UNDERSTANDING ORAL HEALTH

Oral hygiene is the practice of keeping one's mouth clean and free of disease and other problems (e.g. bad breath) by regular brushing of the teeth (dental hygiene) and cleaning between the teeth. It is important that oral hygiene be carried out on a regular basis to enable prevention of dental disease and bad breath.

Most oral health surveys in Nigeria have been sporadic and based on convenience samples. Periodontal disease with deep pocketing occurs in Nigerians at an early age, the prevalence being 15-58% in those aged above 15 years.

The health of the teeth, the mouth, and the surrounding craniofacial (skull and face) structures is central to a person’s overall health and well-being. 

Oral and craniofacial diseases and conditions include:

• Dental caries (tooth decay)

• Periodontal (gum) diseases

• Cleft lip and palate

• Oral and facial pain

• Oral and pharyngeal (mouth and throat) cancers

• Xerostomia (dry mouth)

The significant improvement in the oral health over the past 50 years is a public health success story. Most of the gains are as a result of effective prevention and treatment efforts.

One major success is community water fluoridation, which now benefits a lot of persons who get water through public water systems, especially in developed countries.

However, some countries (especially developing countries) do not have access to good preventive programs. People who have the least access to preventive services and dental treatment have greater rates of oral diseases. A person’s ability to access oral health care is associated with factors such as education level, income, race, and ethnicity.

The main objective for this topic area is to address a number of areas for public health improvement, including the need to:

• Increase awareness on the importance of oral health to overall health and well-being.

• Increase acceptance and adoption of effective preventive interventions.

• Reduce disparities in access to effective preventive and dental treatment services.

SIGNIFICANCE OF ORAL HEALTH

Oral health is essential to overall health. Good oral health improves a person’s ability to speak, smile, taste, chew, swallow, and make facial expressions to show feelings and emotions.

However, oral diseases, from cavities to oral cancer, cause significant pain and disability.
Good self-care, such as brushing with fluoride toothpaste, daily flossing, and professional treatment, is key to good oral health. 

Health behaviors that can lead to poor oral health include:

• Tobacco use

• Excessive alcohol use

• Poor diet 

Barriers that can limit a person’s use of preventive interventions and treatments include: 

• Limited access to and availability of dental services.

• Lack of awareness of the need for care

• Cost

• Fear of dental procedures

There are also social determinants that affect oral health. In general, people with lower levels of education and income, and people from specific racial/ethnic groups, have higher rates of disease. Also, people with disabilities and other health conditions, like diabetes, are more likely to have poor oral health. 

Community water fluoridation and school-based dental sealant programs are 2 leading evidence -based interventions to prevent tooth decay. 

Community water fluoridation is the most effective way to deliver the benefits of fluoride to a community. Studies show that it prevents tooth decay by 18 to 40%. Sadly, municipal water treatment and supplies is gradually finding it's existence to our history books while privately owned, insanitary / untreated borehole water supply proliferates in most developing countries like Nigeria thereby making municipal / community fluoridation process impossible.

School based dental sealant programs, which focus on sealing the chewing surfaces of permanent molar teeth, usually target schools that serve children from low-income families. Dental sealants can prevent up to 80% of tooth decay in the treated teeth. 

Major improvements have occurred in the oral health scientific research, but some challenges still remain. A recent Centers for Disease Control and Prevention (CDC) publication reported that despite dental sealants preventing over 80% of dental cavities, only 1 in 3 children aged 6 to 8 has a dental sealant. 

Potential strategies to improve access to dental services and improve oral health of children and adults include:

* Implementing and evaluating activities that have an impact on health behavior

* Promoting interventions to reduce tooth decay, such as dental sealants and fluoride use

* Evaluating and improving methods of monitoring oral diseases and conditions

* Increasing the capacity of State dental health programs to provide preventive oral health services

* Increasing the number of community health centers with an oral health component

* Encouraging and adequately funding school health services in all nursery, primary and secondary schools in Nigeria.