India launches oral health strategy
The Indian government is about to launch a programme to tackle
the subcontinent's poor standards of oral and dental health. The
campaign will raise awareness of the dangers of sugary food and
tobacco products.
"Periodontal disease affects 90-95% of our population, and dental
caries affects 60-80% of our children," said Hari Parkash, president
of the Indian Dental Association and head of dental surgery at the
All India Institute of Medical Sciences, New Delhi. Malocclusion
of teeth is also common among 50% of school children, he said.
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"Consumption of tobacco products even among children is causing
serious concern and is manifesting itself as oral submucous fibrosis
- a precancerous condition," said Dr Satya Paul Agarwal, director
general of health services in the Indian government's ministry of
health.
Oral cancer accounts for almost 40% of the total diagnosed cancer
cases in India - considered to be one of the highest rates in the
world. The reasons for the high rates are not known, but the common
habit of chewing tobacco is implicated.
A new intervention project, covering the states of Delhi, Punjab,
Maharashtra, Kerala, and Assam, will soon be implemented according
to the Indian Dental Association. "More than 80% of dental surgeons
are catering to the needs of 20% of the population in urban areas,
while almost no dental treatment facilities are available to 80%
of the population living in the rural areas," said Dr Agarwal. "We
envisage implementation of the oral health project right down to
village level," he added.
The project aims to bring down the incidence of oral and dental
diseases to less than 40% of existing levels. It also aims to reduce
the rate of decayed, missing, or filled teeth in school-children
aged 6-12 years to half of the current rate; children aged 16 in
rural areas have an average of four such teeth.
Mass oral health awareness Campaigns - against excessive consumption
of sweets, confectioneries, sugary drinks, chewing gum, carbohydrate
rich foods, and tobacco products - will be conducted. Development
of curriculums for training "multipurpose" health workers in oral
health and for establishing mobile clinics to cover remote rural
areas will hold a key place in the envisaged programme.
The project also plans to encourage the use of fluoridated toothpaste
and fluoride solutions and varnishes - much to the chagrin of India's
antifluoride lobby, which says that there is already serious contamination
of groundwater in India, with fluoride affecting the health of millions
adversely in vast tracts.
Rohit Sharma, Bombay
studentBMJ 2000;08:131-174 May ISSN 0966-6494
