Nigeria has only 39 orthodontists, says NAO
• 50% of population have poorly arranged teeth
• Association begins three-day 9th annual scientific conference in Abuja from October 6
• Launches orthodontic month, offers screening, educational programmes in secondary schools
ORTHODONTISTS under the aegis of Nigerian Association of Orthodontists (NAO) have decried a situation where there are only 39 registered members and 4,600 dentists for a population of 170 million people.
Top members of the Association in a chat with journalists in Lagos recently said the situation in Nigeria where there is one orthodontist to four million people is in contrast to the United States where there are about 9,000 orthodontists serving a population of 310 million people, which is about one orthodontist to 35,000 people.
NAO said as part of efforts towards advancing orthodontic education and providing orthodontic care for underserved populations in Nigeria, the association is holding its 9th Annual Scientific Conference at the National Hospital Abuja from October 6 to 8, 2015.
The Association said the Conference will be preceeded by the launch of the ‘Orthodontic Month’ on October 5, 2015, which will be marked by orthodontic outreach with screening and educational programmes in secondary schools in Abuja.
The theme of the Conference, according to NAO is “Smile Aesthetics and Psychosocial Wellbeing” with a prominent Nigerian orthodontist in the United Kingdom, Dr. Patrick Williams as the keynote speaker.
The NAO members include: Past President and Associate professor/consultant orthodontist at the College of Medicine University of Lagos (CMUL)/Lagos University Teaching Hospital (LUTH) Idi-Araba, Dr. Oluranti Olatokunbo da Costa; Current President and lecturer at CMUL/LUTH, Dr. Ifeoma Utomi; Publicity Secretary and lecturer/consultant orthodontist at CMUL/LUTH, Dr. Gerald Ikenna Isiekwe; and Social Secretary and lecturer in orthodontist at Lagos State University College of Medicine (LASUCOM)/Lagos State University Teaching Hospital (LASUTH), Dr. Toluase Abosede Yemitan.
According to NAO, orthodontics is a highly specialized and oldest area of dentistry. Orthodontics, NAO, said can be defined in simple terms as the study of the growth of the face and jaws and the management of maligned teeth and jaws.
To qualify as an ortyhodontist in Nigeria, Utomi said an individual must have undergone a minimum of four years post graduate training in orthodontics, post qualification as a dentist.
These training programmes are coordinated by the National Post-graduate Medical College of Nigeria and the West African College of Surgeons, resulting in Fellowship in orthodontics.
There are now about six accredited post graduate orthodontic residency programmes in the country,” she said. The NAO President told journalists: “Till date, close to forty locally trained orthodontists have graduated from these programmes thus far.
However, this is an insignicant number, considering our population of over 170 million… Considering the fact that there are currently 4,600 dentists in Nigeria, orthodontists currently constitutes 0.01 per cent of the dentists in Nigeria.”
Utomi said NAO is an association with the vision to be the leading group of excellence in the advancement and promotion of orthodontic practice in Nigeria and throughout the world.
She said the objectives of the Association include increasing knowledge and awareness through education of the causes, prevention and treatment of malocclusion as well as promoting further training and research in the special field of orthodontics.
According to Wikipedia, “a malocclusion is a misalignment or incorrect relation between the teeth of the two dental arches when they approach each other as the jaws close.
The term was coined by Edward Angle, the “father of modern orthodontics”, as a derivative of occlusion, which refers to the manner in which opposing teeth meet (mal- + occlusion = “incorrect occlusion”). “Malocclusion is a common finding, although it is not usually serious enough to require treatment.
Those who have more severe malocclusions may require orthodontic and sometimes surgical treatment (orthognathic surgery) to correct the problem.
Correction of malocclusion may reduce risk of tooth decay and help relieve excessive pressure on the temporomandibular joint. Orthodontic treatment is also used to align for aesthetic reasons. “Malocclusions may be coupled with skeletal disharmony of the face, where the relations between the upper and lower jaws are not appropriate.
