Prevention of dental caries through the use of fluoride--the WHO approach.

Dental caries continues to pose an important public health problem across the world. The World Health Organization (WHO) emphasizes that the disease affects about 60–90% of schoolchildren, the vast majority of adults and that dental caries contributes to an extensive loss of natural teeth in older people globally (Petersen, 2008a; WHO, 2016). Meanwhile, in most westernized high income countries, an improvement in dental health has taken place over the past three decades in parallel with the introduction of prevention-oriented oral health systems. A decline in the prevalence and the severity of dental caries is particularly observed in countries having established public health programmes using fl uoride for dental caries prevention, coupled with changing living conditions, healthier lifestyles, and improved self-care practices. In Eastern Europe and Central Asia dental caries levels are high and with health systems in transition the exposure of the population to fl uoride for disease prevention has diminished dramatically. In low and middle income countries of Africa, Asia, and Latin America the lack of preventive programmes is further complicated by the fact that these countries have a shortage of oral health personnel and the capacity of health systems is mostly limited to treatment of symptoms or emergency care. In children and adults suffering from severe tooth decay, teeth are often left untreated or they are extracted to relieve oral pain or discomfort. In the future, tooth loss and impaired quality of life are therefore expected to increase as a public health problem in many developing countries. The current global and regional patterns of dental caries largely refl ect distinct risk profi les of countries which relate to structure of society, living conditions, lifestyles, and the existence of preventive oral health systems (Kwan and Petersen, 2010). The socio-behavioural risk factors in dental caries are found universally and they play signifi cant roles in children, adults and older people. The disease level is relatively high among underprivileged population groups, i.e. people with low education background, poor living conditions, people with poor dietary habits and high consumption of sugars, and people with limited tradition of dental care. Unless serious efforts are made to tackle the social inequity by modifying risk factors and by establishing effective caries prevention