The tooth will out: It's time to bring the dentures to the people
Getting new teeth is too pricey for most South Africans, but this this may soon change
Just more than a year ago, Nolusapho Xuba lost all her teeth when they were extracted after years of problems and pain.
A set of dentures would have cost the 75-year-old Butterworth woman more than R6,000 – money she didn’t have, as she depends on the state old-age pension.
Luckily her grandson, Unathi Xuba, 23, is a third-year dental technology student at Cape Peninsula University of Technology in Cape Town. He made her dentures, meaning his grandmother only had to pay the dentist who fitted them.
Other South Africans are not so fortunate. They mainly depend on dentists to get dentures – at prices that are out of reach for most.
It is for this reason that dental technologists – the only professionals accredited to make dentures – have ambitions to serve the public directly.
They want the law changed to allow them to work as clinicians and deal with the public directly instead of being restricted to the laboratory, working as go-betweens. And they believe this will make dentures more affordable.
Countries such as the UK, Australia, parts of the US, Canada, Denmark, Finland and Switzerland already have denturism, a speciality that allows denture manufacturers to receive clinical training so they can have direct access to and communication with the end-users of their products.
In SA, only dentists are allowed to issue dentures, but backyard quacks have penetrated the industry and offer bargain-basement dentures, particularly the popular “gold-plated” versions.
Cape Town prosthetic dental technician Duffy Malherbe, secretary of the Society for Clinical Dental Technology, said allowing dental technologists to work as clinicians would shave about 30% off patients’ bills and cut waiting times and the number of appointments they required.
He said the current arrangement was similar to asking an artist to paint a portrait without meeting the subject. “Making a denture without access to the denture wearer, solely on the instructions of a go-between, is inefficient and frustrating to all concerned and the patient is often the ultimate loser,” he said.
Last month, the International Federation of Denturists chose SA to host its annual meeting, where delegates discussed the latest challenges around legalising denturism.
The Health Professions Council of SA (HPCSA) said dental technologists’ training would have to be altered so much to meet their demands that it would be similar to that of dentists.
HPCSA spokesperson Daphne Chuma said: “Their training programmes will have to be adjusted to include courses in pathology, microbiology, principles of medicine and surgery, anatomy and physiology.” Additionally, being recognised as a clinician meant having to comply with strict safety regulations, including infection control.
“Many systemic conditions and cancers present in the oral environment, and providing dentures without recognising or managing these conditions could be detrimental to the health of the patients,” she said.
But Malherbe said denturists would never do complex procedures. “Denturism shouldn’t be seen a threat to dentists. Instead, it should be seen as specialisation that will actually free dentists from being issuers of dentures to do more complex work, which they are trained to do,” he said.
“In countries where denturism is recognised, it is actually denturists who spot oral malignancies early on and refer patients to dentists. Denturism is all about compassion. We want to reach out to everyone … to make dentures more accessible.”
Unathi Xuba said access to dentures should be a right, but in SA it was a privilege because of the price. “Growing up in the Eastern Cape, I always wondered why older people had no teeth,” he said.
“I only realised their plight when I got older and realised that having dentures is dependent on who you are in society. It shouldn’t be like that. Having a nice smile shouldn’t only be for the privileged.
“Many South Africans who don’t have teeth can’t even get jobs because certain company policies require that you have teeth or dentures. Most of these people don’t go past the interview process … simply because they have no teeth.”
As a young dental technologist, if he wanted to pursue a career as a denturist he would have to emigrate. “I don’t want to go overseas to practise as a denturist, I want to practise here at home and help South Africans.
“Denturism is not about making more money, it’s about compassion for the less privileged.”