Belarus, since 1991 an independent state in northeast Europe, remains somewhat isolated from the European mainstream as one of several successor states to the Soviet Union. Though the country hosts 4.08 physicians per 1,000 people, a figure comparable to many developed nations, there remain areas of the healthcare system that require improvement, and one such area is the dental health sector. For a dental health sector to treat the maximum number of citizens effectively, the population must attain a minimally competent level of oral health literacy. Several oral health literacy studies have diagnosed the quality of dental hygiene knowledge and provide strategies for improving oral literacy in the general population. Though data has been sparse since these studies, they suggest a continuing improvement in dental health and therefore in oral health literacy within the populace.
Oral Health Literacy in Post-Soviet Belarus
In 1996, several years after the dissolution of the USSR, oral health survey data established that tooth decay and periodontal disease affected approximately 85 percent of children and 100 percent of adults. Since then, these findings incentivized research into the development of successful and economical disease prevention strategies. Chief among these is ensuring oral health literacy.
A 2004 epidemiological study sought to uncover the link between urban or rural status and level of education on oral health literacy. The scope of the study encompassed randomly selected subjects from all six regions of Belarus, entailing administration of dental health examinations on six and 12 year-old children, questionnaires directed to mothers and primary school teachers and subsequent processing and interpretation of the data collected.
Of the children surveyed, 93 percent of tested six year-olds and 85 percent of tested 1- year-olds showed signs of tooth decay, with both 12- and six-year-old urban students less likely to have experienced tooth decay than their rural counterparts, although the contrast was more dramatic for 12-year-old test subjects. The questionnaires directed to mothers established that urban mothers were more likely than rural mothers to exhibit oral health literacy, and this knowledge disparity was likewise reflected in better oral hygiene habits in urban families. However, primary school teacher respondents provided generally accurate answers to the questionnaire, with no major knowledge disparity on based on the urban-rural divide.
This study concludes that a strong correlation existed between the knowledge and habits of parents and the dental health of their children. Both six- and 12-year-olds exhibited rates of tooth decay surpassing the 2000 goal set by World Health Organization for Europe, attributable to a myriad of factors encompassing diet, lifestyle change, inadequate parental involvement and mere lack of knowledge. Though primary school institutions should continue to play a pivotal role in dental hygiene education, parents must increase and improve their own role, facilitated through strategies promoting better access to updated dental health information.
Progress in Pediatric Oral Health Literacy since 2009
In order to determine whether progress has been made in oral literacy since these studies, one must consider the most recently released dental health statistics. Perhaps the most striking available data is that of pediatric dental patients’ DMFT index measurements. Dental epidemiologists record the degree to which a patient’s teeth suffer decay, are missing or filled, using a measurement called the DMFT index, which assigns values from zero to 28 or 32. On this scale, a lower score indicates less tooth damage.
In 2009, the Belarusian government determined that the mean DMFT of the country’s 12 year-olds rested at 2.1, while another study the same year found that 30.6 percent of children of the same age rested at zero in the DMFT index. Though the results of this DMFT study are now a decade old, they constitute a significant improvement over the prior decade, in which (as of 1998) only ten percent of 12 year-olds were cavity-free with a mean DMFT of 3.8.
NGO Involvement and a Trajectory for Improvement
Global Dental Ambassadors, an NGO comprised of dental health professionals committed to the exchange of data and improvement of oral health literacy, annually holds academic exchanges throughout the world. From 19 September to 21 September 2019, this organization held an international academic exchange summit at Belarusian State Medical University involving professionals from the United States and Belarus, with 523 second and third year students of the Belarusian State Medical University witnessing the proceedings. Conventions of this sort hold great promise for ensuring that the dental sector in Belarus remains fully literate on the latest developments within the profession.
Established in 2006 by Chernobyl Children International co-founder Mary Sugrue and dentist Marcas Mac Domhnaill, the Chernobyl Children International Dental Programme focuses primarily on improving the hygiene standard and general oral literacy of Belarusian pediatric dentistry. As Mary Sugrue attests, pediatric tooth extraction procedures did not involve the use of anaesthetic when the organization began working in Belarus. Since then, the organization has done much to decrease the infection rate through educating dentists and patients alike, including children.
Substantial progress has been made in the cause of Belarusian oral health literacy over the past several decades. The most recent data and international NGO involvement gives reason for optimism and incentivizes further investment in improving oral health literacy in Belarus.
– Philip Daniel Glass