The State provides dental and oral health services to the public that aim to promote oral health, prevent tooth decay and treat any problems. 
WHAT DENTAL SERVICES ARE OFFERED? At the most basic level of care (primary health care clinics) the dental/oral health service has three parts: promotion, prevention and treatment. In some areas of the province (e.g. Mossel Bay) the same basic service is available at the local hospital. Oral health professionals at clinic level promote oral health by educating people on how to keep their mouths, gums and teeth in good health and by showing people how to prevent tooth decay and other oral problems. The basic treatment services available are oral examinations, X-rays, scaling and polishing of teeth in order to remove plaque and prevent gum disease, fillings and emergency relief of pain and sepsis including dental extractions. Crowns and bridges are sometimes available but are low priorities.
GUM DISEASE A patient can be treated for severe gum disease (periodontitis) at a clinic. However, if there is oral pathology - lesions or ulcers in the soft mouth tissue often caused by excessive smoking, drinking or due to HIV infection - and the patient is in danger of getting cancer, then they will be referred to a tertiary level hospital.
ORAL THRUSH People who are HIV positive and those that have Aids often suffer from oral thrush. These are open sores or lesions in the mouth. Diflucan, a drug, which treats oral thrush, is available free of charge at primary health care clinics.
ANAESTHETICS Patients can be given a local anaesthetic for dental and oral problems at primary health care clinics. If a general anaesthetic is needed, the dentist will book the patient in at a local hospital theatre and the dentist will perform the procedure at the hospital. The Hope Street Clinic in Cape Town is the only clinic where general anaesthetic is available.
JAW FRACTURES Fractures of the upper jaw (often as a result of domestic violence or car accidents) will be referred to the secondary or tertiary hospitals. Simple lower jaw fractures can be seen at the primary health care facilities. The more complicated cases will be referred to secondary or tertiary hospitals.
WHO CAN GET SUBSIDISED DENTAL SERVICES? The provincial government subsidises a denture service for indigent adults, those receiving old age pensions and those who have been institutionalised. There is a fee involved to cover laboratory costs. People with orthodontic problems can be seen at primary health care facilities but will be referred to dental schools at the University of the Western Cape and Tygerberg Hospital. Children who need to have braces put onto their teeth or removed will need to be referred to these dental schools. In urban clinics the oral health team is made up of a dentist, a dental assistant and an oral hygienist. The situation is different in rural areas that are visited by a dental team with mobile equipment. The equipment can be set up as an emergency service, usually at schools.
PROMOTION AND PREVENTION The promotion and prevention programme includes visits by health workers to some crèches and some primary schools. Oral and dental information and education is also given to pregnant women as part of the antenatal service. Primary school children are taught about the need to prevent the build up of plaque and how to remove it through correct brushing and flossing of teeth. Toothbrushes and toothpaste are provided. They are also given a mouth rinse containing fluoride as part of the Fluoride Supplementation Programme. Fluoride strengthens teeth and helps prevent tooth decay. The children are educated about nutrition and the need for healthy eating habits to prevent the build up of plaque and tooth decay. Cape Town is the only city that is fluoridating its water supplies according to the Regulations under the Health Act, 1977 (Act 63 of 1977).) The Minister of Health and the Minister of Water Affairs and Forestry have jointly approved the regulations. |