Such skeletal disharmonies often distort sufferer’s face shape, severely affect aesthetics of the face and may be coupled with mastication or speech problems. Most skeletal malocclusions can only be treated by orthognathic surgery.”
Utomi added: “In particular, the Association aims to increase awareness and access to orthodontic care for underserved populations across the country. It hopes to achieve this through orthodontic screening and educational programmes in various schools.
This will be followed by pro-bono services from members and partnerships with well meaning individuals and corporate bodies. Indeed this is the focus of our forthcoming 9th annual scientific conference.”
On why there are few orthodontists in Nigeria and what NAO is doing to address the situation, da Costa said: “I think it is a matter of when we started the training.
The training started in earnest, in the early 1980s. “We need to double our number by lets say, almost a hundred fold but what is important for now is I think we have to start gradually to create awareness because many people have problems and would not know they have.
I think because they are not many, they are about thirty-nine, so for you to get trained to have to get trained by some orthodontist who is experienced within some number of years. So the quota, the number of people that can be taken in by the different centres is minimal, they probably can take like two. LUTH takes the highest. So you cannot take more than four people at a time for a six or five years training.
The more orthodontist we have, the more the awareness of the fact that people can get treated because if you treat one person, the word of mouth is what we have. I think want we have to gather is public awareness first.
On the national; level, more centres are getting accredited to train orthodontist. I think in the north like Kano they are in the process of getting centres.
Fourteen years of intensive training.” The past president further stated: “If there is a problem with an orthodontist, they can take you to their association, the association is there to maintain ethics and standards.
So if a member goes against that then it means you will have to face the disciplinary action. “I think because they are not many, they are about thirty-nine, so for you to get trained to have to get trained by some orthodontist who is experienced within some number of years.
So the quota, the number of people that can be taken in by the different centres is minimal, they probably can take like two. LUTH takes the highest. So you cannot take more than four people at a time for a six or five years training.
Even to train dentist, we have a certain number. You cannot admit more than a certain number because we do not have a lot of facility for training. So even if we need like a thousand dentist and we have only facility for hundred, that is all we can take.
Even right now, the hospitals are groaning, the universities are groaning because they cannot cope with the numbers they are getting for training. So If the hospitals get adequate subventions, then they can have more facilities then we can now train more orthodontist.
Lack of funds is a major problem. “Our specialty is a very interesting one because there are some problems that can be treated by general practitioners even we as teachers, we are lecturers, we train dentists on the rules of simple appliances that any general practitioner can use to treat like the little children, those kind of problem, some of them the general practitioner, any dentist who is well trained can treat those children but the thing is a lot of them know the limit, they know where the line is either for financial gains they want to cross that line, so they are stepping into the line of the orthodontist but more importantly it is a specialist programme.
Specialist means specialist that means they must have undergone certain years and those years you are gaining something each year that makes you qualified.
So the problem is they do not get the experience. A number of our patients may spend maybe at least two years of continuous treatment.
This is very tasky. You have to be knowledgeable; you have to know what you are doing to be able to see a patient for two years if not it will be disaster in the end.”
Yemitan said the percentage of Nigerians that have on form of malocclusion range from 48 to 75 percent. “So you can averagely say that one in every two Nigerians has one form of mallocution, that is one form of poorly arranged teeth or the other,” she said.
Yemitan added: “You can averagely say that one in every two Nigerian could have one form of maloccusion or the other that would require attention.”
Isiekwe said: “The knowledge is important because I mean people, they do not know they can be treated here in Nigeria, they go to India, Dubai where they go on holiday to fix their braces.
They think there are no orthodontist in Nigeria because they do not know. “In fact some of us travel for conferences abroad and our colleagues tell us that if you have orthodontist in Nigeria, then why do people come to the UK to get their patients treated. So there is still a low level of awareness.
People say ‘oh! Do they do that kind of treatment in Nigeria.’ And so that is part of creating awareness to know that people can get treated for such.”