00:00Think of a severe toothache, the kind that keeps you awake at night, makes your face swell, and
00:05that make even eating difficult.
00:07Now imagine you are in a municipality where there is no dentist who can treat you.
00:11To get that tooth checked, he has to take a bus, a boat, or even a plane and travel for
00:18hours.
00:19That, which may sound extreme, is a situation faced by thousands of people in different regions of Colombia.
00:25A recently published study on the supply of dental services found that it is highly concentrated in certain areas of the country.
00:34While in large cities there are doctor's offices and clinics in practically every neighborhood,
00:39In large rural and peripheral areas, the supply is becoming increasingly scarce as the
00:45complexity of care.
00:47There is a fact that helps to understand this much better.
00:50In 614 municipalities there are no authorized dental radiology services.
00:54It is more than half of all the municipalities in Colombia.
00:57And here it is worth pausing for a moment.
01:00A dental x-ray may seem like a highly specialized service, but it is part of quite routine procedures.
01:06To perform a root canal, for example, the dentist needs to know what is happening inside the tooth.
01:13how the ducts are distributed and how far it should work, and so on with many other procedures.
01:19Therefore, one of the researchers in the study wonders how general dentistry is being practiced in the municipalities.
01:25where there isn't even a place to get an x-ray.
01:28The problem has much to do with the way in which the supply of services has been distributed
01:33health in Colombia.
01:34Although dentistry is part of the health system and its services are included in the benefits plan,
01:39A significant portion of the supply is in the hands of private providers.
01:43And these tend to concentrate where there are enough patients and where the business is viable.
01:49That helps explain why it's so easy to find a dental office in Bogotá or Medellín.
01:54while in many remote municipalities the situation is completely different.
01:59One of the researchers even speaks of a gap between having an affiliation with the system
02:04and be able to actually access a service.
02:06According to their estimate, around 25% of the country has insurance coverage.
02:11but it does not make an effective excess of attention.
02:14And when that offer isn't available, people look for ways to solve the problem.
02:18One of the authors of the study recalls a photograph he took about 10 years ago in Coyaima, Tolima.
02:24It was a house with earthen walls, and in the yard there was a small sign that said
02:28Dental Service on Sundays.
02:30The man who worked there offered dental services and even extracted teeth.
02:35The researcher still has the photograph because, he says,
02:40If she hadn't taken it, probably no one would have believed her.
02:43That image somehow summarizes what happens in places where the system
02:48It fails to guarantee a sufficient supply.
02:50That's why researchers believe the State needs to intervene much more directly
02:55in these territories. First, identifying what each municipality needs and then bringing
03:01the services and staff that are needed.
03:04Because building a dental office is not very useful if there are no dentists.
03:08assistants or hygienists who want to work there.
03:11That's why they talk about better working conditions and incentives to bring specialists to these areas.
03:16and changes to some of the rules that currently hinder the provision of services in rural and dispersed territories.
03:23Another possibility also emerges, teledentistry, which could help to bring diagnostic capabilities to the table.
03:30and guidance to places where it is not possible to have a specialist permanently.
03:34All of this stems from a fairly simple situation.
03:37What happens when someone has a toothache and there's no dentist nearby?
03:41If you want to learn more about this gap that affects thousands of people in Colombia
03:46and what other alternatives do the authors of the study propose to close it?
03:50You can find the full article published in the Health section of El Espectador.
03:54And if you don't want to miss this kind of news, don't forget to follow us on all our social media channels.
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