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ISSN (Print) 1013-9052
EISSN 1658-3558
The Saudi Dental Journal,
P.O. Box 52500,
Riyadh 11563,
Kingdom of Saudi Arabia
Tel.
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966-1-467-7328
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Fax.
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933-1-467-7308 /
966-1-467-7534
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Email
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saudidj@ksu.edu.sa
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SDJ
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Editorial
Dentistry in the 21 st Century (1420 H)
The World Health Organization (WHO) has declared
a universal goal of "health for all by the year 200''. In 1978 at Alma
Ata, the WHO declared the urgency of this goal by adopting the primary health
care conception. They declared that:
"Primary health care is essential health care based
on practical scientifically sound and socially
acceptable methods and technology made universally accessible to individuals
and the community.."1
The questions, we, as dental professionals in Saudi Arabia should be asking are, "What can we
do now to reach the goal of dental health for all in Saudi Arabia by the year 2000 (1420
H.)? Should we be continuing with our same curative- and treatment-oriented
traditional approaches to our profession with limited emphasis on prevention,
or should we now be considering the enormous changes that will impact on our
philosophy of dental care and our role in society as dental professionals?" It
is prudent to look at where we are now and, on the basis of that situation
analysis, establish goals as to where we want to be a decade from now. National
goals should be established in order to stimulate and guide the oral health
delivery system toward making quantitative progress in the improvement of
dental health in the country.
The WHO oral health program has established long-range oral health
goals which are very important stimuli to advancing the oral health of the
world. In 1979, the goal of a DMFT of 3 by the year 2000 in 12-year-olds was
established. Saudi Arabia
is already below this goal (DMFT, 1.6 in males; 1.7 in females; and 41.9% free
of caries among 12-year-olds}2; therefore, a lower DMFT goal should be set to prevent a
recrudescence of caries and consolidate a decreasing trend.
The Oral Health Survey of Saudi Arabia - Phase l2established
base line information of the oral health status of the central province of the
country. Although this is not the representative of the entire country,
this can be the preliminary basis for establishing national goals to reach in
the year 2000. A representative cross section of the dental profession, led by
the Saudi Dental Society, College of Dentistry, King
Saud University
and the Ministry of Health, should carry out detailed discussions to establish
these national goals. At the heart of any goals should be the concept of
preventing oral diseases. This has been talked about but limited efforts have
been made in actual implementation of pre vention programs.
In dentistry of the 21st century, we can expect dramatic declines in
dental caries in both the indus trial and developing world.3 There will be a general use vaccine against
caries applied along with basic immunizations against childhood diseases. The
use of fluorides and fissure sealants will expand to home self-applied systems.
Pulpal diseases will become almost unknown. Periodontal disease will also
decline sharply, with the use of chemotherapy against plaque and calculus, and
the development of vaccines against the multiple organisms of destructive
periodontitis. As a result of the sharp reductions in tooth loss, tooth
extractions will be rare. The science of prosthodontics will focus away from
removable appliances to fixed ones using primarily more perfected methods of
bone integrated implants. The practice of dentistry will subsequently be
broadened to concentrate on needed specialties such as surgery,
orthodontics/pediatric care, gerodontics, and aspects of medicine. Issues of
healthy life style guidance will become more important to the practice.3 Examples include general dietary counseling,
smoking and smokeless tobacco cessation, HIV diagnosis and control, health
education, and other broader medical and health issues. The enormous
technological changes of the future should be integrated, upon development, as
quickly as possible into the dental delivery system.
With these incredible changes, there will con currently be a need to
transform our education of dentists and a need for retraining and re-education
of existing dental personnel. The separate health science schools of the
present will probably coalesce into one health science college. The sci ence
of informatics using computer-based laser and CD-ROM disc-training systems will
carry the weight of the future education system. The basic core studies would
be identical in medicine and dentistry. Students would later move on to their
particular specialties. A dentist in the future would be more accurately called
an oral physician or stomatologist.
The goals for the year 2000 established by the Saudi dental profession
should be quantitative and measurable, and should include the following topics:
health status, risk reduction, public aware ness, professional education and
awareness, ser vices and protection, and surveillance and evalua-tion. If our
generation is to meet the internationally established goal of "health for
all", ourtime to act is now. A Chinese proverb states that "a journey of
thousand miles begins with one step." Let's collectively take that step.
E. Ernest Guile, BSc. DMD, MPH
Editorial Board Member
References
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World
Health Organization. Global Strategy for Health for all of the year 2000. WHO, Geneva, 1981.
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Shammary
A, Guile E, El-Backly M. An Oral Health Survey of Saudi
Arabia - Phase I, King Abdul Aziz City
for Science and Technology, 1990.
-
Barmes DE. International perspectives for the first quarter of
the twenty-first century. Swed Dent J 1989;13:1-6.
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