Access to health care remains a major concern in some of the remote mountainous regions of Pakistan, especially in Chitral. Residents may drive hours to reach main hospitals to access basic healthcare services. While government and non-governmental agencies have worked to provide healthcare facilities and improve their quality, one area remains a particular challenge: oral health.
Dental problems and oral diseases are prevalent across Chitral. Losing teeth limits what one can eat, compromises nutrition and affects general health. Pain from toothache affects quality of life. Meanwhile bacteria from gum disease can infect the bloodstream and cause or worsen other illnesses, from inflammation to heart disease.
The World Health Organization recommends a dentist to population ratio of 1:7,500 for achieving optimal oral health. But in Upper Chitral, for example, almost 200,000 people share a sole dentist. Most are deprived of primary dental care, let alone access to implant surgery and dental prosthesis.
Dr Ali Hussain Khan, founder and CEO of Noor Dental Clinic in Karachi, had recently introduced a portable dental unit that caught the interest of the Aga Khan Health Service, Pakistan (AKHS,P). The unit comes with the latest oral imaging technology, a dental chair and an autoclave machine to sterilise equipment. It can be transported from one village to another and delivers needs-based assessments and procedures.
Dr Khan volunteered to help promote oral health in Chitral. In October 2021, he, his team and AKHS,P’s regional staff conducted mobile dental clinics in Upper and Lower Chitral to reach people in need of dental care.
Despite the cold weather and heavy snowfall in some areas, the team from Noor Dental Clinic examined more than 2,000 patients for consultations. They conducted 1,500 procedures, including root canal therapy, fixed prostheses, fillings, gum treatment, scaling and polishing, surgical extractions and emergency procedures. The visiting team included a lab technician who provided removable prostheses for the patients to continue their daily routines while awaiting prostheses from dental laboratories in Karachi.
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“In Chitral, oral health is completely neglected,” said Dr Khan. “There is a lack of awareness about oral diseases and the impact of good oral health on overall health and well-being. A lot of work is to be done in terms of equipping hospitals with proper dental facilities and qualified dentists…”
The project included talks in each village on infections and oral hygiene, and identifying qualified dentists. The team visited schools to conduct free oral health check-ups and awareness sessions for students and teachers.
It also built the capacity of the lady health visitors and nurses who assisted during the project period to respond to basic oral health needs and refer patients to dentists at the Regional Health Centre Mastuj and the Aga Khan Medical Centre, Booni.
The team hopes that more volunteers will come forward to continue the dental clinic. They plan further outreach camps in other remote locations within Chitral, and to establish a permanent dental unit.
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