Tooth and nail: Thailand’s health services strain as dental appointments delay

The lack of medical personnel in every department, coupled with the measly number of dentists has pushed health services to the brink in Thailand with patients finding themselves on the verge of collapse as dental appointments are pushed two years ahead.

At 9am yesterday, a caregiver, who was accompanying an 11 year old boy for tooth decay treatment, shared this grim situation. The patient was treated at a provincial hospital in Chachoengsao. After the dentist performed root canal treatment, the boy was given a second appointment, in two years’ time.

The hospital advised the family that they would not schedule any appointments, instead, patients were asked to report for follow-up treatments after the two-year period. Alternatively, patients or their caretakers can also turn to private dental clinics to expedite their root canal treatments.

This sparked curiosity and concerns among the public. Why did the hospital schedule the second treatment two years later? It was seen as an exorbitant waiting time, reported Sanook

From the province’s main hospital, Dr Chonticha Aromseree gave some insight. A root canal treatment requires a specialist who can dedicate roughly 1-1.5 hours per patient, spread across 2-3 sessions depending on the number of roots per tooth. Besides the lack of specialists, many patients are awaiting similar treatments. If the hospital prioritises one patient, 2-3 others would inevitably miss their treatments.

Patients who are not suffering from toothache but have severe tooth decay are given emergency treatment to clean and medicate the root canal before being included in the queue for further treatment.

The hospital currently has only two root canal specialists among its 19 dentists. These two are also in charge of general dental treatments such as fillings, tooth extractions, and dental scaling. Their afternoons are spent in root canal treatments wherein they can cater to only four sessions. Given the lengthy duration of each session, they have to manage a long waiting list.

Previously, patients had to wait up to three years, but the system has been revised following a surge in cases and the imminent resignation of one root canal specialist in September 2023. This would leave only one root canal specialist in the hospital. To manage this, general dentists would be assigned the simpler root canal treatment cases, and patients residing near other healthcare facilities would have their cases forwarded.

Doctor Nattaya Mills, director of the hospital, expressed her concern over losing healthcare staff daily. With an initial count of around 1,500 people, the hospital sees daily resignations due to strenuous eight-hour shifts that pay only 700 baht (US$20). Employees are opting for easier 1-2 hour jobs, offering double the pay at private companies or aesthetic clinics.

The hospital is the last stop for various societal problems linked to mental health and various diseases. The rise in cases of diabetes, hypertension, and mental health problems seems only to be increasing with time. This has resulted in the hospital being a mirror of the societal changes we are grappling with today. The focus must now shift towards preventative healthcare and maintenance.

This worrying scenario reflects the concerns of doctors, nurses, and staff towards improving the health conditions in the vicinity. The situation, alarmingly, seems to promise no respite shortly.