Dr. Shyam P Lohani

Oral health greatly affects eating, speaking, smiling, and showing emotions. Besides, it also affects our ability to smell, taste, touch, chew, and sallow. A person’s self-esteem, work performance, and attendance at work or school are also influenced by oral health. No matter what our age is, oral health is vital to general health, well-being, and quality of life. In addition to lower and poor quality of life, oral diseases have a direct economic impact on individuals, family and the healthcare system of the country.
Globally, oral diseases are among the most prevalent ones. They have serious health and economic burdens and people affected with oral diseases have a poor quality of life. Often taken for granted, oral health has an influence on every aspect of our life. It not only shows signs of nutritional deficiencies or infection but also some systemic diseases such as cardiovascular diseases and diabetes. Thus, it has been widely said that our mouth is a window into the health of our body.

Burden
Dental caries (tooth decay), periodontal disease, tooth loss, and cancers of the lips and oral cavity are the most prevalent and substantial oral diseases all over the world. Affecting almost half of the world population, oral diseases, including tooth decay, gum disease, and oral cancers, and untreated dental decay are the most common health conditions worldwide.
It has been estimated that oral diseases affect close to 3.5 billion people worldwide, with caries of permanent teeth being the most common condition (The Global Burden of Disease, 2017). According to WHO (2020), it has been estimated that 2.3 billion people suffer from caries of permanent teeth and more than 530 million children suffer from caries of primary teeth.
The poor and socially disadvantaged members of society are disproportionately affected by oral diseases. It has been shown that there is a very strong association between socio-economic status and the prevalence and severity of oral diseases. In low- and middle-income countries (LMICs), oral diseases are present in high prevalence owing to widespread social and economic variations as well as insufficient funding for treatment and prevention. In such countries, dental services and oral health care facilities are often poorly available, and in most cases, unaffordable for the majority of the populations and most significantly to the economically disadvantaged people in the rural areas.
The modifiable risk factors common to the most significant non-communicable diseases such as cardiovascular disease, cancer, chronic respiratory disease, and diabetes are similar to most oral diseases. Those risk factors are the use of tobacco, alcohol consumption, and unhealthy diets containing high amounts of sugars. In addition, diabetes is linked reciprocally with the development and progression of periodontal disease. Moreover, studies have found a causal link between the high consumption of sugar and diabetes, obesity, and dental caries.
The burden of oral diseases and other non-communicable diseases can be reduced through public health interventions by addressing common risk factors. These preventive public health interventions include promoting a well-balanced diet low in free sugars and high in fruit and vegetables and favoring water as the main drink instead of sugary drinks. The additional approaches are stopping the use of all forms of tobacco including chewing of areca nuts; reducing alcohol consumption; and encouraging the use of protective equipment when doing sports and traveling on bicycles and motorcycles to reduce the risk of facial injuries.
There are many steps we can take to keep our teeth healthy. For example, dental and oral disease can be greatly reduced by brushing teeth with a fluoride toothpaste at least twice a day, flossing teeth at least once a day, reducing the intake of sugar, taking a diet high in fruits and vegetables, complete avoidance of tobacco products, drinking fluoridated water, and seeking professional dental care regularly.

Integration
It is a known fact that adequate exposure to fluoride is an essential factor in the prevention of dental caries. Different sources such as fluoridated drinking water, salt, milk, and toothpaste can be utilised for obtaining an adequate level of fluoride. Twice-daily tooth brushing with fluoride-containing toothpaste (1000 to 1500 ppm) should be promoted.
Good oral health can help people live longer, happy, and healthier life. Good oral health has a positive impact on our general health, well-being, and quality of life. The effective practices to maintain good oral hygiene should be promoted among children and adults equally throughout the country. It should not be taken lightly to schedule regular dental check-ups to keep a smile, and healthy.
A large-scale regular campaign on oral health in schools and communities can greatly prevent oral diseases in our population. There is also a need to expand curative dental care to the grass-roots level such as up to the sub- health posts level. It is, therefore, important to integrate dental health care into primary care services in order to safeguard the oral health of the population.

(Professor Lohani is the founder and academic director at Nobel College. lohanis@gmail.com)