The Oral Health System Next Door:
A First-Hand Look at Dental Care in Cuba
) Dr. Yihong Li, right, and Dr. Gregory Stoute, Associate Professor of Health Policy and Health Services Research and Director of Minority Affairs at Boston University )
A street scene in Old Havana |
Last
April I was part of the first-ever United States public health delegation
to travel to Cuba to assess the state of oral health in a nation with
a system of free, universal access to health care. Although Cuba’s
ability to provide technologically advanced therapies has been hampered
by a 40-year U.S. trade embargo, I can report that the nation has
developed some surprisingly effective approaches to preventive care.
For example, the percentage of caries-free five-year-old Cuban children increased from 30 percent in 1984 to 55 percent in 1998, according to the World Health Organization. And between 1973 and 1999, the mean number of carious teeth in 12-year-old Cuban children dropped from 6.0 to 1.4. There have been achievements in adult oral health as well, including oral cancer screenings for 71 percent of adults over age 60. Preventive efforts center on a network of primary care clinics throughout this island nation, where 9,877 dentists serve 11 million people (a ratio of approximately 1:1,100). The clinics care for an average of 700 to 900 local residents from cradle to grave. They provide annual dental examinations for all Cubans (twice annually for those under four years old or over 60), pre- and postnatal infant oral health instruction, and 16 annual fluoride mouth rinse treatments for all school-age children. Since returning to the U.S. my colleagues and I have been discussing ways to help Cuban dentists learn about advanced dental technologies and therapies. Just how far our efforts will go remains to be seen, given the trade embargo’s continuing restrictions. But those of us who made the trip remain hopeful that our mission has laid the groundwork for an ongoing productive relationship with the Cuban dental community. |
