We have read with serious concern, a front-page headline article titled "Tooth extraction is bad -Dentist" in the Friday, 21st October 2016 edition of The Mirror.

We at Oral Health Express-Ghana were alarmed reading the above headline and subsequently the article itself hence our decision to respond.

Background

To give a background, oral health awareness, although improving, is still relatively low among the population despite the best efforts of the few professionals across the country. Oral Health seeking behaviours of the people is even arguably lower and as a consequence many would take over-the -counter medications (painkillers usually), apply herbs or wait until they report in advanced or worse states. Hence many still report when their teeth cannot be saved or when the risk to their health by leaving a grossly broken down tooth in the mouth grossly outweighs any attempt to save the tooth. In the more severe cases which are not uncommon, some report with severe infections of the head and neck region which can spread to the brain, the chest and other parts of the body leading to debilitating morbidity and in some cases death.

From the above therefore, oral health issues even if limited to the teeth and gums, excluding the other varied conditions that affect the mouth and its surrounding structures, can and does have serious consequences.

Also, there is the issue of fear of visiting the dentist and dental treatment especially extraction. This is a significant barrier which accounts for some of the delays above. Over the years, with increasing awareness, people are gradually losing this fear and are beginning to visit the dentist early. Thus, assertions that have the potential of reviving this fear should not be encouraged.

It is for this reason that any misinformation or even the semblance of it cannot be taken lightly. More so, when it is purported to come from a "dentist".

Reasons for extraction

Over the years, Oral health care has advanced all over the world and here too in Ghana. Various treatment modalities have evolved to preserve the teeth as much as possible and to restore even toothless mouths to a near normal state. Various sizes of cavities can now be filled, missing teeth can be replaced and poorly arranged teeth well arranged to give a confident smile. Dentists are thus trained to preserve the tooth unless it is beyond saving.

The advancements notwithstanding, extractions are still a necessary part of oral health care. Primarily, teeth that cannot be restored or may pose a great risk to the health of the person, just like a gangrenous foot, may need to be removed.

Extractions are performed for a wide variety of reasons, but are mostly done after a careful consideration of the dental and medical history, examination findings, investigations as well as treatment modalities available. Hence Ghanaians should be rest assured that dentists don't just pull out teeth for the sake of it but will only extract teeth when it is necessary. Reasons for which a tooth may need to be extracted includes:

1.Grossly broken down teeth that cannot be restored most commonly due to tooth decay and dental trauma (severely cracked teeth). 2. Severe and advanced gum disease where the tooth is very loose.

3. Wisdom teeth and other teeth that are impacted and unable to erupt into the mouth. These may cause recurrent infections of the gum (pericoronitis), may lead to cavities in nearby teeth or may be associated with cysts or tumors if left.

4. Deciduous teeth (baby teeth) that fail to fall out in time preventing the permanent teeth (adult teeth) from erupting or erupting in the wrong position may also be extracted to allow the normal eruption of the permanent teeth.

5. Supernumerary teeth (extra teeth) which may be blocking other teeth from erupting or disturbing the arrangement of the normal teeth or preventing proper cleaning.

6. Teeth may also be extracted when patients are undergoing orthodontic treatment(braces) to create space so that teeth can be properly arranged. Sometimes patients who are due to receive chemotherapy (cancer drugs), radiotherapy or organ transplants may require infected teeth to be extracted. This is because cancer treatment and the drugs given to patients undergoing Organ transplants weaken the immune system causing an escalation of any preexisting infection or the failure of the transplant.

In all this it is important to note that in extracting a tooth, the dentist is acting in the best interest of the patient to save the surrounding teeth, stop an infection or prevent the more serious and potentially fatal complications like abscesses and spreading infections of the head and neck.

It is also important to know that extraction is not the end of it all. Extracted teeth can be replaced with removable dentures, fixed bridges and top of the range implants right here in Ghana so that both function and aesthetics is maintained.

Claims by "Dr." Kwame Asiedu Kissi and his status as a dentist From the above it is clear that dentists will only do extractions when necessary, unavoidable or when it is the best course of treatment. This is standard practice even in the best of centres.

Therefore, for "Dr" Kwame Asiedu Kissi, who purports to be a dentist, to make sweeping statements that "tooth extraction is bad “, "no human being should extract his or her tooth" and to also claim that "no matter how bad the state of the tooth, it should be treated with organic products " is unfortunate. He also says "those with dental problems must apply natural organic products such as mouthwash, organic powder and pyramid roots to treat all dental infections".

This statement betrays the "dentist's" poor understanding of dental conditions and dental infections and casts doubt as to whether he actually is a dentist. Although there are herbal preparations that may relieve pain there is none in literature that causes a cavity in a tooth to close by itself as he would have us believe. Perhaps, he was taking advantage to promote the various herbal products his "Global Dental Foundation " advertises on their Facebook page.

A check on the Medical and Dental Council's 2016 and 2015 list of licensed medical and dental practitioners shows that "Dr." Kwame Asiedu Kissi is not registered in any of the registers and hence not licensed to practice in Ghana as a dentist. Could he be a quack? It would only be proper that the law enforcement agencies can verify this.

Although admittedly, he gave some general oral health advise which is useful, the main theme of his interview is erroneous and must be discarded in the interest of safeguarding he health of readers and the general population.

To this end also we will like to humbly appeal to both print and electronic media establishments especially reputable and widely circulated ones like The Mirror, to be diligent in selecting individuals to speak on technical issues. Lest they indirectly engage in misinformation of the public with dire consequences.

As a start, they can contact the Ghana Dental association and the Ghana Medical Association; who will be glad to assist them with credible experts to speak on such matters.

We will also like to appeal to dentists and other oral health professionals to intensify efforts to educate the public on oral heal health issues and also to prevent quacks and others from taking advantage of their ignorance while leaving us with more difficult and costly conditions to treat.

To the public, be rest assured that dentists don't just pull out teeth for the sake of it but will only extract teeth only when it is necessary and in the best interest of the patient.

Let's practice good oral hygiene and regularly visit the dentist at least once a year to maintain that confident smile and optimum oral health. Let's remember always that, a healthy body needs a healthy mouth!