Access to dental care depends on where you live

More high-income countries offer dental care to children and adults to prevent dental and oral diseases, research finds.

In comparison, prevention is poor in low-income countries. And the global state of health suffers as a result.

Healthy teeth and mouth are linked to a person’s state of health in general. At the same time, diseases in the oral cavity and general chronic diseases share risk factors such as an unhealthy diet, sugar consumption, use of tobacco, and high alcohol intake. Therefore, prevention of dental and oral diseases aimed at the common risk factors also has a positive effect on the state of health in general.

The research is based on a questionnaire survey conducted among the health authorities in the 194 member states of the World Health Organization (WHO).

“Low- and middle-income countries have seen an explosion in dental and oral diseases…”

The results show that there is only 1 dentist per 152,721 citizens in low-income countries, and 1 per 13,810 citizens in middle-income countries. In comparison, there is 1 dentist per 1,708 citizens in high-income countries. That is, a dentist in a low-income country should take care of around 90 times as many people as dentists in high-income countries like Denmark, says professor emeritus Poul Erik Petersen from the odontology department at the University of Copenhagen’s Faculty of Health and Medical Sciences.

“Especially in low-income countries like Burkina Faso and Laos, for example, many people receive no treatment at all. And if they do, it is only in connection with symptoms that may end with extraction of the tooth,” he says.

According to the study, this lack of preventive dental care is a result of poor financial resources, failing political support from governments, limited public health sectors, and a shortage of dentists.

Local health services are often insufficient. For example, 52% of low-income countries provide schoolchildren with local healthcare. The same is true of 75% of high-income countries. Of low-income countries, 43% offer emergency treatment, while the same is true of 92% of high-income countries.

In addition, there are significant differences between the countries’ offer of preventive dental care such as regular dental examinations, information about dental diseases and self-care, diet and nutrition, sugar consumption, tobacco and alcohol, school dental clinics, and the use of fluoride against cavities.

“Low- and middle-income countries have seen an explosion in dental and oral diseases, mainly due to the intense increase in consumption of unhealthy food containing a lot of sugar, sugary soft drinks, use of tobacco, and insufficient dental care and ineffective systems. Add to this, poor material living conditions, which are a threat to people’s dental and oral health as well as to their state of health in general,” Petersen says.

“By increasing disease prevention and health promotion it is possible to avoid pain and discomfort in teeth and mouth, just as the quality of life and function may be improved by saving the natural teeth.”

Dentists today have extensive knowledge of how dental and oral diseases can be prevented. The challenge is to translate this knowledge into practice and thus establish effective dental healthcare and public health programs for all population groups in all countries.

“We need to strengthen the preventive measures for all age groups and both for poor and rich people. In the world’s high-income countries, disease prevention is generally aimed at children and young people and only to a minor extent at adults, just as it is fairly modest for senior citizens. There is also a need for clear health policies that gives priority to prevention,” Petersen stresses.

The report appears in the journal Community Dentistry and Oral Epidemiology.

Source: University of Copenhagen

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