Mapping oral cancer prevention in Eurasia countries

We had a talk with Olga about her project, and the impressions she got from visiting a huge amount of clinics in Moldova, Belarus and Armenia.

Tell us a bit about your project.

"As a dental hygienist I know that prevention and prophylactics is the key for good oral health. In Norway, patients make regular visits to dentists and dental hygienists who are trained to recognize mucosal diseases, oral precancer and cancer during undergraduate studies (our curriculum includes teaching and training in oral medicine and oral pathology) and through continuous education. In this way, oral diseases are discovered at an early stage when the treatment is easier or not necessary at all. Oral medicine and oral pathology are in early stages in Eurasia countries and in order to improve the quality of the oral health services in these countries to include oral mucosa morbidities and oral cancer, which poses an important burden of disease in these countries, we wanted to first map the knowledge, attitudes and practices of dental professionals in these countries regarding oral mucosal examination and oral cancer prevention. This is also meant to help in informing future policy initiatives aiming to develop and extend the role of oral healthcare professionals in prevention, by developing and implementing teaching of oral pathology under the form of courses, workshops and seminars.

To gather this information, I have been travelling since May in Moldova, Belarus and Armenia, distributing questionnaires to dentists and dental students in clinical year studies."

Any impressions you would like to share with us from your experience visiting dental clinics in these countries?

"From my observation, the biggest part of patients from these countries are presenting to the dentists when oral diseases are at the late stage, when they require quite intensive treatment, or when it is even too late for any curative treatment, as in the case of oral cancer. That’s why this project is very important and necessary to point out the need for training dental care professionals in preventive methods and for allocating time for preventive measures in the dental clinics in particular and health system in general. In contrast to Norway, the dentists in these countries are very much pressured by acute cases, especially at state clinics. They have lots of emergency cases, tooth extractions and cavity treatments, which requires more time, and because of that, there remains little time for oral mucosa examination. However, I was impressed with what they did with the little time they had, and how good they were at communicating, specially with children. Dentists were able to sit down and talk to their patients even if they had restriction in time." 

How many clinics did you visit?

"In Belarus and Moldova we visited more than 200 clinics and in Armenia we visited around 130 clinics. Also all clinical-year, dental students at the Belarusian State Medical University (total of 313 students), at the Yerevan State Medical University (total of 562) and at the Moldavian Faculty of Stomatology, State University of Medicine and Pharmacy “Nicolae Testemiţanu” (total of 285 students) were invited to participate in the study."                                             

How did you manage to do this in such a short time?

"It wasn't easy, but with good organisation between the collaborating parties and with great help from local coordinators and staff, we manage to do this. I also got a lot of help from my supervisors, Professor Costea and Assoc. Professor Ozkaya, on how to organise the work in the best effective way."

How were you received by the collaborating institutions?

"Coordinators and specialists in those countries are open for collaboration and most importantly to changes in oral curriculum to accommodate the need for mucosa examination, and recognition of precancerous and cancerous lesions. There is a positive attitude to improve the teaching curriculum in order to increase the knowledge and abilities in oral healthcare prevention. In Moldova, for example, I was invited to the rector of the university at the State University of Medicine and Pharmacy “Nicolae Testemiţanu”, where an even more radical approach was discussed, the implementation of a new profession and education program as “dental hygienist“. This profession, my profession, is very relevant for prevention of oral diseases and increasing the oral health status of a population with limited resources, such as the population of Moldova. With  support from this project and exchange of knowledge from a country like Norway, who have good experiences with this profession, it will be much easier for Moldova to implement it."   

What about your personal experience being part of this project and travelling in these countries?

"We started the project as a collaboration between Norway and 3 different Eurasia countries on the premises that the teaching curriculum and health systems are very similar, as well as that they harbour similar cultural features. After travelling to all of them, I realized that these countries are completely different from each other in many different aspects and difficult to compare. Minsk, the capital of Belarus, for example, is a combination of modern buildings and big green parks and at the same time it hosts an old post Soviet factory that has remained unchanged after the dissolution from the Soviet Union. This combination makes the city special and beautiful. Moldova and Chisinau are very green, with large, calm parks, historical monuments, amazing religious buildings, castles and fortresses dating back to medieval times, fantastic food and joyful people.  

One thing that perfectly describes Armenia, is people’s hospitality and spirituality, and it's beautiful nature, this has impressed me from the first day being there, and made me feel like home.

Working in this project has been an amazing experience. I had the opportunity to meet various people and talk with highly profiled professionals, to see the beauty of these countries as well as to learn about their oral health care system and their struggles. I am very glad I had the opportunity to learn about their rich culture and be a part of it during my visits there."

We wish Olga the best of luck with her very interesting project, and look forward to the results!