Oral health campaign beset by teething problems
Oral health campaign beset by teething problems
Text and photo
by Yoko N. Sari
JAKARTA (JP): Yos Andesbon, a self-taught dentist, practices
on the sidewalk of Jl. Gatot Subroto, a main thoroughfare in
South Jakarta.
The 35-year-old Yos sees his work as a public service,
providing quick, painless and inexpensive treatment, as well as
dispensing drugs to patients who need them.
Judging by the flocks of customers that come for treatment,
his business is booming.
Never mind the dust, the exhaust from passing cars, buses and
trucks, or the lack of hygiene. Many people find his treatment
effective, at least that's what the man who hails from Medan
would have you believe.
"I've been doing this since 1984, and all praise to Allah, I
haven't received any complaints from customers about infections
or anything," Yos told The Jakarta Post as he was busy cleaning a
patient's teeth.
In this year, which the World Health Organization (WHO) has
declared as the Year of Oral Health, Yos's sidewalk practice can
be seen as either a boost or an impediment to increasing public
awareness of oral health, particularly dental health.
In Indonesia, as in most other developing countries, there
remains a tremendous ignorance among the people about the
importance of regular dental checkups.
Last resort
Going to a dentist is considered only as a last resort for
most Indonesians. Or as WHO puts it, "pain and pay" is still the
norm for most people in developing countries.
Indonesia is joining this year's WHO campaign to promote oral
health, although as one health official pointed out, it is not on
the government's list of health priorities.
Nor is it a priority for the bulk of the population.
"I only have my teeth examined when I feel pain and need to
get fillings," said Jovita, a 26-year-old lecturer at the School
of Social and Political Sciences of the University of Indonesia.
"But if I can deal with the pain, why should I go see a dentist?"
Her opinion is echoed by many Indonesians, most of whom still
shun doctors, opting instead for traditional treatment and
traditional medicines.
Ingrained attitudes seem to be the biggest obstacle to
promoting oral health. Admittedly however, Indonesia suffers from
a shortage of dentists.
One official statistic shows that each qualified dentist in
Indonesia serves 22,500 people. Yet another figure shows that
some 1,100 dentists are currently unemployed.
The problem lies in the poor distribution of dentists, with
most bunched up in major urban centers. An official recently
remarked that many female dentists would rather remain unemployed
than work in remote areas.
Another major obstacle to promoting oral health is money, or
lack of it.
The cost of dental checkups is exorbitant for most
Indonesians, and dentists have only themselves to blame.
"We cannot interfere with the way dentists set the fees at
their private practices," says Zaura Anggraini, a board member of
the Indonesian Dentist Association (PDGI).
She quickly adds that the cost of visiting dentists in
hospitals or community health centers is quite low.
A private practice using laser beam technology charges Rp
120,000 (US$56) per quadrant for cleaning the caries, and $150 to
$240 per filling depending on the extent of the damage.
Zaura says the high cost is due to the large investment
dentists must make to buy equipment.
A dental equipment supplier in Central Jakarta claims that the
cheapest set of dental equipment costs Rp 10 million ($4,683),
while a set of laser equipment could cost upwards of Rp 100
million.
"It is up to the dentist to choose whether to purchase cheap
or expensive equipment," said Soetiyono who runs a dental
equipment supply shop.
"Many of them invest heavily simply to build their
reputations, furnishing their practices with expensive equipment
to make their patients more comfortable," Soetiyono said.
Statistics
WHO statistics suggest that dental decay and other related
diseases in developing countries are not as severe as in the more
advanced countries, mainly because more affluent people tend to
eat more sugar and starch, which are both harmful for teeth.
The PDGI, in connection with the Year of the Oral Health, is
also doing its part.
It is launching a campaign urging people to have their teeth
checked more regularly, at least once a year. It is also sending
teams to selected villages to offer free dental care services.
The government is also taking an active role. By next year, it
plans to furnish all the community health centers across
Indonesia with dental care equipment.
Most elementary schools in Indonesia already have programs to
bring in dentists regularly to examine the pupils, believing that
the habit of caring for one's teeth, like all other disciplines,
must begin at an early age.
Unfortunately, this measure is not supported by the capability
of the dental care industry, S.L. Leimena, the director general
of community health, acknowledges.
It is not followed up with quality service, something which
would definitely help boost the children's awareness, he
reminded.
"Unfortunately the dental clinics in elementary schools do not
yet supply information, such as how to keep teeth clean; most of
them only conduct clinics," he says.
The lack of awareness regarding oral health coupled with the
messy state of the dental care industry has left a huge gap for
self-taught dentists like Yos.
He advises his clients of the need to maintain their dental
health, while reminding them that they can do much of the work
themselves.
"You don't have to go to dentists to have clean teeth. You can
clean them yourself. It's cheaper," he said.
"Sir, you need to avoid tooth decay or you will lose all your
teeth," he said while preparing to treat a customer.
For Rp 3,000 ($1.40), a client can have his teeth cleaned
thoroughly and leave with a sweet taste in his mouth, apparently
from the medicine Yos administered to him.
Yos said the formula contains 15 percent toothpaste and the
rest Vitamin C.
"I don't feel numbness. I can still feel the sweet formula
though," said one happy client as he left the open-air practice.