (Q): Mr President, recently you were one of those who attended a grand meeting between Tanzanian doctors and President John Magufuli. What would you say about that meeting? Was it inspirational, motivating?
ANSWER (A): Yes, indeed. I had an opportunity to attend as the President of the Tanzania Dental Association. The meeting was very inspirational and motivational as well. TDA is an independent body that attends to the needs of the dental profession. It was so pleasant to see how the President is committed to improving the health sector.
Q: After the President gave TDA a building, have you moved into it? Does TDA occupy part of the building?
A: Not yet. The Medical Association of Tanzania (MAT) is still working on this offer. TDA will be allocated some spaces as soon as the building is formally handed over to MAT.
Q: When was TDA founded?
A: Our association was founded on April 2, 1980 and has been registered with the Ministry of Home Affairs and has an incorporation number. Our office is located at the Dental Building, Muhimbili University of Health and Allied Sciences.
Q: Why did you start this association --- to advocate the ‘growth’ and ‘competitiveness’ of this branch of medicine --- dentistry?
A: I think so. The core mission of TDA is to promote and uphold high standards of ethics and conduct in dental practice among its members.
Q: How big is TDA?
A: Currently TDA has more than 280 members out of about 700 dental personnel in the country.
Q: How does a member benefit from the association?
A: TDA has the duty to ensure, maintain and safeguard the interests, privileges and welfare of its members. Our members can access learning opportunities through the association. TDA will also endorse applications for research grants for our members and their affiliated institutions. Through TDA, our members can receive CPD accreditation from the Medical Council of Tanganyika (MCT).
Q: How does a doctor of dentistry surgery (DDS) differ from an MD?
A: A human being is a whole person. Therefore, a symptom in one area of the body might link to an issue in another part of the body. Unfortunately, there simply isn’t enough time for one person to learn about all intricacies of the human body.
They’d be in college for their entire lives. As it is, those in dentistry and medicine already spend years in college training for their particular healthcare field. There also isn’t enough time in the day for a general physician to take care of all of their patients’ needs, including oral health.
A physician is a professional trained to identify, prevent and treat conditions affecting any part of the body. Such a physician may specialise in a particular organ system, or sub-specialise even further (such as performing only certain types of treatment or surgery).
A dentist is a professional trained to treat conditions (diseases, injuries and malformations) of the oral cavity, neck and head, but still has a baseline of generalised medical knowledge. Some specialised dentists who perform oral and facial surgeries are trained both as dentists and medical doctors.
Dental specialists are dentists who receive additional 3-5 years training in a specific dental specialty, above and beyond their general dentistry degree.
There are more than 7 specialties in dentistry. For general enlightenment let me give you a few examples: We have specialities like prosthodontics, periodontics, paediatric dentistry, orthodontics, oral medicine, oral and maxillofacial surgery, endodontics etc.
Q: I once came across the following statement from the FDI World Dental Federation: “… oral health is multifaceted and includes the ability to speak, smile, smell, taste, touch, chew, swallow and convey a range of emotions through facial expressions with confidence and without pain, discomfort and disease.” How do you relate this to the Tanzanian situation?
A: FDI is an international, membership-based organisation that serves as the main representative body for more than 1 million dentists worldwide, active in some 200 national dental associations (NDAs) and specialist groups in close to 130 countries.
A common understanding of oral health raises awareness in communities, guides oral health professionals, and encourages effective preventive care and treatment. With a universally understood definition of oral health, patients, policymakers, oral health professionals and other stakeholders can approach this topic in a united way.
FDI's definition proposes a common understanding of oral health in order to: clearly position oral health within general health, demonstrate that oral health affects overall health and well-being, raise awareness of the different dimensions of oral health and how they shift and change over time, empowers people by acknowledging how values, perceptions and expectations impact oral health outcomes.
FDI’s definition of oral health also paves the way for standardised oral health assessment of measurement tools.
Q: The Children and Youth Prosperity Organisation (CYPO) says in a 2016 study entitled: Dental Health Situation in Tanzania that the majority of Tanzanians develop tooth decay and ultimately Tanzanians have to face extraction which organisation terms as “the most prevalent mode of treatment” in Tanzania. It attributes this situation to low knowledge and awareness on oral health issues among Tanzanians. It’s a sad situation. Isn’t it?
