THERE IS a clear relationship between sugars consumption and tooth decay or dental caries.
Dental caries results when plaque forms on the surface of a tooth and converts the free sugars (all sugars added to foods and beverages by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and fruit juices) contained in foods and beverages into acids that destroy the tooth over time.
A continued high intake of free sugars, inadequate exposure to fluoride and a lack of removal of plaque by toothbrushing with fluoride toothpaste containing 1,000-1,500 parts per million concentration can lead to dental caries.
The burden of dental caries is also influenced by social determinants of health, which comprise the social, economic and political conditions that influence oral diseases, including access to safe water, sanitation and hygiene.
There is a strong and consistent association between socioeconomic status and the prevalence and severity of dental caries.
It disproportionately affects poor, vulnerable and/or marginalized members of societies, often including people who are on low incomes; people living with disability; older people living alone or in care homes; people who are refugees, in prison or living in remote and rural communities; and people from minority and/or other socially marginalized groups.
Additionally, the burden of dental caries is also affected by commercial determinants, which are the strategies used by some private-sector actors to promote products and choices that are detrimental to health. This includes marketing, advertising and sale of products that cause oral diseases and conditions, such as foods and beverages that are high in free sugars.
Population-wide strategies to reduce the consumption of free sugars are a key public health approach to reduce the burden of dental caries, the World Health Organization (WHO) says.
Such interventions include: nutrition labeling: front-of-pack or other interpretative labeling to inform about sugars content, including mandatory declaration of sugars content on pre-packaged food; reformulation limits or targets to reduce sugars content in foods and beverages;
Public food procurement and service policies to reduce the offer of foods and beverages high in sugars; policies to protect children from the harmful impact of food marketing, including for foods and beverages high in sugars; and taxes on sugar-sweetened beverages (SSBs) and on sugar or foods high in sugars.
Many oral diseases including dental caries can be prevented and treated in their early stages with cost-effective interventions. Integrating a set of essential oral health care services into national universal health coverage benefit packages using the public health care approach will have a significant impact on reducing the global burden of dental caries by improving availability and accessibility to quality care, the WHO says.
Such interventions include the use of topical fluoride and simple restorative techniques as part of comprehensive patient-centered oral health care, it says.
Often, dental caries does not receive adequate priority in health planning due to an underestimation of the true burden and impact of the disease.
The focus of interventions is generally characterized by an isolated disease approach and a focus on costly clinical treatment, rather than on integrated cost-effective public health strategies that address entire populations, focusing on shared risk factors for noncommunicable diseases and strategies to reduce the impact of the commercial determinants of health.
Unequal distribution of oral health professionals and a lack of interprofessional collaboration with other primary health care workers means that access to essential oral health services is often low.
Out-of-pocket costs for oral health care can be major barriers to accessing care. Paying for necessary oral health care is among the leading reasons for catastrophic health expenditures, resulting in an increased risk of impoverishment and economic hardship, according to WHO.
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Dr. Joseph D. Lim, Ed. D., is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; Honorary Life Member of the Thai Association of Dental Implantology; and Founding Chairman of the Philippine College of Oral Implantologists. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.
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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines, College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De la Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate Professor; Fellow, International Congress of Oral Implantologists; and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com./PN
