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Dr. Yahya Saleh Ghannam is a well-known Yemeni dentist. He owns and directs the Shehab Orthodontics Center in Sanaa. After his bachelor's degree in dental surgery from the College of Dentistry, Baghdad University, he has been working as a general dental practitioner since 1988.
Yahya, 36, attended several post-graduate courses in dentistry in Yemen, Iraq, Jordan, Syria and Dubai. He has also attended several scientific conferences in the USA, Germany, and various Arab countries.
Walid Abdullah Al-Saqqaf of Yemen Times talked to Dr. Ghannam at his private clinic and filed the following report.

Q: Could you give us a brief overview of the Shehab Orthodontics Center? What sort of facilities and equipment does it have?
A: The Shehab Orthodontics Center is a modern clinic specialized in orthodontic treatment such as malocclusion, open bite, crowding of the teeth, protrusion of the teeth, and other dental irregularities.
Our job is to correct occlusion and position of the teeth. The treatment takes a long time - nearly one year or more - to return the teeth to their normal position and function.

Q: You have recently treated your millionth tooth. What have you been able to achieve in the field of dentistry in Yemen?
A: When I first graduated from Baghdad University in 1988, Yemen had no more than 30 dentists working in the public sector in the morning and their private clinics in the afternoon. The country's population was around 8 million at that time. I don't exaggerate when I say that each of these 30 doctors has treated a quarter of a million teeth.

Q: Among which group of the population is tooth decay more prevalent?
A: Chewing qat and Shamma are widely spread. They contribute directly to bad oral hygiene and an increasing incidence of certain oral diseases such as periodontal diseases and oral cancer. For these reasons, paying real attention to oral hygiene is considered one of the primary needs to increase health care. This is particularly important as there is no research center to study the side effects of chewing qat and using Shamma.

Q: How important is oral hygiene for pregnant women?
A: I always advise mothers on the importance of primary health care for them and their children. As a dental specialist, I find great negligence in taking good care of oral health among pregnant women. This goes far beyond the extraction of one tooth or more after each delivery. Some physiological changes may occur during pregnancy due to poor oral hygiene. There are no national plans for combating the spread of dental diseases, especially during pregnancy.

Q: What about dental diseases among children?
A: There are dental problems among the majority of Yemeni children, especially from the age of three up to their teens. Due to lack of fluoride in drinking water, many oral health problems occur. Schools do not give children instructions on how to clean their teeth or the use of preventive methods.
The loss of deciduous teeth before the eruption of the permanent ones leading to malocclusion and malnutrition is one major problem which affects Yemeni youths. Because there is no planning for oral hygiene, I have made much effort to advise and treat my patients whenever possible.
As you may know, the percentage of fluoride in water in Sanaa is less than what is required, leading to reduced resistance against dental caries. While in other governorates, fluoride is extremely high causing fluorosis - the teeth becoming yellowish and ugly, resulting very frequently in psychological problems especially among females.
Q: How harmful is chewing qat?
A: From my personal experience (12 years), I found a great number of patients loosing their teeth at an early age as a result of chewing qat and using Shamma. Also, periodontal diseases are quite common among people who chew qat. Almost all qat chewers drink sweet drinks thereby compounding the problem.
Because of the problems I mentioned previously, I started writing in newspapers and taking part in TV programs in order to give proper advise to everyone in society. It is an extended service.

Q: How developed is dentistry in Yemen?
A: Before the revolution of September, 1962, there were no dentists in Yemen. After the revolution, a number of students were sent to study dentistry in other Arab countries. In the 1970s there were only three or four dentists in this country. The number rose to 12 in the 1980s. There are now about 250 Yemeni dentists. There is a lot of cooperation between with Arab and other countries in this field. There are now five dentistry schools in Yemen.

Q: What are the other causes of dental cavities?
A: Some bacteria, found naturally in the mouth, secrete an acid that dissolves the teeth enamel. Some people have high acidity in their mouths (pH higher that 7.5), causing caries despite them cleaning their teeth regularly.
Oral hygiene comes with increasing public awareness. Water fluoridation is also very important, especially at schools and urban centers in general.

Q: How do you advise readers to take better care of their teeth?
A: Brushing and cleaning the teeth daily is a must. I also call on the authorities to combat qat planting and consumption. More research should be done to evaluate the risks of this bad habit - qat chewing.