A: This is a very sad situation indeed. Many studies are in line with this finding. The most prevalent mode of treatment in Tanzania and in many other developing countries is tooth extraction. This is partly because many people don’t have the habit to visit dental clinics for check-up.
People only visit dentists when they are in pain. At this point the damage would have gone too far, and beyond repair. On the other hand, this situation is due to insufficient number of skilled personnel or dentists, lack of proper equipment and dental materials.
You will appreciate and I am happy to say, the government has increased resources to address these discrepancies.
Q. Renowned Prof Flora Fabian was recently quoted by the press, commending joint efforts of TDA and the government towards reducing the dental disease burden, but said a lot remaieds to be done. Can you summarise what TDA has jointly done with the government to reduce the dental disease burden in Tanzania?
A: Since its establishment, TDA has been working with the government in different aspects of oral healthcare towards reducing the burden of dental diseases in Tanzania. Collaboration with the government has been through media campaigns, outreach initiatives and training in terms of CPDs, aiming at building the capacity of oral health workers in reducing the burden of oral diseases.
To give a few examples, TDA in collaboration with the Ministry of Health and Tamisemi reached 72,792 people during a week or oral health activities in commemoration of Oral Health Day on March 20, 2019. This was a big number compared to people seen and attended to in 2018. This was an increase of more than 100 per cent.
The target for this year was to attend to 95,000 people, but unfortunately the Covid-19 pandemic has highly interrupted this year’s World Oral Health Day activities. However, for the few first days before the Covid-19 interruption, we managed to attend to more than 4,000 people in Katavi Region.
Of course, people were attended to in other regions too. TDA, in collaboration with the Ministry of Health and other stakeholders is conducting a countrywide oral health survey. The results of this survey will be very crucial in obtaining base line data on the oral health status in Tanzania.
This is important in planning oral health interventions. We are very grateful to the government for allocating funds to procure dental equipment to 28 public hospitals. Recently, also the government approved the employment of 1,000 young doctors from different fields in the health sector. We are thankful for this support.
Q: Yet a lot remains to be done! Can you throw some light on what remains to be done --- and what are you planning to do?
A: As technology in medicine is evolving very fast, TDA understands that still a lot has to be done to take dentistry to the next level. Among the plans TDA has is to increase the number platforms and contents for CPD programmes.
In line with this, TDA is planning to solicit resources to establish a dental complex where dental specialists, dentists, dental therapists, dental laboratory technologists, dental nurses, biomedical engineers, and other oral health workers could easily access training to upgrade and share skills.
Q: In you rating, do you think a big number of informed Tanzanians know that disease conditions in the oral cavity may reflect systemic diseases, such as HIV/Aids and diabetes --- that those conditions may present symptoms that could be first signs of such diseases as Prof Fabian once said?
A: No, I don’t think so. You see, many Tanzanians know very little or nothing about this fact. Recent researches and publications show that many systemic diseases have oral manifestations.
Atherosclerotic vascular disease, pulmonary disease, diabetes and pregnancy-related complications are some of the major conditions that effect a large percentage of the population and have been well studied for their relationship to oral health.
Most patients with these chronic conditions probably do not think that a problem in their mouth can affect their general health. However during campaigns, we have been informing the public of common risk factors. Metabolic and behavioural risk factors are the most common causes of non-communicable diseases.
Q: Is TDA a member of FDI World Dental Federation?
A: Yes, TDA is an active member of FDI-World Dental Federation. We have been attending annual general meetings, exhibitions and other activities organised by this federation. Unfortunately, this year due because of the Covid-19 pandemic, FDI Council has cancelled the FDI World Dental Congress scheduled for Shanghai, China, from September 1-4, 2020.
Q: Do you have working relations with the Children and Youth Prosperity Organisation (CYPO)?
A: So far TDA has no working relations with CYPO. However, we welcome any initiatives to work together with any organisation or institution with programmes that aim at promoting positive health impact on Tanzania’s children and the youth.
● The author is a professional journalist working as a media and research consultant based in Dar es Salaam. He can be reached at 0713-466661 or email@example.com