BETTER ORAL HEALTH TO ALL

Abstract

Despite vast improvement in global oral health, problems persist in many populations and communities particularly among the underprivileged in both and developed and developing countries. Dental caries and periodontal diseases have for years burdened the majority of populations with heavy treatment and financial needs. Dental caries is still a major oral health problem in most industrialized countries as it affects 60-90% of school-aged children and the vast majority of adults. According to the World Health Organization oral diseases are the fourth most expensive to treat. Their treatment costs exceed those of cancer, heart and coronary diseases, stroke and dementia in most industrialized countries. It has been estimated that the European Union countries used 79 billion euros for oral health care in 2012. Should the present trend continue the costs could exceed 93 billion euros in 2020.
Oral and dental care, as known in the developed world, is not available to 90% of the global population. The millions living in poverty do not have access to emergency dental care or to preventive measures to help them in their own oral health. It has been estimated that 80% of dentists in the world are serving 20% of the global population. Given their prevalence worldwide oral diseases represent major public health problems causing pain, suffering and reduced quality of life. Generally, studies on dental caries and periodontal diseases have shown a decreasing trend of oral diseases in developed countries. On the other hand assessing the situation in developing countries is characterized by lack of continuous and reliable data despite the recommendations of WHO. To provide or even to plan dental services required to meet the needs, oral health need assessments and surveys are necessary both locally and nationally.
The major oral diseases are today understood more clearly than ever as behavior-related diseases. They are preventable through individual’s own actions supported by the health professionals. Generally, health behaviors, either health-enhancing or health-detrimental, are mostly derived through norms, values and goals of the family. The family plays the primary role in the acquisition, modification and improvement of health behavior. However, maintaining let alone changing health related behavior is a vast challenge. Everyday life is full of health related risks known or unknown to the individuals. A health-related behavior is not a simple matter of freedom of choice rather than reflection of one’s lifestyle. Lifestyle with different risks being also determinants of different diseases should be understood as an expression of the cultural and social environment in which people live and work. This concept bears significant impact on oral health. The core group of modifiable risk factors for the chronic diseases often cluster in the same population groups and individuals. These factors include smoking, alcohol consumption, diet, hygiene and stress. Controlling one or a small number of risk factors have a major impact on a number of chronic diseases including oral diseases.
The behavioral science experts are of opinion that only comprehensive and integrated common-risk-factor-based health promotion activities can enhance oral health and its equity as a part of general health. Are health professionals ready to assume their responsibility for promoting better oral health?