The Silent Epidemic: India's Overlooked Oral Health Crisis

Oral Health is important for overall well-being. Oral health promotes essential functions such as eating, and speaking and psychosocial dimensions such as self-confidence, and the ability to socialize and work with no pain and discomfort. Oral health is an integral part of general health and supports individuals to participate in social activities with immense potential. Dental caries and periodontal disease are the biggest threats to oral health, out of which dental caries are prominent in children. The fact to be understood is ignoring the disparities persisting in oral health could lead to increased difficulties in treating which on long-standing exacerbates the condition( cavities/periodontal diseases). ⁽¹⁾

Oral disease disparity affects deprived communities, especially children, the elderly, and rural communities where access to treatment is limited.⁽²⁾ The World Health Organization's latest report reveals: that 43.3% of children are affected by untreated dental caries and 28.8% of Indians above 5 years of age have untreated cavities in permanent teeth. The most concerning is that 36% of global oral cancer cases and 42% of deaths, an unimpressive 136,000 cases and 75,000 deaths every year are noted in our country. These are statistics to look upon where the quality of life is being affected by preventable oral health conditions. ⁽³⁾

A survey that was conducted in 2019, witnessed more than 7 out of 10 adults claimed to have healthy teeth, and 89% of them have fallen victim to a major oral health problem.  A recent Colgate-Kantar study also revealed that 46% of Indians have fallen victim to oral health problems, yet only 35% take action, while 11% do nothing. Among those who act, merely 19% seek professional consultation. Our country has one of the world's largest dental workforce, with more than 270000 dentists, where most of them pertain to urban areas. The dividing rule of rural and urban has more impact on cost, where urban areas have one dentist per 10,000 people, and rural regions manage just one per 150,000 individuals. Due to inadequate public health infrastructure and unaffordable treatment costs the division of rural to urban is exacerbated. ⁽³⁾

Most of the insurance companies do not cover dental treatments considering it as a cosmetic procedure, further adding burden on the financial state to seek treatment. By IDA’s Vision 2032, to overcome all the challenges, Like preventive approaches in other health areas – from regular health check-ups to fitness routines – Our nation's health and productivity improve by considering oral health as essential as general health. The government health schemes have been covering only 30% of the population for basic dental procedures, this approach has to be increased to achieve success in oral care. Modern dentists are problem solvers and as healthcare partners, they focus on preventing issues before they arise. This way of preventive approach not only improves healthcare outcomes but also significantly reduces the economic burden on individuals and our healthcare system and promotes a more productive nation. ⁽⁴⁾

Raising awareness by promoting messages about preventive approaches to oral health such as regularly brushing and flossing of teeth, encouraging reduced sugar intake, and reducing acidic beverages must be broadcast through all sources of media including newspapers, magazines, television, radio, internet, and dental literature.

We need to focus on Preventive care and oral hygiene education as most people with oral problems will take no action. There should be a lot of awareness developed among communities to have a preventive approach and also regarding the availability of access to preventive services. The Rashtriya Bal Swasthya Karyakram (RBSK) also provides a platform for comprehensive oral health screening and education. This focuses on children to teach good oral hygiene habits and identification of problems before they get serious. Through this, we connect with families.

Having focus on only the diagnosis could not clear the problem so access to treatment is of utmost importance. Including dental coverage in national health insurance programs could help dental care access to the majority of the people in the country. Basic screening can be supported through teledentistry and mobile dental vans to remote areas. Altogether we need to look at oral health as part of general health and well-being. Raising awareness by promoting messages about preventive approaches to oral health such as regularly brushing and flossing of teeth, encouraging reduced sugar intake, and reducing acidic beverages must be broadcast through all sources of media including newspapers, magazines, television, radio, internet, and dental literature. We can incorporate the preventive approaches towards oral health and the public health schemes available towards oral care into educational curricula targeting children, caregivers, and communities. To transform India's oral healthcare system, it should be a joint effort from government agencies, healthcare providers, educational institutions, and the private sector. After all, we need to understand that better gums, better teeth, and better health reflect a better productive nation. ⁽²⁾

REFERENCES:

1. World Health Organization.Oral health: overview, causes and symptoms and WHO response. Accessed January 9, 2025. https://www.who.int/health-topics/oral-health#tab=tab_1

2. BenjaminRM.Oralhealth:thesilentepidemic.PublicHealthRep.2010Mar-Apr;125(2):158. Accessed 9 January 2025 . https://pmc.ncbi.nlm.nih.gov/articles/PMC2821841/

By Dr. Lakshmi Sahithi Tanneru