THE GOVERNMENTS of most Third World countries, including Guyana, have undertaken to provide dental services to their populations either free, or at very subsidized costs. Because these countries are generally poor and underdeveloped, naturally, the oral health status of the people prevails in accordance with economy and degree of social development of these nations. But is this necessarily so? Are there other existing factors which contribute to this lamentable circumstance? What could the people themselves do to overcome the crises of widespread dental disease in light of governments’ inability to afford adequate ministration?
The development of health care planning systems seems to depend upon compromises that take into account governmental legislation and expenditures, existing population interests and needs, and professional organizations and their attitudes to service delivery by others. Priorities in planning and service provision are political decisions for almost every country. Issues of effectiveness, efficiency and demands have also to be considered. Intrinsic decisions have to be made: How much of the available resources should be given to health services? What services are to be provided, by whom and for whom?
Now, governments in countries like Guyana usually have extensive commitment to their population because of political ideologies. Concern centres on achieving a basic level of care, and creating access for the population to that care. But the systems, in reality, often do not afford conditions for accomplishing what is desired. First, the representative of dentistry in government tends not to have power, tends to be a voice which frequently is not fully supported by the rest of the health team. In addition, in many countries, the dental profession is very small in comparison to the overall population, and therefore it has little political force to exert among the much larger pressures within the political system. Secondly, dentistry has, in most countries, very few representatives within the system, and in many countries, none at all. Often, the very location of the dental advisory unit within government precludes its advice from reaching higher levels. It is common for dentists not to be consulted in the early stages of health planning, or in the development of services.
What is dentistry in government? Frequently, there is no dentist to provide advice at central governmental level. In consequence, much dental policy is established on an ad hoc basis. Many times decisions are reached through non-dental interpretations, or by other health or political personnel of the concepts applicable to dentistry. Often, if a person is not a dental professional who is in a powerful policy-making position on health issues, dentistry is not considered a priority. And that is understandable, especially when confronted with diseases like AIDS, malaria, etc.
But dentists are not without blame. The profession does not communicate readily and effectively with the public. Besides, in seeking to influence governmental policies, there is a need to collect and interpret data on dental disease in forms which the politicians can appreciate. This would make impact within the governmental framework, and lead to more rapid action. Greater public awareness will help in the formulation of governmental policies, but only if dictates for action is supplemented by explanations of their aims. Dentistry must be more prepared to listen to the government and to approach the solution of common problems in a constructive and flexible manner.
Meanwhile, nothing should be able to detract persons from personally pursuing the tenets of the prevention and maintenance of good oral hygiene by seeking relevant information to achieve this. In fact, I have been trying to provide such knowledge for many years in partnership with this newspaper. And this has nothing to do with neither government nor the dental profession. It has to do with respect and care for one’s physical being, civilized cleanliness, and the basic intelligence to realize that what you fail to do now as far as oral care is concerned, you would absolutely regret sometime in the future.