Primary Oral Disease Prevention Strategies by WHO

Introduction

At the community level of public health, the World Health Organization (WHO) recommends different primary oral disease prevention strategies that are more practical than just inculcating dental awareness alone, for preventing the global incidence of dental diseases. Read the article to know the approaches advocated by the WHO.

What Are the Primary Prevention of Oral Diseases Suggested by WHO?

Have you heard of the oral health programs that are aimed at community levels, to prevent children and young adolescents from falling easy prey to dental diseases? Yes, just like these programs, irrespective of the age group, because of the growing global prevalence of dental diseases, there are several Basic principles of prevention of oral diseases in children and adults alike as recommended by the WHO Global Oral Health Programme. The World Health Organization (WHO), in favor of public health, has set down basic principles and approaches to effectively prevent oral diseases. Let us explore the oral disease prevention strategies for children specifically as set by the WHO.

Oral diseases need to be prevented firstly on a community level or a primary scale or primary prevention of oral disease. Whether it is dental caries, periodontal diseases, serious oral pre-cancers and cancers, red or white lesions of the oral cavity, bacterial, viral or fungal origin oral infections or diseases, oral diseases occurring in the immune-compromised or the geriatric or high-risk population groups need to be addressed at the community level by preventive dental or oral care programs.

What Are the Addressing Socio Determinants of Health?

The WHO oral disease prevention strategy for children and high-risk population groups is centered mainly on the socio-determinants of health, working through the "common risk factor" approach.

So what do we mean by the Socio-determinants of health? The socio-determinants of health in the perspective of dental medicine are basically individual behaviors such as oral hygiene practices, dietary patterns, and awareness or attendance towards dental care, which are the main prevention strategies for oral diseases. The common risk factor approach as deciphered by the WHO mainly addresses the conditions that are largely influenced by family, social, and community factors playing an innate role in dental hygiene and immunity.

Further, there is also the involvement of the local governments, as well as the political and economic measures implemented that are cast from country to country. Hence the community approach recommended by the WHO for oral disease prevention strategies is called public health strategies- directed at these above-enlisted socio-determinants of health. From the context or perspective of socioeconomic and political positions in healthcare systems in different regions of the world, it is indeed important to hence address the growing global burden of dental diseases.

What Are the Common Risk Factors Approach Method?

The common risk factors approach is touted to be one of the major underlying strategies for public health implemented by the WHO. This approach recognizes that chronic non-communicable diseases basically as obesity, cancers, diabetes, or oral diseases that are extremely common in today's age definitely share a common set of risk factors or environmental conditions/ stressors.

According to the primary disease prevention strategies at the public/community level, there should be a mix of complementary public health approaches that should be focused on assisting from the individual as well as the community perspective, how best to create a supportive, sustainable environment that is conducive to overall systemic and oral health. These are done through dental researchers, from systematic reviews and studies as well. Research conducted in public health dentistry between 1994 to 2005 reveals that there are several preventive approaches for oral diseases at a community level.

While water fluoridation was one of the most effective public health measures to reduce the incidence of dental caries, the use and awareness of topical fluorides for toothpaste, the advocation of fluoride-containing mouth rinses and varnishes as effective agents for dental caries reduction (by nearly 14 percent to 46 percent over the last decade as per epidemiological reports)- are all the primary disease prevention strategies advocated currently by the WHO.

The use of new age Nano hybrid restoratives, dental occlusal pit, and fissure sealants are reported to have nearly reduced dental caries reduction over the years observed by nearly 86 percent in 12 months and a 57 percent decline seen within 48 months time period according to dental research. There are different oral diseases/conditions prevention approaches as per the WHO.

What Are the Strategies or Public Health Approaches Recommendation by Who?

Given below is also the Effectiveness in oral disease prevention addressed as follows according to research patterns:

• Dental Health Education or Dental Health Awareness:

Though dental awareness is certainly one of the major factors that should influence societal norms, and community behavior at a public health level- this alone cannot be sufficient for the prevention of oral diseases according to current research. With this approach, only short-term improvement in oral health knowledge was seen in individual communities. There seemed to be an overall limited effect on oral health-related practices and behavior. It is not really effective for dental caries reduction when observed practically. Further dental awareness alone cannot have a long-term effect on plaque (a sticky film which coats the teeth and contains bacteria) control or in gingival bleeding and the development of periodontal diseases (inflammation and infection seen in the tissues that support the teeth structure). Hence there is a need for widespread public or community-level approaches to dental disease prevention.

• Topical Fluoride-Based Caries Reduction Approach:

With the fluoride approach at a community level by the WHO, an overall reduction in dental caries is seen as follows with the use of the given below fluoridated products :

1. Fluoridated Toothpaste- 24 percent decline in caries.

2. Fluoridated Mouthwashes- 26 percent decline in caries.

3. Fluoride Gels- 28 percent decline in caries.

4. Fluoride Varnishes- 46 percent decline in caries.

5. Fissure Sealants- Caries reduction by 57 percent in a year or two of usage.

6. Water Fluoridation- Caries reduction by nearly 14 percent.

• Dietary Approach:

In this public health approach advocated by WHO, caries reduction or even periodontal disease prevention is not possible as effectively as seen with the above-fluoridated methods used practically. The dietary approach recommended the consumption of less sugary foods, less acidic, and more nutrient-dense foods for sustaining oral health.

• Role of Dental Personnel and Dental Community:

Ranging from dentists, dental therapists, dental hygienists, dental nurses, community dental workers, or other accessory oral health workers, it is important to primarily accept public health challenges and responsibilities towards oral health education (OHE) in preventing dental diseases as per WHO guidelines.

Conclusion

As oral diseases are primarily high-risk diseases, just like systemic cancers and cellular diseases, the WHO increasingly recognizes as well as acknowledges several preventive strategies for improving oral health at a public level. These are a combination of the high-risk and directed population approaches with evidence-based implementation scientifically of oral health interventions. By evidence-based implementation of this approach, there can be scope for multiple preventive strategies in different social settings across the world.