The MalDent Project has at its core a philosophy of prevention of oral and dental disease. This under-pinning mantra of ‘prevention, prevention, prevention’ which was coined at the National Oral Health Policy Workshop, is emerging strongly in the ongoing work of the Oral Health Policy Task Force. Prevention of dental caries in children will be central to Malawi’s Oral Health Policy and Ronald Manjomo’s PhD project is focusing on this area.
It will be very important to be able to measure the impact of any interventions that are introduced as part of a programme to prevent dental caries in children. However, in order to do so it is essential to establish the baseline level of disease. At present, this is unknown but work is now underway to design and plan a national child oral health survey. This component of the MalDent Project benefits from funding granted by the Borrow Foundation in addition to our core funding from Scottish Government.
A multi-disciplinary team has been established to deliver this survey and the first meeting was held on Friday 23rd April:
The team includes representation from the Malawi Government Ministry of Health, University of Malawi College of Medicine, WHO Africa, Strathclyde University, University of Glasgow, Smileawi and the UK Community Dental Service.
Following general introductions, Nigel and Vicky Milne gave a presentation about the pilot child oral health survey that they had completed with Glasgow and Dundee University elective students in 2019.
They took us through the various stages of the process …
… including illustrations of their interactions with teachers and pupils …
… and of the dental examinations being undertaken…
The data generated have now been submitted to the African Journal of Public Health and we are awaiting responses from the referees.
One of the most important aspects of the pilot study was to identify specific challenges of undertaking oral health surveys in Malawian schools. A number of lessons were learned, particularly in relation to collecting socio-demographic data from the children and this will help to inform the definitive study design.
One of the other aspects of the Smileawi pilot study related to fluoride content of local water supplies and the prevalence of dental fluorosis among the children examined. This work was undertaken in collaboration with Strathclyde University and provided fascinating data which have now been published in the journal Water:
A copy of the paper can be accessed here.
Professor Bob Kalin, who heads the group at Strathclyde University with which we collaborated, gave a fantastic summary of the joint work and of the wide variation in fluoride concentration of groundwaters in different geographic areas of Malawi. He also described the amazing technology that this group uses to map the boreholes with extensive information on each individual water source. His knowledge and experience will be of great value to our team moving forward.
We continue to collaborate closely with Dr Yuka Makino, the WHO Technical Officer for Oral Health in Africa. We are delighted that Yuka has agreed to be part of our team and she gave a presentation on the oral health indicators which the WHO recommends for Africa. We will ensure that the survey design we use maps onto the principles espoused by WHO.
This first meeting, which introduced the team members to one another and began to lay down the foundations of the survey, will be the first of many. Our intention, COVID-19 permitting, is to complete the planning and ethical approval application this calendar year, with a view to undertaking the survey in the first half of 2022.