The prevention and control of dental caries in industrialized countries have been due mainly to use of fluorides in many different ways and to the widespread adoption of effective oral hygiene habits.
In spite of these successes the disease is not conquered in all communities. It might still be called a neglected epidemic in under-privileged and low-income groups.
There are many high-risk populations in the USA:
97% of the homeless need oral care, black children have 65% more untreated decay than the
average citizen, low income 91% and American Natives 265%.
More than 50% of the housebound elderly have not seen a dentist for 10 years.
Traditional systems for oral care are based on various combinations of public salaried services and private practice. The public services are usually responsible for prevention, care of school children and disadvantaged groups; and private practitioners provide a wide range of treatment to the general public. All these systems are oriented in such a way that the dentist provides most of the care.
In the USA:
84% of 17 year olds have had tooth decay and an average of 11 tooth surfaces is damaged.
People aged 40 to 44 have an average of 30 tooth surfaces affected by decay.
41% of people aged 65 or over have no teeth at all.
In developing countries, the level of dental caries was rarely as high as in industrialized countries and, in some, successful preventive activities have been implemented. However, in many there is still the threat of increasing caries related to changing diet and lifestyles.
Common oral disease in developing countries
The burden of demand for treatment only of severe caries or periodontal disease can be "estimated". In about one third of these populations, about 1350 million people will require pain relief treatment (extractions) 3 times in their lives. About two-thirds or 2400 million people will need 5 or more extractions.
However in many communities these systems do not meet even the basic needs of the public. Most public services have only very low coverage; communities in low-income rural and urban areas cannot afford private oral care. Further, developing countries cannot afford to establish, staff and run education facilities for dentists; or hope to provide adequate employment opportunities for dentists trained abroad.
In all countries economic restraints, changes in demand for oral health care, political pressures to extend services to under-privileged groups, concern about quality, costs and effectiveness of care demand that alternative ways of organizing oral health and care are examined and implemented.
Cost and lack of access for under-privileged and low-income groups constrain all oral health care systems.
What actions can be taken to combat this neglect, break down the barriers of cost and improve access to oral health and care? Alternative oral care systems need to be developed m that a maximum number of people can have access to and can afford oral health and care.
Several recent advances give great scope for the transformation of the delive，英语论文，英语毕业论文 |
