Oral health is a neglected area of global health and has traditionally registered low on the radar of national policy makers. The reasons for this situation are complex and varied. In many countries oral health is not included in national health surveys. And, if data are collected, it is usually in isolation from the context of general health. Moreover, in some cultures, oral health is neglected because teeth are seen as expendable. Dentists have also taken little interest in advocacy to promote good oral health, preferring to treat rather than prevent oral diseases. And, because poor oral health affects morbidity more than mortality, governments have viewed oral conditions as less important than other, more life-threatening diseases. (emphasis added)
We were gratified to read this confirmation that the dental industry as a whole tends to privilege treatment over prevention. And it’s not hard to see why. There’s just more money in it. But while prevention doesn’t pay the dentist, it does benefit the patient. It also benefits society via lower overall costs of care and reduced risk that public funds will be needed to help treat conditions stemming from poor oral and dental health and which could have been prevented in the first place.
We didn’t appreciate this part of the editorial quite so much:
The daily use of fluoride is the most cost-effective, evidence-based approach to reduce dental decay. Water or salt fluoridation are possible population-wide approaches but their implementation depends on the development and infrastructure of the country as well as political will and community acceptance. Promoting the daily use of effective fluoride toothpaste is a more realistic strategy but its cost prohibits its widespread use in many low-income and middle-income countries. Governments can remove taxes on fluoride toothpaste, which in some countries represent up to 50% of the product’s price, and they can work with manufacturers to produce lower cost toothpaste.
We wish they would have mentioned specifically at least a bit of the “evidence” of fluoride’s efficacy – especially in light of the recent JADA study indicating fluoride supplementation does not appear to help prevent cavities in children. We would also like to know if the evidence of efficacy outweighs the well-documented risk of putting this known neurotoxin in the body.
The editoral concludes with other, less problematic recommendations, and overall, it is a strong statement of the need to address oral health as part of an overall public health policy both here and abroad. Much is to be gained in terms of overall health by addressing the health of the teeth, gums and other oral tissues.
We just wish they’d leave the fluoride out of it.