Oral diseases: a grave health challenge

Lazarus Sauti

Oral health is essential to general health and quality of life.

It is a state of being free from mouth and facial pain, oral and throat cancer, oral infection and sores, periodontal (gum) disease, tooth decay, tooth loss, and other diseases and disorders that limit an individual’s capacity in biting, chewing, smiling, speaking, and psychosocial wellbeing.

“Sadly, in most African states, 60 to 90 per cent of children and nearly 100 per cent of adults suffer from oral diseases,” noted the South African Dental Association (SADA) – an organisation that represents the vast majority of active dentists in the private and public sectors in South Africa.

The common oral diseases, according to the World Health Organisation (WHO), are dental cavities, periodontal (gum) disease, oral cancer, oral infectious diseases, trauma from injuries, and hereditary lesions.

FDI World Dental Federation, the world’s leading organisation representing the dental profession, said the high risk of oral diseases and stumpy access to care condemns Africa and other developing states to sub-standard oral health.

“Low expenditure on dental health in developing countries severely undermines oral care,” noted the organisation.

Professor Eyitope O. Ogunbodede, an expert in the field of Dental Public Health, believes the grave challenge of oral diseases in African countries is due to lack of government support for oral health research.

“Oral health personnel on the continent of Africa are not yet strategically placed to be able to influence health policy and decisions on funding.

To add on, there is a general lack of government support for oral health research,” he said.

He added, “Most African countries do not have established bodies that fund oral health research.”

SADA and WHO appended that oral health care coverage is still at its lowest level in most African countries.

“Although, most oral diseases and conditions require professional dental care, however, due to limited availability or inaccessibility, the use of oral health services is markedly low among older people, people living in rural areas, and people with low income and education,” they explained.

However, SADA and WHO suggest that oral diseases can be prevented by maintaining a constant low level of fluoride in the oral cavity.

“Fluoride can be obtained from fluoridated drinking water, salt, milk and toothpaste, as well as from professionally-applied fluoride or mouth rinse.

“Long-term exposure to an optimal level of fluoride results in fewer dental cavities in both children and adults,” they noted.

According to the World Health Organisation, the high cost of dental treatment in most African countries can be avoided by effective prevention and health promotion measures.

Further, public health solutions for oral diseases are most effective when they are integrated with those for other chronic diseases and with national public health programmes.

Though, the WHO global oral health programme aligns its work with the strategy of chronic disease prevention and health, there is still more to be done to combat the challenges of oral diseases.

Countries, therefore, need to address risk factors such as decreasing sugar intake and maintaining a well-balanced nutritional intake to prevent tooth decay and premature tooth loss, consuming fruit and vegetables that can protect against oral cancer along with stopping tobacco use and decreasing alcohol consumption to reduce the risk of oral cancers, periodontal disease and tooth loss.

SADA, WHO and the FDI World Dental Federation also urged African countries to develop plans, strategies and policies in oral health promotion and oral disease prevention.

“African states should develop strategies in oral health promotion so as to stimulate development and implementation of community-based projects for oral health promotion and prevention.

Focus must be on disadvantaged and poor population groups,” the expert groups said.

Dr Poul Erik Petersen, the Responsible Officer for Oral Health at the World Health Organisation, encouraged national health authorities to implement effective fluoride programmes for the prevention of dental cavities.

He also advocated for a common risk factor approach to simultaneously prevent oral and other chronic diseases.

Without doubt, oral diseases are major public health problem in Africa.

They cause pain, disfiguring, discomfort, anxiety, suffering and death.

Accordingly, governments, development partners and key stakeholders in the health sector in the continent must review present oral health care systems in their respective countries if Africa is to reduce the burden of oral diseases in the communities.