CATEGORY AUSTRALASIAN DENTIST125 DENTISTRY AROUND THE WORLD and the construction of hastily erected, substandard houses increase, as does the consumption of non-traditional, often unhealthy food. Now there is a lot of problem with sugar, including soft drinks, cakes and such, which causes childhood caries to increase, says Gabriella Schmidt- Corsitto’s colleague Dr. Anuudari Erkhembaatar. Through the school, preschool and after-school center that her foundation runs, Gabriella Schmidt- Corsitto and her employees on site are able to implement positive lifestyle changes among the children from the poor neighborhoods around them. Here, in the shanty towns around Ulaanbaatar, many of the parents are unemployed or low-paid, schooling is often inadequate and knowledge about dental care and other public health is neglected. The foundation has now worked for over six years treating children. And the situation is a little better today compared to when we started, especially when it comes to interest in toothbrushing and children’s dental health, comments Dr. Anuudari Erkhembaatar. One example is the preschool run by the Misheel Kids Foundation. Right now the children are sleeping peacefully there, but eventually a healthy snack is served – and then it’s time to brush their teeth. Several blue plastic cups and accompanying toothbrushes are lined up, all neatly labelled with the children’s names in Cyrillic letters. But even though Misheel Kids Foundation works extensively with prophylactic health interventions, many of the children have greater challenges, including when it comes to dental health. One example is eleven-year-old Any, who we meet at the center’s after-school care center and who has two lateral incisors in her upper jaw that are threatening to grow straight out, almost like tusks. The reason to the current issue is that Any’s previous baby teeth in the same place were badly corroded and were simply pulled out by the dentist at the time. The space that remained then shrank and was soon taken up by emerging canines instead. Baby teeth are not only supposed to function for chewing food, but also to hold space for the permanent teeth. When the baby teeth are gone, the adult teeth don’t “know” where they should be and grow a little bit anyway, explains Gabriella Schmidt-Corsitto, showing Any’s upper jaw. Problems like these recur from time to time in poor countries, where patients’ inability to pay and the limited level of education of the treating dentists mean that most people choose to extract teeth affected by caries instead of repairing them. Now this girl needs surgery and probably orthodontic treatment for three years. As it is now, she can’t bite, so we need to solve this problem soon, laments Gabriella Schmidt- Corsitto. Poor Any’s case is certainly unusual even in a Mongolian context. Since the baby teeth were extracted at a critical age, the entire jaw structure has been affected. She needs an X-ray to see how deep the problem is. I really don’t know if you can just take them out or if you might have to make the entire upper jaw bigger. In that case, lots of procedures are needed, says Gabriella Schmidt- Corsitto. We continue from Bayasgalant and into central Ulan-Bator to visit Dr. Anuudari Erkhembaatar’s own dental clinic, Prodent. The facility is impressive – well-kept examination rooms, modern equipment and new dentist’s chairs, as well as murals and Spiderman figures hanging from the ceiling next to the high chair. In an office, orthodontist Purevdulan is preparing for upcoming procedures. At the same time, not everyone can afford to have their teeth examined here. For example, in the state clinics they don’t have enough anesthetics in stock. And they don’t use composites, only dental cement, says Dr. Anuudari. Prodent has a lot of resources, including eight dentists and 15 other staff. But patients who come here have to pay for their visit entirely out of pocket – treatments at private clinics in Mongolia are not covered by any government dental care subsidies. For the many poor Mongolians who need dental care, the only option left is the simpler procedures at public clinics – or to hope for charity from organizations such as Misheel. X Dr. Anuudari Erkhembaatar.
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