The President of the Nigerian Dental Association, Tope Adeyemi, tells OGHENOVO EGODO-MICHAEL about his career and other issues
What is your assessment of the state of Nigeria’s oral health sector?
Some of the most common dental diseases are prevalent in Nigeria. The control of these diseases is affected by the availability of manpower and dental services, especially in primary healthcare centres. Most of Nigeria’s primary healthcare centres do not have a dental presence, yet those centres are the closest to the people. It is the first place people usually go to. The Nigerian Dental Association abides by the National Oral Health Policy to ensure that oral healthcare is available at primary health centres. If that is done, it will increase dental awareness in the country.
As the President of the NDA, what initiatives or strategies are you implementing to improve oral health awareness, and access to dental care in the country?
The NDA is a non-governmental organisation that is dedicated to the advancement of oral health in the country. We engage in community dental services, where we organise programmes such as ‘Talk to a Dentist’.
We organise this programme in partnership with the World Dental Federation, and Unilever. We go as a team to different locations that have limited access to dentists to educate them on oral health; as well as distribute flyers, toothpaste, and toothbrushes. We also conduct free examinations for them, and do some teeth extractions and fillings for those that have caries. For those that cannot easily be treated there, they are sent to the nearest hospitals.
This year’s edition of the programme started in June and will end in October. It will take place at different locations, including Lagos, Plateau (Jos), Kano, Ogun, Rivers, Delta and Abuja.
For those who cannot afford dental care, the association takes it upon itself, as a form of social responsibility, to go to different locations with a dental team and render dental services free of charge for members of those communities. We believe that will go a long way in reducing the burden of oral diseases.
We do advocacy as well. We go to radio and television stations to organise awareness programmes. Aside from these, on every March 20, which is the World Oral Health Day, we organise similar activities in the 36 states of the country, including the federal capital territory. We go around offering free dental services, such as check-ups and fillings. Our members are usually happy to offer these services to the people for free, and the people in those communities appreciate us. They are usually very happy, and they pray for us.
We are happy to contribute our quota to the country.
How does the association fund these programs you’ve mentioned?
First, our members know that they are giving back to society, and they do it out of their own benevolence. However, in the process of rendering those services, some materials would be used. For instance, during teeth extraction, some materials such as local anesthesia and some instruments need to be used. Those are things that really need funding and over the years, we have been in partnership with the World Dental Federation, and they support us from time to time. We also have the support of brands such as Unilever and Pepsodent, who provide us with materials and finances.
In terms of payment for services, our members often do it free of charge, and that is how we have been able to sustain this. Some members also pay a token to help us achieve those programmes.
What specific policies or reforms do you believe are necessary to strengthen the oral health sector in Nigeria?
I like to look at it in three ways. First, in terms of policy. Oral health should be incorporated into every primary healthcare centre, so that the ordinary Nigerian can have easy access to dental care.
Second, from our research, we have found that the National Health Insurance Authority covers a limited number of dental services. If they can increase the scope of dental services that are covered, it would go a long way. Also, moving some of the dental services, such as scaling and polishing, and simple extraction from secondary care to primary care, will go a long way in making oral healthcare readily available to people.
Low-interest loans can also be made available to dentists, so that they can set up their own dental clinics. By doing so, they would be able to reduce the burden of dental diseases in the country, while providing employment and reducing quackery in the dental profession.
What are some of the achievements of the Nigerian Dental Association under your leadership?
The leadership of any organisation is a continuum. I took over the mantle of leadership in November 2022; and between then and now, we have achieved many things.
In the aspect of advocacy, we have been able to reach out to a number of organisations and government agencies to preach the gospel of oral health.
Also, taking oral health to communities is a good achievement, especially for Nigerians who cannot afford to pay for dental healthcare. We also have a journal titled, ‘The Nigeria Dental Journal’.
Furthermore, our relationship with our international partner− the World Dental Federation− has improved. They sponsor some of our programmes, and that makes it easy for us to take those dental programmes to people in no-access areas.
We are pursuing other things as well, such as ensuring that oral healthcare is integrated into primary healthcare centres across the country vis-à-vis the implementation of the National Oral Health policies.
We are also partnering with different organisations to make sure that oral health is taken to different communities.
As an association, we are also members of the Medical and Dental Council, and the Medical and Dental Practitioners Investigative Panel. These are bodies charged with the responsibilities of delivering and maintaining quality oral health services to the citizens. We checkmate practitioners at every point to make sure that whatever treatment they are giving to members of the public is of the highest available standard. If for any reason, members of the public report any doctor, the panel would carry out an investigation, and depending on their findings, they would refer the case to the Medical and Dental Tribunal, where judgment would take place.
We also endorse oral care products. Our endorsement process is stringent, to ensure that we protect the oral health of Nigerians and do not endorse unsafe products for them. Members of the association also have continuous medical education. Every week, we enlighten members on new procedures in the dental space.
There is a rise in the occurrence of tooth diseases in young people. Why do you think that is so, and how can the situation be improved upon?
