1996-2-Editorial - Saudi Dental Journal

ISSN (Print) 1013-9052
EISSN 1658-3558

The Saudi Dental Journal,
P.O. Box 52500,
Riyadh 11563,
Kingdom of Saudi Arabia

Tel.	966-1-467-7328
Fax.	933-1-467-7308 / 966-1-467-7534
Email	saudidj@ksu.edu.sa

Editorial

Prevention And/Or High-Technology Dentistry ?

The clear message from our current knowledge of the etiologies of dental caries and periodontal diseases is that the prevention and optimal treatment of these diseases is achievable. Dental education in Saudi Arabia provides the Kingdom with dentists and dental hygienists with a considerable level of technical skills. However, such efforts to improve dental treatment facilities must be viewed in the context of those factors which increase disease activity, for example the high levels of consumption of sweets and soft drinks, and the lack of public oral health-related knowledge.

In order to balance these opposing forces, and to control dental caries activity, as well as the progression of periodontal diseases, there is a need to modify the population's subjective treatment demand through information about the causes and prevention of these diseases. The responsibility of the dental profession toward such an objective through social engagement, must be markedly increased if dental health problems are to be addressed and solved in a scientifically-based manner: efficient oral health care delivery can probably only be achieved through the extensive use of auxiliary personnel (Jacobsson, 1971).

The above suggests that the increasing dental caries incidence and gingival inflammation in the Saudi population must be eradicated, not only by means of high-tech reparative methods but also by means of prevention. This has very elegantly been shown in the Karlstad study (Axelsson & Lindhe, 1974), where dental nurses and hygienists were able to reduce and almost arrest dental caries and gingival inflammation by simple oral prophylaxis, education, motivation and check-ups. Further, the education of teachers, parents and schoolchildren by auxiliary personnel in this way is the necessary first step in achieving the controlled and predictable levels of reduction of diseases.

Traditionally, it has been the responsibility of the authorities to provide health care for all, although such oral health care has mainly been focused on children, and performed through public services. This strategy has been successfully adopted in Western communities with an increased proportion of children rendered caries-free and the remainder showing reduced frequencies of untreated carious lesions. Improved oral hygiene and good compliance amongst patients also reduce the risk of gingivitis and advanced periodontitis. In those individuals affected by dental caries and/or periodontitis, it is essential that: (1) the responsible dentist makes a treatment plan based on diagnosis; (2) the treatment is cause-related; (3) the performance of treatment is meticulous; and (4) the causal phase is carried out prior to the restorative and reconstructive phases. After finishing the reconstructive phase, patients should be kept on an individually-designed recall basis.

In the case of the elderly, the inter-relationship between age, increased prevalence of chronic disease, medication, and oral health has been poorly investigated. How these interactions affect the perception of need for care, the demand for care and the efficiency of delivery systems, is still unknown. These factors need to be solved in the near future and require a multiprofessional approach dealing with the problem of oral health care for the elderly (Gjermo & Bergenholtz, 1992). Due to general improved social welfare, the mean age of the population will increase, and with that, new oral health demands will emerge within the coming 20 years. Just as scientifically-based long-term strategies have been shown to be predictable in the improvement of oral health in the young, similar approaches need now to be urgently explored for the aged.

Prof. Axel Bergenholtz
Member, Editorial Board