The Dental need in Liberia
Liberia has a population of over 5.5 million people. It is one of the few countries in the world that does not have any dental training facilities. The acute shortage of dentists and/or dental practitioners in the health system has posed a serious public health problem.
Currently, only three out of fifteen counties in Liberia are providing any dental care services to the Liberian population. There are only around seven dentists working in Liberia along with a handful of, lesser qualified, Dental Practitioners.
Oral diseases pose a major health burden for most people in Liberia. The affects are profound and affect people throughout their lifetime, causing pain, discomfort, disfigurement and even death. The impacts of poor oral health are far reaching across the population and have severe consequences for health, including the economic and social development of Liberia.
The most common oral disease observed in Liberia is dental caries (or tooth decay), which, if left untreated, can result in serious complications such as sepsis. Other oral diseases include periodontal diseases, trauma, oral manifestations resulting from general diseases and oral cancers.
Importantly, most oral health conditions are largely preventable and can be treated successfully in their early stages with access to basic and regular dental care. In addition to this, the burden of oral diseases can be reduced in the population by effective community prevention to promote oral health awareness, key prevention messages and self-care.
Trinity Dental Clinic
Trinity Dental Clinic (see here) was established in 2008 at ELWA hospital in Monrovia to help meet these needs. In 2019, the clinic expanded to a new purpose-built facility with 8 clinical rooms and currently employs 20 staff. These include a Liberian team of a dentist, a dental nurse practitioner, 3 senior dental assistants who extract teeth, 3 hygienists, 2 denturists, along with 4 expatriate missionary dentists.
In 2018, the Clinic sent one staff member to train at Nairobi Dental School, Kenya. He already had several years clinical and administrative experience, but no formal dental qualification. He is due to qualify in February 2025 and return as team lead. A second staff member was sent for training in 2022, she is due to qualify in 2028. These 2 will be fully qualified Liberian dentists.
The Clinic also periodically sends out teams on short, 2-3 day, dental outreach trips in rural areas. These provide dental extractions in places where there is no dental provision. But would it not be better if there were well trained people, spread around Liberia, able to provide dental care on a permanent basis?
The Liberia Dental Therapy School
By 2022, the time was ripe to further the original vision for the clinic for dental training by developing a formal two year Dental Therapy Practitioner training course. The school was launched in October 2022 and in June 2024 we hope to be graduating our first seven Dental Therapy Practitioner (DTP) graduates.
- They will have completed a 2-year diploma course, approved by the Liberian Ministry of Health. This will be awarded by Cuttington University, a private University in Liberia and supported academically by Peninsula Dental School, University of Plymouth, UK.
- They will be licensed by the Liberia Medical and Dental Council.
- They will be returning to their home towns around Liberia, where they will work, fully equipped (using Dentaid field kits – see here)
- They will be clinically supported, meeting dental needs, and generating their own income.
There are currently 15 students in training. In addition to the first 7 students due to quality in June 2024, a second group of 8 students started in October 2023 and are due to qualify in June 2025.
We plan to take on more students in September 2024, facilitated by the new bespoke Therapist School building adjacent to the existing Trinity Dental Clinic completed in February 2024 (see the videos above). This provides an additional 4 clinical rooms, a waiting area and a classroom.
The 5 year plan (2021-2027)
Although the day to day running of Trinity Dental Clinic is generally self-financing from patient fees, neither the dental therapist students’ fees nor the patients’ charges are nearly sufficient to establish and run the Dental Therapist School, and additional funds are required.
The Trinity Dental Clinic and Training Centre is a project managed through SIM Liberia, part of the Serving In Mission international Christian charity; training and treatment are offered to people of all faiths, and none. Due to the challenges of transport to Liberia, we are seeking support only in the form of cash donations which may be made here.
For further information, please contact Dr Stretton-Downes directly at strettondownessimon@gmail.com.
The project is led by Dr Simon Stretton-Downes OBE BDS, who has been the Principal Dentist at Trinity Dental Clinic, as a volunteer, since 2017 and led the construction of the new clinic in 2019 as well as the extension opened in February 2024. He qualified in 1983 from Newcastle University, in the UK, and his dental experience includes eight years in Ethiopia with SIM, eight years as a civilian dentist for the UK Armed Forces and 16 years as a partner in general practice in England. He was awarded an OBE for services to dentistry in Africa in 2021.