Most young people eat sweet things, and after doing that, they don’t brush their teeth. Ultimately, those sweet things would stick to their teeth for a long time, and the bacteria in their mouth will act on them, producing lactose acid which would break down the teeth and lead to decay. That is why we have more cases of dental caries in the young, compared to adults. If people must eat those sweet things, they should brush after. However, it is better to replace chocolates and other sweet things with fruits. They could eat fruits, such as apples and carrots. That will help to cleanse the teeth.
What impact has your membership of the World Federation of Orthodontists had on your position as President of the NDA?
Knowledge and awareness of dental hygiene is poor. Knowledge of aesthetics, occlusion, and arrangement of the teeth as well as solutions is even poorer, and many people have issues with the arrangement of their teeth. Some have resigned to fate, thinking that nothing can be done about it. But, whether it is natural or not, something can be done about it. An individual whose teeth are not arranged properly would be exposed to lots of things. If the teeth are not well arranged and are crowded, that individual can be exposed to dental caries, because it will be difficult to clean the teeth properly, and particles would be lodged inside. The longer those particles stay in the teeth, the more exposed the person would be to dental caries; and the longer the particles stay in the gum, the more exposure to periodontal diseases. Some of them, especially adolescents, are usually teased and bullied by their peers in school, and this can make them withdrawn and shy, and ultimately affect their academic performance. Some of them could even develop psychosocial issues, while some could be unable to get jobs as newscasters or air hostesses. Some might even find it difficult to get spouses.
As a member of the World Federation of Orthodontists, we partner with local and international orthodontist bodies on available treatment options for individuals in the country, as well as letting people know that those can be treated. Knowing that there is a solution to those problems gives those suffering from them a kind of psychological satisfaction.
What is the highlight of your time as a senior lecturer at Bayero University, Kano State, and a consultant to the institution’s teaching hospital?
One of the things I enjoy at Bayero University is the serene environment. The students are very willing to learn. When one gives them assignments, they do it on time. Students there are also reserved, compared to those in the western part of the country. The industry is, however, the same in the country, regardless of where one is studying. The medical council ensures a fairly uniform standard of learning.
What are the things that can be done to address the shortage of dental professionals in Nigeria?
The hospitals need to be properly equipped to carry out different dental procedures. When a dentist wants to work and there are no adequate tools, it becomes frustrating. Many dental practitioners are relocating outside the country, but if the government can improve the quality of clinics in the country, that could prevent people from leaving.
If there are amenities, such as good roads and quality healthcare, that will go a long way in preventing people from leaving. Even if there is quality education for one’s kids, that could prevent people from leaving. It is difficult for one to take one’s children to public schools in this country now, because one cannot guarantee the quality of the education there. Those are some of the things that make living in the country unfavourable.
There should be improved funding for dental education. New dental schools should also be established to meet up with the demand. If the ‘push’ factors are addressed, it will reduce the number of dentists leaving the country. Some of these push factors are insecurity, absence of good healthcare services, better education for children, and proper remuneration. To make the country attractive for dentists, their salaries should be increased, security should be improved, and there should be constant supply of electricity. In some places, there have been reports of dental procedures being completed with torchlight, because electricity was interrupted in the middle of an operation.
For private dentists, there should be access to low-interest loans, so they can also fund their practices. I believe if these things are done, they will go a long way in reducing brain drain, and improving on the available manpower to take care of the oral health of the nation.
What advice do you have for individuals on maintaining good oral hygiene and preventing dental diseases?
Every individual is expected to visit the dentist twice every year. During this visit, it is expected that a dentist will carry out examinations, and do what is called ‘scaling and polishing’. Scaling and polishing would remove all the things that the toothbrush would not remove, and keep the teeth in a healthy state. We expect that individuals should brush twice a day. They should brush last thing at night after eating all they want to eat and, in the morning, they should just rinse their mouth, eat and brush afterward, before stepping out. The reason is that if one brushed last thing at night, one’s teeth would still clean. Also, brushing after one’s first meal would help reduce the time that bacteria would act on the teeth.
People should also use the right kind of brush. For people who are 12 years and above, we recommend medium-texture toothbrushes and fluoride-containing toothpaste. Fluoride is a substance that helps to prevent tooth decay. We conduct tests on some toothpastes. We take them to the laboratory and do an analysis on them to be sure of their fluoride content, because too much fluoride can damage one’s health. It is helpful to the teeth, but there is a certain quantity that is recommended. That is why, as an association, we ensure that when we carry out an analysis and can beat our chest to say it is a good product, we give them our endorsement.
We implore Nigerians to always look out for toothpaste that has the endorsement of the Nigeria Dental Association.
How do you plan to address the stigma and fear associated with visiting the dentist, and promote a positive attitude towards oral healthcare?
The major issue is the lack of awareness when it comes to dental care. If one goes to the dentist for routine check-up, there won’t be any fear of pain in the first place. My advice is that people should develop the attitude of visiting dentists, and not wait till there is a problem before they go to the dental clinic.
