It was in 1994 when Rachel Santos graduated from the University of the Philippines Manila and received her diploma in Dentistry. By December of that year, she took and passed the Dentistry Licensure Examination. Less than a year later, she was employed.

Rachel tells MIMS that she started as an associate dentist. For the most part she acted mostly as an apprentice to another, more senior dentist. It did, however, give her the exposure and experience of working in a clinic setting.

Not long after, Rachel continues, she left that job and decided to go back to school, still at UPM, to receive further training for clinical dentistry. Dentistry wasn’t always her first choice, though, she tells MIMS: she was poised to go into medical school.

The choice to go into Dentistry instead was mostly economical: she didn’t qualify for UPM’s Intarmed program, she recalls, so she thought taking Dentistry instead would cost less. In the end, she tells MIMS, because of all the equipment they had to buy themselves, it cost them more than if she had gone to med school.

Currently, she has her own clinic where she holds her private practice, not under the supervision of any other dentist.

Roadblocks: economy and understanding

In her more-than-a-decade tenure in the industry, she has seen that the biggest challenge that their profession faces, especially here in the Philippines, is that dentistry and oral health are both still seen as fringe.

“The popular mindset of people is that they only go to see dentists when their teeth start to hurt,” she laments. This lends to what Rachel calls the bunot (extraction) culture. By this, she refers to zeal and keenness with which people who have toothaches and other oral problems opt for tooth extractions.

“I think it still boils down to economics – that they think a tooth extraction is a one-time big-time cost and will cost less than if they go for the proper dental procedures. Sometimes I even have to explain that, in total, the cumulative cost of having an extraction and all the follow-ups related to it is in fact greater than if they have their teeth treated properly,” she tells MIMS.

Mia Morasa, a dentist of six years, agrees that economics is definitely a big part of the problem. “The most important issue here is that only a handful of people (those belonging to the upper classes) can afford quality dental care,” she writes in an e-mail.

People who are less well-off tend to opt for treatments that cost less, even if it isn’t the best or the proper option for them. On top of this, facilities that are available to them tend to usually offer fewer treatments or those of lower qualities.

As a result, dentistry and, by extension, oral health, is seen as a luxury available only to those who can afford it, and not as a vital part of overall health and well-being.

oral_health0117

Oral health, Rachel explains, has continuously been shown to be correlated to many diseases and several measures of physical health: diabetes, physical fitness, low birth rate, and heart disease, among others.

But really, even without consulting the data, she continues, the impact and relevance of oral health on overall health and productivity should be easily palpable: “if your teeth hurt, what are you most likely to do? Call in absent. Even if you do show up for work that day, you’d be too disoriented by the pain to be efficient at your job. It becomes counter-productive.”

Government support

“I think the government should include a dental department in all government hospitals that can offer quality care to those in need,” Mia offers, suggesting that the government invest in the improvement and promotion of better oral health.

“The government should allot funds for the acquisition of good facilities, dental equipment, instruments and materials. It should offer free dental check-ups and scaling procedures in barangays, and have a referral system to public/government hospitals for other major procedures,” she continues.

Similarly, Rachel also believes that improving the state of oral health in the country is the responsibility of the government. For her, however, even the most basic and simple tooth brushing mass media campaigns should result in a big difference.

Unfortunately, she continues, there is a serious shortage of such campaigns in our airwaves right now. “We should push for basic tooth brushing campaigns. Even the Philippine Dental Association lacks that thrust,” she offers.

Things are, however, starting to look up. The Philippine Pediatric Dental Society, Inc. is in the business of launching several campaigns and programs geared towards teaching local communities the proper attitude to oral health and tooth brushing techniques.

In addition, several small efforts, organized by student organizations, schools, and other advocate groups are doing similar things: educating local communities about the importance of, and the proper practices to, ensure good oral health.

The problem, however, remains widespread. These efforts are effective, but too isolated to effect any real change. What is critical, Rachel offers, is that these types of campaigns reach a critical mass, penetrate mass media, and achieve country-wide influence.