Prevention is better than treatment

News In the early 2000s, Thailand was in the throes of rolling out universal health care for its citizens and Prathip Phantumvanit knew – from years of dental practice and research – that tooth decay was remarkably widespread among adults and children for a developing country. Phantumvanit teamed up with the health ministry to create a new cadre of dental nurses to staff rural health centres and community hospitals. These nurses became key to running an outreach programme for the prevention of tooth decay and gum disease. " There were few dentists in our country and most people could not afford dental services, " recalls Phantumvanit, who founded the faculty of dentistry at Tham-masat University in Bangkok, where he is a professor. " These dental nurses worked well with the appropriate equipment and technology to fulfil this need ". A core element of the Thai oral health programmes has been promoting tooth-brushing with fluoridated toothpaste in primary schools – health education made possible by collaborating with teachers and parents. The result: the proportion of children with tooth decay in their permanent teeth has decreased and children, parents and schoolteachers are more aware of the importance of oral health, according to the 2013 national survey on oral health. Diseases of the mouth, such as tooth decay or cavities (dental caries) and gum disease (periodontal disease) are among the most common noncommunicable diseases in the world and, traditionally, some of the most neglected. " The incidence of tooth decay in low-and middle-income countries is rapidly increasing among adults and children and there will be a huge burden of this health problem in the future without sustainable prevention programmes, " says Professor Poul Erik Petersen, director of the World Health Organization Tooth decay affects an estimated 60–90% of schoolchildren and nearly 100% of adults worldwide, according to the WHO Global Oral Health Database. Severe dental disease can result in tooth loss and the prevalence of complete tooth loss is increasing rapidly in low-and middle-income countries, while currently about 30% of the world's population aged 65–74 lose all their natural teeth. According to a recent Global Burden of Disease study, untreated tooth decay is the most prevalent of 291 major diseases and injuries. Periodontal disease is the sixth most prevalent. " If left untreated, dental diseases can cause severe pain, infection and negatively impact the quality of life, children's growth, school attendance and performance, …