Also, going to the dentist is not a death sentence. A dentist uses a lot of techniques, materials and equipment to calm the patient down and be able to carry out whatever procedure they want to carry out. Meanwhile, one of the skills of a well-trained dentist is to be able to calm patients down, discuss with them and employ techniques that would numb the place that is to be operated on. If that is properly done, patients would not even know when any procedure is being carried out. They might feel pressure, but not pain. People should also ensure that they visit proper dentists, as not everyone that wears a white coat is a dentist. There are people who have opened shops in the name of private clinics, and they are not dentists. That is where regulatory agencies should come into play. Anybody who is not a dentist and is practising dentistry is a criminal, and should be arrested. As a matter of fact, I recommend that patients should ask whoever is attending to them if they are really dentists, and let it be documented, so that in the future, if they turn out not to be dentists, there would be a good basis to sue them for claiming to be who they are not.
Can you share any personal experiences or stories that have inspired you in your work as a dental professional and leader in the oral health sector?
As a leader in the oral health sector, one of the main objectives is to ensure the advancement of oral healthcare, and to make it reach as many people as possible.
Sometimes, a patient could come to the clinic due to pain or inability to sleep. By the end of the operation, the patient that was feeling like they were going to die would be smiling and happier. A patient that wanted all the teeth removed would then realise that the teeth are still there, and are not giving any issues. That has been a motivation to me to actually continuously improve, so I can help people keep their teeth for as long as possible, and avoid pain.
As orthodontists, it is our duty to make sure individuals smile and improve their self-esteem through the treatments we offer. A patient once came to the clinic, and we did not want to treat her due to a lack of materials, but she kept pleading that we should. She said she had an interview and she was sure that if she went there with the way her teeth were, she would not get the job. I asked her why she was so sure about that, and she told me she had attended two interviews, and she did not get the job. So, I did all I could in terms of getting materials to make sure I fixed braces for her, and we finished late. A week later, she called me, and with joy in her voice, she told me she got the job. I asked her how she got the job, because her teeth were not arranged at that time. She said after answering all their questions, they were going to deny her the job, but she told them that she knows her teeth were not well arranged, and that was why she had sought dental care. She showed them that she was already on braces trying to correct it, and they gave her a thumbs up. They eventually gave her the job and she was very happy. I then thought of the many people having such teeth defects and do not even know there is a solution. So many single ladies with such defects are finding it hard to find suitors. So, it gives me joy when we can find solutions for such people. We transform people’s lives and destinies, and make the world a happy place.
How do you envision the future of dentistry in Nigeria, and what measures are being taken to keep up with advancements in technology and treatment options?
he future of dentistry in Nigeria is very bright. We might be limited by technology but, to me, it is a journey. Once we make steady and conscious steps, we will get there. Our dentistry has really advanced, and I believe that with time, more collaborations and private sector initiatives, the profession would be better.
Nigerian dentists are well trained, but without adequate equipment, magic cannot be performed.
What are some of the misconceptions or myths surrounding dental care in Nigeria, and how can they be debunked?
Some people put different things, such as battery acid in their teeth, and when they bring out something like a worm, they believe that is what caused the defect. But, that is a misconception. The right theory is dental caries, and it is well established. We have treatments that are available in hospitals for dental caries.
Another misconception is that when one removes a tooth, the caries will move to another one, until one removes all of one’s teeth. That is actually not true. If one has a tooth with caries and one treats it but still indulges in bad habits, such as not brushing regularly or eating chocolate, one’s other teeth will be affected.
It is widely believed that medics are usually too engrossed in their careers to have a social life. Is that the case for you?
That is where work-life balance comes in. Many dental doctors get engrossed in saving lives, because life is a gift that cannot be replaced. If one is the only doctor and one cannot even be away for too long for the fear that people are going to die, one cannot have a social life. However, if there is adequate manpower, dentists would have more time for themselves and their families, as well as attend other functions. A doctor would rather sacrifice his social lives to save the lives of others.
How do you maintain personal relationships despite your busy schedule?
Social media is really helping one to maintain relationships with friends and family members. One is able to put a call through to one’s loved ones, regardless of where one is in the world. It has helped to bridge the gap in communication. I also attend functions and make time for church activities. I try not to miss family events as well.
Tell us about your family.
I have been married for over 10 years, and my wife is also a doctor. I have four children− three boys and a girl. Whenever we can, we attend functions together. We try to maximise every time we have together, because I am usually busy, attending one meeting or the other. My family is very understanding, and I am full of gratitude to them.
As a dentist, have you had any course to visit the dentist?
Yes, I have had cause to visit the dentist. My first experience was when I was an undergraduate at the University of Lagos, and I had throat pain. Being a dental student, I just spoke to one of my senior colleagues, who took a look and said I had a hole in my tooth. I thought to myself that what I had done to people would then be done to me. I treated the tooth, and I have been consistently visiting the dentist twice a year.
How would you describe your style?
I am a highly organised person. Whenever I am attending family gatherings, I like to wear native attire. When it is an official duty, I wear a suit.
What do you do for fun?
I play football and table tennis. I also do brisk walking sometimes.
What advice do you have for young dentists out there?
My advice to young dentists is that they should constantly develop their knowledge base. Dentistry is a very dynamic profession. They should also continue giving back to society.
