Getting to the root of dental problems in Kenya

Fewer than 1,000 dentists serve the 44 million people of Kenya, from the far reaches of the bush to Nairobi’s vast Kibera slum. Dental hygiene is a rarity outside privileged urban regions.   

“In most rural areas, people have to travel long distances to see a dentist,” says Stephen Irungu, chief dental officer at Kenya’s Ministry of Health and past president of the Rotary Club of Murang’a. “Most of the patients will go to the dental clinic only because they have pain.” 

Cultural norms suggest that “it’s OK if your teeth fall out, if your teeth are broken. They think people are not going to die from it,” says Past District Governor Geeta Manek. 

Yet tooth decay is the most common chronic disease of childhood and a harbinger of health woes in later years, says Karen Sokal-Gutierrez, a physician trained in pediatrics, preventive medicine, and public health with the Joint Medical Program of the University of California, Berkeley, and the University of California, San Francisco. “We worry about AIDS and malaria and TB among the world’s poor, but tooth decay is so much more common, ” she says. “Unfortunately, it’s always been neglected,” even as processed and sugared foods proliferate in developing nations.

 Enter Kenya Smiles, a project created by Sheila Hurst, an educational consultant and member of the Rotary Club of Redding West, California, and Laura Day, past governor of District 5160 (California). Six Kenyan dentists including Irungu traveled to California in April 2013 as part of a vocational training team to attend meetings, seminars, and training. The global grant project included the Rotary Club of Karen-Nairobi and Districts 9212 (Eritrea, Ethiopia, Kenya, and South Sudan) and 6150 (Arkansas). 


In July, 10 Americans, including Hurst, Day, and Sokal-Gutierrez, made the trip to Kenya, where they distributed four suitcase-size portable dental operating units, educational materials, and 5,000 Rotary-blue backpacks filled with toothbrushes, toothpaste, and collapsible stainless-steel cups – dubbed “magic cups” by their young recipients. A $10 donation funded each kit. 

The team demonstrated how to use the kits with a hippo hand puppet, an oversize tooth and brush, and a whiteboard game with magnetic cutouts representing healthful and unhealthful foods and drinks, which the children tried to swipe away. “The message was ‘which one is going to stick to your teeth?’ ” Hurst says. “There would be laughter and smiles when the food would slide off.” 

The project is also funding nutrition education for mothers, along with locally manufactured, energy-efficient Jiko stoves to make it easier to prepare traditional grain- and produce-based meals. 

Team member Jim Green, of the Rotary Club of West Calaveras, California, expects that the 12-hour days the group spent in the field will pay dividends as mothers teach good habits to their children. “No mother in the world wants anything but good things for her children,” Green says. 

The educational component sets Kenya Smiles apart from many other dental projects, says team member MaureenValley, an orthodontist on the faculty of the University of the Pacific in San Francisco. Some traditional dental missions tally success by teeth drilled and extracted, she notes. “There’s been so little attention to attacking the root cause with education and intervention.”


Peter DuBois, executive director of the California Dental Association, agrees, noting the program brings together the resources of Rotary, governmental, and medical leaders to enhance the oral health of the Kenyan population. “I have never seen a program quite like it.”

DuBois arranged meetings between the visiting Kenyans and dental professionals, and brought the team to the California State Assembly, where they were recognized by lawmakers.

The project is good news in a place where “the only thing they can do is extract teeth, ” says Jeff Bamford, past Kenya country chair and charter president of the Rotary Club of Karen-Nairobi.

“Yes, we need more dentists and more mobile facilities,” Bamford continues, “but right at the beginning, we need to make sure that tooth decay happens as little as possible. ” 

He is heartened that the project’s biggest evangelists have been the children themselves. “I see the kids with great big smiles on their faces. When we talk to them, they’re so juiced about it. We can see the knowledge spread from one grade to another.”

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