The bitter truth about Estonia's dental health

  • 2004-02-19
  • By Justin Petrone
TALLINN - It could be said that Estonia has a bit of a sweet tooth. According to Kalev, the Tallinn-based confectionary giant, Estonians consumed almost 7,000 tons of sweets last year, and each person in the country eats on average about 9 kilograms of chocolate per year.

These types of figures put Estonia in the same category as Norway in terms of chocolate consumption, and represent nearly double the rate of America's chocolate intake.
Some people though, like Dr. Kristjan Gutmann, president of Estonia's Dental Association, might say that Estonians like it a little too much.
"Sweets are a big problem," he says. "They sell sweets at schools. They sell gummy bears in the school shops."
Gutmann's organization gathers private practitioners from around the country together to raise awareness about dental health. But when it comes to tooth decay, which can result from the consumption of sweets, it seems they are up against a national habit that's hard to break.
Along with the powerful cravings comes a market to accommodate them, and Gutmann says that companies locate sweets in specific places within shops to encourage increased consumption.
"They are always placed near where you buy your food, so you don't have time to think about buying them. Parents don't understand how dangerous it is. Public awareness is not very high," he says.
His comment hints at the relatively little attention that some Estonians give their dental health. "General awareness is not as good as it should be. Young women don't know how to take care of their children's teeth," he says. "They don't have dentists in schools, and nobody is checking them."
Moreover, not much can be said for the prophylactic, or preventative, work - such as brushing and flossing - of the Estonian nation when held up against its neighbors.
"There isn't a very good source which can tell us this, but my personal belief is that [dental hygiene] work isn't as good here as it is in Finland and Sweden," he says.
He also says that the priorities of a country where it is not uncommon to meet a man with half a mouthful of teeth are incredibly mixed up.
"People are spending their money in the wrong places. It's a problem with attitudes and your priorities. If a young man is missing a tooth and decides to spend his money on a mobile phone, that's his problem," he says.
But a potential patient may think twice before he drops 500 kroons (32 euros) on a toothache instead of his grocery list. Many see dental work as beyond their budget.
Aware of the public's conceptions, Gutmann refutes the idea that dental care is too expensive for the average Estonian.
"Generally speaking it's affordable for everybody, although there are some kinds of work that are more expensive," he says. "Prices vary very much according to materials and where the work is being done. In general it will cost you 500 kroons to 600 kroons for a filling."
However, Estonians may not be completely responsible for their sugar addiction. According to some sources, they may all be exhibiting features of a psychological condition called seasonal affective disorder. Referred to as SAD, it often strikes people in those countries with shortest daylight hours and leaves them with symptoms of depression - general feelings of laziness, a strong need for sleep - along with a disproportionate craving for sweets.
The science behind this disorder has to do with an influential biological substance called seratonin, which helps the nervous system function. According to Nordic Light Care AS, a Norwegian company that offers SAD treatments, the body can produce seratonin naturally with the help of sunlight but can also obtain the substance from sweets and other foods.
It's no surprise then to find that northern countries, such as Nor-way, Finland and Estonia, lead the world in chocolate consumption.
Ruth Roht, public relations manager for Kalev, substantiates this cocept. According to Roht, autumn and winter are the busiest months for the company in Estonia.
"Fall is the busiest especially before Christmas. The consumption of candies is highest before and during Christmas," she says.
The holiday festivities also mark the time when sunlight reaches its lowest level of the year in Estonia.
"People prefer chocolate mostly in autumn and wintertime, when chocolate can be considered 'a replacement for the sun,'" Roht explains.
Gutmann says that while Estonians may have a predilection for sweets, efforts have been made in similar countries to curb their chocolate addiction. The dentist stresses that, while awareness is rising, it is not as high as in neighboring countries.
Furthermore, healthier alternatives are not as popular. "So-called 'smart sweets,' such as sugar-free bubblegum, are not used as often as they are in other Nordic countries," Gutmann points out.
For him and other dentists it is an uphill battle of trying to raise awareness to salvage Estonia's remaining sweet teeth.