May 8, 2013

The State of Oral Health Care Around the World

Proper oral health care is critical to good overall health; poor oral hygiene can contribute to the development or exacerbation of certain diseases. When severe gum disease is present, chronic inflammation and deterioration of bone and connective oral tissue generally results in tooth loss.  Around the globe, approximately 15-20% of adults, ages 35-44, have advanced gum disease, and approximately 30% of adults between the ages of 65-74 have none of their natural teeth intact1. In addition, statistics from the World Health Organization (WHO) show that approximately 60-90% of children and close to 100% of adults worldwide have cavities2.

Tooth decay is the most common chronic disease worldwide, with over 90% of the population affected. It is also the most common childhood disease, affecting over 70% of school children3. Surveys of oral hygiene habits among children from 41 countries show a difference in frequency of brushing between North American and European countries. The American Dental Association (ADA) reports that 78% of American adults brush twice daily, while only 44% of children do the same.4,5 European countries vary in rates of tooth brushing from a high of 75% of adults brushing twice daily in Switzerland, Sweden, Netherlands, Germany, Denmark and Norway to a low of fewer than 46% in Finland, Romania, Greece, Lithuania, Turkey and Malta6.

The current state of oral health care in developing and developed countries

The staggering rate of oral disease is a health burden that needs to be addressed on a global level. Fortunately, the World Health Organization (WHO) Global Oral Health Programme is focusing on the importance of oral health around the world. The goal of the program is to find ways to aid the millions of people who are unable to receive preventative dental care due to low income or lack of access. In recent years, several European countries have deregulated oral health care services and made it impossible for many to afford. Furthermore, school dental services that were once offered in most eastern European countries have been discontinued, leaving children without oral health care coverage. Minimizing the prevalence of gum disease and its associated chronic health problems requires the availability of preventative treatment for everyone7.

Developed countries have the greatest access to oral health care with the United States, Japan and Canada having the highest number of employed dental professionals8.  Income levels seem to be a contributing factor in determining good oral health. Middle-class families often struggle to pay for the recommended twice-yearly checkups and necessary dental work, because many health insurance plans do not include dental coverage.

One bit of good news is that the number of dental hygienists entering the field in all developed countries has been increasing over the past decade as research continues to show the many risks associated with gum disease. Between 1987 and 2006, the number of dental hygienists in Canada increased by 200%, and in Italy, by a whopping 2207% 9. In the U.S., the Bureau of Labor Statistics has predicted a 38% job growth in the field between 2010 and 2020—a percentage much higher than the growth average for all occupations10. Some explanations for this substantial rise include a growing population, a higher demand for preventative dental care, and the need to maintain oral health (and prevent tooth loss) in the aging population.

Easy preventative steps for good oral health

From a global perspective, we have a long way to go to improve worldwide oral health.  Increasing awareness and change will take time.  The first step toward improving the global statistics of gum disease is to focus on personal preventative measures — one should never underestimate the importance of daily brushing and flossing. WHO clearly states that the high cost of dental treatment can be avoided by effective health preventative measures. Maintaining healthy gums and teeth in between dental visits is imperative to help ensure a better quality of life.

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References:

  1. “Oral Health.” Who.int. World Health Organization, n.d. Web. <http://www.who.int/mediacentre/factsheets/fs318/en/>.
  2. WHO, same
  3. “Dental Caries (Tooth Decay).” Nidcr.nih.gov. National Institute of Dental and Craniofacial Research, n.d. Web. <http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/DentalCaries/>.
  4. “Survey Results Reveal Oral Hygiene Habits of Men Lag Behind Women: WebDentistry: SmileFinder Annuaire Des Dentistes.” Webdentistry.com. Web Dentistry, n.d. Web. <http://www.webdentistry.com/Article1421-fra.html>.
  5. Huget, Jennifer LaRue. “Kids Should Brush Teeth for Two Minutes, Twice Daily.”Washingtonpost.com. The Washington Post, 17 Aug. 2012. Web. <http://www.washingtonpost.com/blogs/the-checkup/post/kids-should-brush-teeth-for-two-minutes-twice-daily/2012/08/16/883060a0-e7d0-11e1-9739-eef99c5fb285_blog.html>.
  6. Eaton, Kenneth A., and Monica J. Carlile. “Tooth Brushing Behaviour in Europe: Opportunities for Dental Public Health.” International Dental Journal 58 (2008): 287-93. Unilever.com. Unilever. Web. <http://www.unilever.com/images/sd_Tooth_brush_behaviour_in_Europe_opportunities_for_dental_public_health(International_Dental_Journal_2008)_tcm13-160710.pdf>.
  7. WHO, same
  8. Johnson PM. international profiles of dental hygienist 1987 to 2006: a 21-nation comparative study. Int Dent J. 2009; 59(2): 63-77. (2.)<http://www.thefreelibrary.com/Dental+hygiene+around+the+world%3a+present+and+future+considerations.-a0245543673>
  9. Johnson, same
  10. “Dental Hygienists.” Bls.gov. U.S. Bureau of Labor Statistics, n.d. Web. <http://www.bls.gov/ooh/healthcare/dental-hygienists.htm>.



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