(By Dr. Joseph D. Lim and Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI)
IT MAKES good sense to limit the consumption of sweetened juices and products, especially among children.
Severe dental caries (also called tooth decay or dental cavities) is a frequent cause of absenteeism at school.
An association between dental caries and undernutrition in children has been reported in some low- and middle-income countries. However, according to the World Health Organization, it has yet to be determined whether this is cause or effect, or both.
Dental caries is a major public health problem globally and is the most widespread noncommunicable disease. It is also the most prevalent condition included in the 2015 Global Burden of Disease Study, ranking first for decay of permanent teeth (2.3 billion people) and 12th for deciduous teeth (560 million children).
Dental caries can be prevented by avoiding dietary free sugars.
Moreover, dental caries is largely preventable through simple and cost-effective population-wide and individual interventions, whereas treatment is costly, and is often unavailable in low- and middle-income countries.
Teeth affected by caries are often extracted (pulled out) when they cause pain or discomfort.
Severe dental caries can impair quality of life, including difficulties in eating and sleeping, and in its advanced stages (abscesses), it may result in pain and chronic systemic infection or adverse growth patterns. Tooth decay is a frequent cause of absence from school or work.
Everyone is at risk of dental caries, but children and adolescents are most at risk.
Almost half of the world’s population is affected by dental caries, making it the most prevalent of all health conditions.
High levels of dental caries occur in middle-income countries, where sugars consumption is high. The majority of dental caries occurs in adults because the disease is cumulative.
There is a clear dose-response relationship between sugars consumption and dental caries. The disease is also associated with socioeconomic status, with high prevalence rates among the poor and disadvantaged population groups.
Dental caries develops over time; loss of tooth substance (enamel and dentine) is caused by acid production resulting from bacterial metabolism of sugars. Early stages are often without symptoms, but advanced stages of dental caries may lead to pain, infections and abscesses, or even sepsis.
It has been estimated that, globally in 2010, US$ 298 billion was spent on direct costs associated with dental caries. In addition, indirect costs came to US$ 144 billion, with the total financial cost reaching US$ 442 billion in 2010.
Population-wide strategies to reduce free sugars consumption are the key public health approach that should be a high and urgent priority.
Because dental caries is the result of lifelong exposure to a dietary risk factor (i.e. free sugars), even a small reduction in the risk of dental caries in childhood is of significance in later life. To minimize the lifelong risk of dental caries, free sugars intake should be as low as possible.
It is important that population-wide prevention interventions are universally available and accessible. Such interventions include the use of fluoride and comprehensive patient-centered essential oral health care.
The challenges are many. Dental caries disproportionally affect poor and disadvantaged populations, which have lower access to prevention and care.
Dental caries often 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 and focus on common risk factors for non-communicable diseases.
Economic growth is associated with increased access to sugar-sweetened beverages and other dietary sources of free sugars. Increased availability of sugars in the absence of adequate oral health preventive measures is associated with a marked increase in the burden of oral disease.
In other words, much work has to be done. And the time to start is now.
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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; Member, American Academy of Implant Dentistry and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com./PN
