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Population caries prevention and control-handout

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12 views

Population caries prevention and control-handout

Uploaded by

angelabeagarcia
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PDF, TXT or read online on Scribd
You are on page 1/ 3

1/11/2022

• Realistic approaches to prevention and management of caries are


Last topic: necessary for the settings of LMICs.

Population caries control • → approach should be ‘realistic’


Ch 22

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World Bank classification (of countries):


The Primary Health Care system PHC
- based on GNI (gross national income) per capita
• Low income tier - Emphasizes prevention and
control of common diseases at
• Lower-middle- the lower levels of the health
• Upper-middle- system rather than focusing on
costly hospital-based care
• High-income -

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Barriers to integration of oral care to PHC Workforce planning


• Increase in the number of dentists
• BUT:

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1/11/2022

Public health approaches to address caries in


low- and middle-income countries
• Policy options
• Such as addressing key modifiable risk factors for NCD’s (non-communicable
diseases) : reduction of sugar, salt, tobacco, and alcohol consumption
• Oral health strategies must be integrated and embedded within other
contexts, such as broader NCD policies or planning for mother and child
health
• Settings approach: school and workplaces allow for government control

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Fluoride strategies as public health tools in L


Fluoride strategies:
and LMICs
• The use of fluorides– widely accepted as the most cost-effective and • Water fluoridation –
only realistic way of reducing the burden of caries • Salt fluoridation
• Weak evidence base
• The WHO promotes ‘automatic fluoridation’ where fluoride exposure • Practical and technical problems
is less dependent on compliance: fluoridation of water, salt and milk • Does not have ethical drawbacks
• Rarely achieved • Professionally applied fluorides-
• Developed the ‘FLINT’- Fluoride Intervention Template • high cost; unrealistic for population-wide caries prevention in LMICs
• Fluoride toothpaste
• Most significant
• Safe, with proven efficacy
• Need compliance– daily tooth cleaning

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1/11/2022

Integrating basic oral health care into primary


health care PHC
• The basic package of Oral Care BPOC (WHO 1990’s)
• Management of caries and its consequences
• First element: oral health promotion and self-care through oral hygiene with
affordable fluoride toothpaste (AFT)
• Second element: OUT- oral urgent treatment
• Simple tooth extraction, draining of abscesses, control of acute oral infection, first aid for
maxillo-facial trauma, and recognition of oral conditions requiring patient referral

• Third: ART- atraumatic restorative treatment


• No need for dedicated clinical environment or sophisticated equipment

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Points to address
• Strengthening surveillance and research in LICs and LMICs • PUFA- pulpal involvement, ulceration, fistula, abcess
• Measuring caries matters
• S/as DMFT
• New caries index: the PUFA index- designed to complement other dental
caries indices that have no facility to record the clinical consequences of
untreated dental caries
• Integration, advocacy, and a supportive policy context
• Change in dental education and professional practice
• In LMICs- considered as political neglect and thus should be addressed with
political advocacy

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End of course. Review questions:


• What is the basis for the World Bank for economic classification of
countries?
• What are the differences between the DMFT and PUFA indices?
• Why is the BPOC not or not fully implemented in LICs and LMICs?
• What can be recommended to promote the WHO programs such as
BPOCs?

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