|Year : 2014 | Volume
| Issue : 3 | Page : 195-196
A step toward cavity-free future
People's College of Dental Sciences, Bhopal, Madhya Pradesh, India
|Date of Web Publication||2-Jul-2014|
N D Shashikiran
People's College of Dental Sciences, Bhopal, Madhya Pradesh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Shashikiran N D. A step toward cavity-free future. J Indian Soc Pedod Prev Dent 2014;32:195-6
In the past, we seem to have accepted that teeth are expendable and that a cavity here or there was not too bad for one's health. Yet, when one looks at the statistics, the consequences of poor oral/dental health are considerable. Although very few people die as a direct result of oral diseases, poor oral health contributes significantly to both the infectious and noncommunicable disease burdens and also to health care costs. For the vast majority of the global population access to dental care is very limited. Even for those living in countries where dental services are more readily available, publicly funded dental care is rare thus entailing out-of-pocket expenses. Moreover, we should not forget the "determinants of oral/dental health," among which we might include the marketing and advertising of unhealthy and nutritionally questionable beverages and food to children, lack of access to safe water supplies, as well as the consumption of tobacco products.
There are substantial inequalities in oral health, both between as well as within countries. Despite the fact that it is preventable, dental caries remains a global public health problem, and it is the most common chronic disease on the planet. Moreover, researchers have already shown for some years that caries is a disease continuum that at the early stages is reversible, yet many Ministries of Health and dental professionals misunderstand this. We believe it's important to address these issues and to drive broader understanding and action. As such, a public health program, "The Alliance for a Cavity-Free Future (ACFF)" was developed. In the history of dentistry, we have never yet had effective engagement between health care professionals, the government and other stakeholders to curtail this widespread problem of dental caries in the world. The alliance is a social movement, which convenes a worldwide group of experts who have joined together to work toward the goal of a cavity-free future for all age groups. It acknowledges the global problem of caries, promotes an understanding of caries as a disease continuum, which is reversible, and will drive action to move communities and individuals to make the changes necessary to achieve the goal of a cavity-free future. Overall, the group believes that global collaborative action is needed to challenge global leaders and other regional and local stakeholders to learn the importance of caries as a disease continuum and to participate in action toward the delivery of comprehensive caries prevention and management that can positively influence the continuing problem of caries. At the global level, the alliance was launched on September 3, 2011 at the FDI World Dental Federation Congress in Salvador, Brazil. Since then, the expert panel and co-directors have been working hard to develop this initiative and have already received a tremendous amount of positive feedback from the global dental and public health community. The alliance has identified long-term goals such as:
- By 2015, 90% of dental schools and dental associations should have embraced and promoted the "new" approach of "caries as a continuum" to improve dental caries prevention and management.
- By 2020, regional members (chapters) of the ACFF should have integrated, locally appropriate, comprehensive caries prevention and management systems and monitoring developed and in place.
- Every child born in/after 2026 should stay cavity-free during their life time.
Therefore, based on the best scientific evidence currently available for the control of this disease, the ACFF states:
- Dental caries is a chronic disease resulting from an association between a necessary factor, accumulation of dental biofilm (plaque), and exposure to sugars (negative determining factor). Fluoride has an important role in its control by acting as a positive determining factor to reduce mineral loss when available in the oral cavity. Considering the modern societies' diets, caries is not eradicable, but it can be maintained under control without the appearance of advanced lesions during an individual's life, and the strategies currently available for that purpose involve controlling the necessary and determining causal factors (dental biofilm and diet).
- The epidemiological scenario demonstrates different caries prevalences both at the macro-regional level and at the local level (low-income regions inside the same city have a higher prevalence of caries), showing an important social factor involved in the disease-related to access to education and control strategies, thus characterizing caries as a biosocial disease.
- The addition of fluoride to the public water supply is an important public health strategy to control caries, but there are differences in the caries prevalence in regions with or without access to water containing fluoride. Hence, the inequality in access to water containing fluoride, in addition to its being one of the consequences of socioeconomic differences among regions, becomes an important factor in the control of the disease. The ACFF strongly recommends expanding the addition of fluoride in the water for public supply to cities which still do not have that benefit and stresses the need of heterocontrol of fluoride levels and of monitoring fluoride residual contents (in natura) in the water in order to guarantee maximum benefit with minimum risk of dental fluorosis.
- The use of fluoride-containing dentifrices to control caries is based on scientific evidence and is recommended all over the world to individuals of all ages. Due to concerns about dental fluorosis resulting from the disseminated use of fluorides, it is recommended that a small quantity of fluoride-containing dentifrice be used daily by young children, thus guaranteeing its anti-caries benefit and minimum risk of having them develop dental fluorosis; to this end, providing more detailed guidance by members of the oral health professional team is advisable.
- Preventive programs based on the use of fluoride should be expanded to regions/communities at risk, which lack access to those strategies, maximizing cost efficiency.
- The World Health Organization advises, as a global policy to improve oral health, that an action plan to promote health should be set as part of the integrated prevention against diseases. Converging toward the benefits from reaching that goal, the ACFF states that it is advisable that educational programs including the promotion of oral health as part of general health be continuously expanded by prioritizing groups at social risk of developing diseases, targeting on improving oral and general health. Those programs should be integrated to already existing strategies, such as the Family Health Program, or regional educational programs for oral health education, thus enabling an expansion in the knowledge of dental caries prevention in geometric scale where dentists, oral health technicians, community health agents, teachers and school children could act as multiplying agents in order to reach the ACFF's macro-objective.
As a dental health professional and a public health advocate I would like to advocate that we take oral health more seriously. It plays a vital role in our physical and mental health, and it has a significant impact on community and population health. Good oral health is good for everyone's health.
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