Oral health information systems
Oral health surveillance
In 1979 the most important goal ever to be formulated for global oral health was announced by WHO. By the year 2000, the global average for dental caries was to be no more than 3 DMFT at 12 years of age. At the World Health Assembly in 1979, this declaration was unanimously allocated as being the overriding priority for WHO. In 1983 oral health was declared as part of the Strategy for Health for All (WHA36.14) and in 1989 the Organization endorsed the promotion of oral health as an integral part of Health for All by the year 2000 (WHA42.39). In addition, World Health Day in 1994 was dedicated to oral health which also reflects the importance attached to this issue.
WHO developed oral disease surveillance systems several years ago, particularly in relation to dental caries in children. The first global map with data on DMFT for 12-year-olds was presented in 1969 showing high prevalence of caries in industrialized countries and generally low values in the developing countries. A database was established and over a number of years an increasing number of epidemiological studies documented a pattern of change in caries prevalence, i.e. increasing levels of caries in certain developing countries and a decline in caries in many industrialized countries. Several oral epidemiological studies have been carried out applying WHO methodology and criteria. Figures 5-6 present the current global maps on dental caries levels among children aged 12 and adults aged 35-44 years.
According to the WHO Oral Health Data Bank in 1980, DMFT values were available for 107 of 173 countries, of these, 51% had 3 DMFT or less, while the remaining 49% had higher values. In the year 2000, data were available for 184 countries as recorded in the WHO Oral Health Country/Area Profile Programme4, of these, 68% had less than 3 DMFT.
The caries decline observed in many developed countries (Figure 7) was the result of a number of public health measures, coupled with changing living conditions, lifestyles and improved self-care practices. In some countries this positive trend could deter action to further improve oral health, or sustain achievements. It might also lead to the belief that caries problems no longer exist at least for the developed countries, resulting in precious resources available for caries prevention being diverted to other areas. However, it must be stressed that dental caries, as a disease, is not eradicated but only controlled to a certain degree.
In 1981, WHO and the FDI World Dental Federation jointly formulated goals for oral health to be achieved by the year 2000 as follows:
1. 50% of 5-6 year-olds to be free of dental caries.
2. The global average to be no more than 3 DMFT at 12 years of age.
3. 85% of the population should retain all their teeth at the age of 18 years.
4. A 50% reduction in edentulousness among the 35-44-year-olds, compared with the 1982 level.
5. A 25% reduction in edentulousness at the age of 65 years and over, compared with the 1982 level.
6. A database system for monitoring changes in oral health to be established.
For the new millennium, new oral health goals are urgently needed not only to strengthen dental caries control and prevention activities, but also to address other significant components of the oral disease burden such as periodontal health conditions, oral mucosal lesions, oral precancer and cancer, craniofacial trauma, pain and oral health-related quality of life. Such global goals for oral health will assist regions, countries and local health care planners to develop preventive programmes that are targeted at populations and high risk groups and to further improve the quality of oral health systems.