SWEDISH SOUTH ASIAN STUDIES NETWORK

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Department of Periodontology, Institute of Odontology, Karolinska Institutet Medical University, Stockholm:

Postal address: Odontologiska institutionen, Enhet 3 (Parodontologi), Karolinska institutet, Box 4064, SE-141 04 Huddinge, Sweden
Visiting address: Alfred Nobels Allé 8, Flemingsberg
Fax: + 46 (0)8 711 83 43
Web page: http://www.ki.se/odont/research/research_groups_Parod_en.html

Contact person: Associate Professor Anders Gustafsson , phone: +46 (0)8 524 883 31

Research and Collaboration with South Asia:

The Institute of Odontology at Karolinska is involved in a collaboration project with Altamash Institute of Dental Medicine, AIDM, (photo to the right) a private dental institute affiliated with the University of Karachi, Pakistan, since October 2000. It includes educational and technical assistance, and since 2003 an exchange of students and teachers through the Linnaeus Palme International Exchange Programme.
The Altamash Institute of Dental Medicine is a private dental institute with approximately 100 students founded by Dr. Mohammad Altamash, now AIDM President. Dr. Altamash has been instrumental in realizing the collaboration and has therefore visited Karolinska Institutet several times, where an agreement has been made with Folke Meijer from Karolinska Education AB.

Teachers from AIDM have come to Stockholm as guest lecturers, including Dr Farzeen Tanwir, Dr. Shah Salman Khan and Dr. Fawad Javed, and teachers from Stockholm (Assistant Professor Lars Frihiof, Professor Björn Klinge and Professor Jan Huggare) have gone to Karachi. The ambition has been to gradually extend the collaboration project by including also exchange of students from 2005.

Presently, during the Spring 2007 the first three exchange students from the Dentistry program at Karolinska Institutet are studying at AIDM for three months within the LP-program. Hopefully they will have many followers. Four students from AIDM spent their Spring semester 2006 at KI and four students were recently accepted for the Autumn semester 2007. The exchange program is quite popular at AIDM and the number of applicants by far exceeds available scholarships. Apart from the indisputable educational value for participants from both institutes the students acquire valuable understanding of the respective country, culture and education. Bonds between AIDM and KI are growing stronger each year thanks to the program.

Two of the AIDM teachers, Dr. Farzeen Tanwir and Dr. Fawad Javed were registered as PhD candidates at the department in Stockholm. They have had supervisors both at Karolinska and at AIDM.
Farzeen Tanvir (photo) worked on a project under supervision from Associate Professor Anders Gustafsson. The project consisted of an epidemiological survey on dental status and general health among underprivileged groups in Karachi. It received a SASNET Planning grant in February 2005. On Thursday 12 June 2008, Farzeen Tanwir defended her doctoral dissertation, titled ”Absence of toothache syndrome. Oral health and Treatment needs among urban Pakistanis”. Faculty opponent was Associate Professor Lars Gahnberg, County Council of Göteborg. More information.
Abstract: Dental caries and periodontal disease are among the most common diseases affecting mankind. Oral diseases have a negative impact on an individual’s quality of life and also represent a burden for health care systems worldwide. Populations in the developing nations are afflicted by a panorama of oral diseases similar to that of the developed nations: dental caries, periodontal diseases and oral mucosal diseases. In both developed and developing countries, the burden of oral disease is particularly high in underprivileged groups.
Pakistan, a developing nation, is excessively burdened by oral diseases, particularly dental caries and periodontal disease. The oral health status of adult Pakistanis is poorly documented.
The general aim of this thesis was to survey oral health and oral treatment needs among an adult population from a deprived area in Karachi, acquiring baseline data for future treatment strategies and research. The specific aims of the thesis were to describe perceived oral health and perceived treatment needs among adult Pakistanis; to survey oral health with special reference to habits, knowledge and attitudes; to investigate the influence of betel quid (pan) and betel nut (chalia) chewing on oral health; to relate objectively assessed dental treatment needs to perceived treatment needs; to relate objectively determined oral health status to risk factors such as betel nut habits; and finally, to determine whether – in this population with relatively poor oral health and poor oral hygiene – diabetes is associated with any specific oral problems.
In conclusion, the results of the studies on which this thesis is based show that among urban adult Pakistanis, oral health is not perceived as a major concern and has low priority. No association was found between poor oral health and educational levels or socio-economic status. In general, major restorative treatment is not required: the primary unmet treatment need is for minor restorative work or preventive measures such as scaling. Improving oral hygiene habits and dental health education could achieve major improvements in oral health. In this population with poor oral hygiene, diabetics have more missing teeth and a higher prevalence of peridontitis.

Dr. Farzeen Tanwir is now working as a post-doc researcher at the KI’s Division of Global health (IHCAR), within the research group on Medicines in the health system – focusing antibiotics. More information.

Fawad Javed’s project has been based on similar material and studies the relation between diabetes and periodontitis, including immunological and microbiological methods. It also has a clear clinical approach and aims at finding ways to improve oral health within vulnerable population groups.

A third Pakistani PhD candidate – Dr. Talat Qadri, is also working on a doctoral project at the department. Qadri is also coming from AIDM in Karachi, but is now a practicing dentist in Sweden.

The experiences from the dissertation projects have been very good so far, and both the institutions involved see benefits from the collaboration. The ambition from the Pakistani side is to increase the number of graduated teachers.