Prevention of oral diseases in developing countries

Low caries prevalence, high rates of periodontal disease and widespread oral mucosal disease constitute the major oral health problems in the developing countries. Dental caries is mainly occlusal in distribution and is on the increase. Periodontal disease in the major cause of tooth loss in adults. Its rate of progression is more rapid in developing countries. In the Asian countries, specifically, oral cancer is the most common of all cancers. These problems should be viewed against a background in which there is a shortage of dental manpower; a considerable amount of unmet dental need; escalating costs of curative dental services; and the low priority oral health occupies, due to the prevalence of a multitude of other health problems. A strategy in keeping with the primary health care approach would be an integrated oral health care delivery system with prevention and health education as priorities. Based on the philosophy of self-reliance such programmes would have to be field-based and implemented with maximum community participation. Sri Lanka has developed an oral health programme founded on these principles. School-based health education and preventive programmes are implemented by the dental personnel with the active cooperation of the teachers and parents. The teachers, after basic training in dental health, organize and conduct dental health educational programmes in schools. Fluoride mouth rinses are used for specially selected children. Senior students are given leadership roles in the programmes. They supervise and guide oral health promotional activities in the schools. The public health staff under the leadership of the Medical Officer of Health are actively involved. Village health volunteers, family health workers, traditional medical practitioners and religious leaders all play active roles in the health educational programmes.