Poor oral hygiene and limited dental care are common in northeastern Nigeria, where other societal issues – such as poverty, unemployment, the lack of hygiene and sanitation and frequent attacks by extremists – take preference.

As a result, many do not realise the importance of oral hygiene and suffer toothache and tooth decay for years without seeking help for their condition, which can lead to more serious health complications.

The World Health Organisation (WHO) said lack of oral healthcare could result in dental caries (tooth decay), periodontal (gum) disease and oral cancer, among others.

In the northeast, internally displaced persons, particularly, suffered from oral diseases, mostly because of a lack of awareness about proper dental care but more often because many were indigent and could not afford to get treatment. Lack of hygiene and sanitation only aggravated the problem.

A dentist, Amina Modu Sharif, who works at the Borno State Hospital Management Board – Eye & Dental Hospital in Maiduguri, told RNI reporter Nana Hadiza Mustapha that there had been an increase in the number of people going for treatment.

At least 300 patients a month visited the hospital, she said.

Fatima Alhaji Modu Kawu, a resident of Maifoni in Maiduguri, said she had suffered from toothache for two years before her family had taken her to the hospital for dental care.

She said toothache was extremely painful and her decaying teeth made her breath smell terribly, so much so that she felt ashamed when she spoke to people.

“I could not eat or even drink sometimes because it was so painful. Sometimes the pain felt unbearable.”

Kawu said the first time she saw the dentist she was asked to open her mouth but could not because of the immense pain.

She said her tongue had swollen and, when the dentist forced open her mouth so he could examine her, she was almost crying out loud from the pain.

“And it was terribly sore when the dentist washed my teeth.”

Halima Mustapha, also a resident of Damboa Road, said she first got toothache when she was a teenager. A friend suggested she have the sore teeth removed to relieve the pain.

Later, when she was married, her husband had advised her to go to a dentist rather than have her teeth removed. “He was right,” she said.

Malam Gana Kyari, an elderly man from the Goni Kachallari in the Jere Local Government Area, said over the years he had often suffered from toothache but this time, his first, he went to hospital to seek the help of a dentist. He said he was pleased he had done so.

Sharif said toothache was mostly caused by tooth decay, infected gums, tooth fracture, an abscess in the tooth and carelessness in cleaning the teeth regularly as advised by experts.

She said the mouth was the most important part of the body but most people did not bother to look after it.

“The best way for people to prevent themselves from tooth infection is by observing oral hygiene. It is important for everyone to carry out oral hygiene regularly to prevent dental disease and bad breath,” she said.

In a report, the WHO said that oral diseases posed a major health burden for many countries, affecting people throughout their lifetime, causing pain, discomfort and disfigurement.

Because oral health conditions were costly, many low- and middle-income countries could not provide services to prevent and treat oral health conditions.

It said factors that contributed to oral diseases were an unhealthy diet high in sugar, use of tobacco and excessive drinking of alcohol.

Oral diseases disproportionally affected the poor and socially disadvantaged members of society. There was a very strong and consistent association between socioeconomic status (income, occupation and educational level) and the prevalence and severity of oral diseases, the WHO said, adding that the unequal distribution of oral health professionals and a lack of appropriate health facilities in many countries meant that access to primary oral health services was often low.

It said the ways to help prevent oral diseases were for people to eat a balanced diet low in sugar and high in fruit and vegetables; drink lots of water; stop using all forms of tobacco; and reduce alcohol consumption.

Adequate exposure to fluoride was an essential factor in the prevention of dental caries. An optimal level of fluoride could be obtained from different sources, such as fluoridated drinking water, salt, milk and toothpaste. Twice-daily tooth brushing with fluoride-containing toothpaste should be encouraged.