Hidden cost of tooth pain: Why many endure toothaches instead of seeking treatment
The prevalence of dental caries, gum disease, and dental fluorosis remains alarmingly high in Kenya, with many cases left untreated, leading to long-term complications.
What began as a simple attempt to remove a piece of meat stuck in her molar tooth at the age of 16 has turned into a relentless battle with pain for Esther Wanjiru, now 26. Over the years, the discomfort has been unbearable at times, yet the fear of being toothless has prevented her from seeking proper treatment. Instead, she has relied on painkillers to get by.
“If the affected tooth were hidden at the back, it would be easier to remove it and move on. But knowing that people would constantly ask about the missing tooth has stopped me from taking that step,” she explains.
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For years, Esther has visited multiple health facilities, hoping for a solution within her means. However, each time, the most affordable option presented to her is tooth extraction—an irreversible choice she is reluctant to make.
“As much as I feel the pain, I always ask myself: if I remove one tooth, then another, and can’t afford replacements, won’t I end up toothless? So, I just manage with painkillers, especially since the pain isn’t constant.”
Her struggle has lasted over a decade, with the pain intensifying during cold, rainy seasons. The damage to her tooth has now reached a point where only advanced procedures can save it—treatments she simply cannot afford.
“I visited a reputable facility hoping to get a simple filling or a root canal, only to be told that my tooth is too damaged. The procedure I need would cost between Sh20,000 and Sh50,000, which is way beyond my budget,” she says.
Although tempted to seek cheaper alternatives, Esther was warned by her dentist against shortcuts that could lead to infections and severe gum damage.
“When I heard the cost, I just went to a nearby pharmacy, bought pain relievers, and kept going—hoping that one day, I’ll be able to afford proper treatment.”
Last year, Linet Atieno, now in her 30s, was grappling with excruciating tooth pain. As had become her norm, she opted for extraction—her usual solution whenever a tooth ached. Over time, her trusted dentist had already removed three of her molars. However, this time, the procedure was far from routine, leaving her with severe swelling and intense pain that required further medical attention.
“I didn’t want to spend Sh7,000 on a dental filling, which I couldn’t even afford. The pain was unbearable, so I didn’t think twice about removing the tooth. But the extraction ended up damaging a nerve, and before I knew it, I was not only in pain but also dealing with massive swelling,” she recalls.
Although the tooth removal itself only cost Sh1,000, Linet had to borrow money to seek further treatment at Mbagathi Hospital—an expense she deeply regrets.
"Now, I have four missing teeth, and yet, I still experience pain. I’m unsure if I want to remove any more, but it seems like the more I extract, the worse it gets. I’ve decided I won’t go through another removal.”
The high cost of dental care leaves many with limited choices, often resorting to extractions instead of proper treatment.
The prevalence of dental caries, gum disease, and dental fluorosis remains alarmingly high in Kenya, with many cases left untreated, leading to long-term complications.
Dental treatment in Kenya remains costly, with the Social Health Insurance Fund (SHIF) providing only Sh2,000 per household—an amount that barely covers even a basic tooth extraction. The cost of extraction varies across facilities, typically ranging from Sh1,000 to Sh2,000. A simple root canal in a basic dental clinic costs between Sh6,000 and Sh10,000, depending on the services offered. However, more advanced procedures, such as complex root canals or dental restorations, can range from Sh20,000 to over Sh50,000, making quality dental care inaccessible to many.
Among children, cavities are a major concern, with the 2015 National Oral Health Survey revealing that over 46% of five-year-olds suffer from dental caries. Excessive fluoride exposure has contributed to dental fluorosis in 41.7% of children, causing tooth discolouration. Additionally, gum disease is widespread, affecting over 90% of the population with signs of periodontal disease.
The same survey found that 34% of adults had untreated cavities, while a staggering 98% suffered from gum disease, including periodontitis. Cases of oral cancer and precancerous lesions were also noted, signalling a rising trend in serious oral health conditions.
Untreated dental disease remains a significant issue, with 34% of the adult population experiencing persistent tooth-related problems. Periodontitis, one of the most common gum diseases, affects nearly 98% of adults, while dental fluorosis continues to be a major concern, with prevalence rates ranging between 44% and 77%. Research has also confirmed a strong link between fluoride exposure and dental fluorosis.
The Kenya National Oral Health Policy (2022-2030) highlights these critical concerns, noting that 40% of children suffer from dental caries, over 90% are affected by gum disease, and 41% experience dental fluorosis. Additionally, the survey found that 95.5% of children brush their teeth without supervision, raising concerns about the effectiveness of their oral hygiene practices.
Dr Timothy Mutua, a Nairobi-based dentist, regularly treats patients suffering from severe toothaches—many of whom have endured pain for years without seeking treatment. Others experience dental issues caused by excessive consumption of sugary substances such as sweets, chewing miraa (khat), and substance abuse, including smoking.
“Oral hygiene is largely dependent on personal habits. Unfortunately, many people, due to persistent pain, completely avoid brushing their teeth, which only worsens the damage,” Dr Mutua explains.
He highlights that miraa and sugary substance consumption pose significant risks to dental health. Its constant use can lead to bleeding gums due to particle buildup, disruption of the salivary glands, increased cavities, enamel erosion, bad breath, throat ulcers, tooth sensitivity, and even a reduced sex drive.
Oral diseases impact an estimated 3.7 billion people worldwide, with untreated dental caries (tooth decay) in permanent teeth ranking as the most prevalent health condition, according to the Global Burden of Disease 2021 report. Many oral health issues stem from modifiable lifestyle factors, including tobacco and alcohol use, diets high in free sugars, and poor hygiene—risk factors that are also linked to noncommunicable diseases (NCDs) such as cardiovascular disease, cancer, chronic respiratory conditions, and diabetes.
To maintain good oral hygiene, Dr Mutua advises daily care, including proper brushing with the right toothpaste and avoiding the habit of sleeping with food particles in the mouth.
“Many people neglect painful teeth, waiting until the damage is irreversible. By the time they seek help, there’s often little that can be done to save the tooth,” he warns.
A tooth infection may start as a minor ache, but when left unchecked, it can spiral into severe, even life-threatening complications. What seems like a localised issue can quickly spread, affecting the jawbone, gums, and even vital organs.
When bacteria from an infected tooth spread beyond the gum line, they begin attacking the surrounding bone. This can lead to osteomyelitis, a painful and potentially dangerous bone infection. As the infection worsens, the affected tooth may become too damaged to save, requiring extraction. Over time, the jawbone itself weakens, making it difficult to support dentures or implants, significantly impacting a person’s oral function and quality of life.
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