Oral health in children – A neglected entity?

The World Health Organization Global Oral Health Status Report (2022) estimated that oral diseases affect close to 3.5 billion people worldwide, with three out of four people affected living in middle-income countries. Globally, an estimated 2 billion people suffer from caries of permanent teeth and 514 million children suffer from caries of primary teeth.

The prevalence of the main oral diseases continues to increase globally with growing urbanization and changes in living conditions. This is primarily due to inadequate exposure to fluoride (in the water supply and oral hygiene products such as toothpaste), availability and affordability of food with high sugar content, and poor access to oral healthcare services in the community. Marketing of food and beverages high in sugar, as well as tobacco and alcohol, have led to the growing consumption of products that contribute to oral health conditions and other non-communicable diseases (NCDs).

Dental caries results when plaque forms on the surface of a tooth and converts the free sugars (all sugars added to foods by the manufacturer, cook, or consumer, plus sugars naturally present in honey, syrups, and fruit juices) contained in foods and drinks into acids that destroy the tooth over time. A continued high intake of free sugars, inadequate exposure to fluoride, and a lack of removal of plaque by toothbrushing can lead to caries, pain, and sometimes tooth loss and infection.

The unequal distribution of oral health professionals and a lack of appropriate health facilities to meet population needs in most countries means that access to primary oral health services is often low. Out-of-pocket costs for oral healthcare can be major barriers to accessing care. Paying for necessary oral healthcare is among the leading reasons for catastrophic health expenditures, resulting in an increased risk of impoverishment and economic hardship.

The World Health Assembly approved a Resolution on oral health in 2021 at the 74^th World Health Assembly. The Resolution recommends a shift from the traditional curative approach towards a preventive approach that includes the promotion of oral health within the family, schools, and workplaces, and includes timely, comprehensive, and inclusive care within the primary healthcare system. The Resolution affirms that oral health should be firmly embedded within the NCD agenda and that oral healthcare interventions should be included in universal health coverage programs.

In 2022, the World Health Assembly adopted the global strategy on oral health with a vision of universal health coverage for oral health for all individuals and communities by 2030.