Promotion of orodental health in adolescents in Africa

Abstract

Bad dental hygiene in adults is usually the result of bad care during childhood. Within the framework of Health for All, WHO and the International Dental Federation defined global objectives for dental health which allow for monitoring progress in different countries. The most common dental problems, such as dental cavities, can be prevented by simple and inexpensive methods. Dental health is based on dental hygiene, nutrition, fluoride intake and dental service utilisation. Dental health promotion aims to create an environment favourable to the adoption of these healthy behaviours. The principle recommended dental health measures are through fluoridation of water, salt, and milk, a low consumption of sweets, and modification of the amount of sugar in the diet; implementation of monitored dental hygiene activities in schools; the organisation of regular dental services in schools/workplaces; and adopting legislative texts or laws requiring certain measures of prevention. In the past several years, certain African countries have set up national dental health programmes (there were 12 in 1993), However, the implementation of dental health promotion generally doesn't result from a national initiative, but from a regional or local scale. This is largely due to the lack of integration of dental health in activities of education and health promotion in general. Programmes planned at a national level and then implemented at a local level on a multisectoral base have had more success. This article presents examples of dental health promotion activities in several African countries, mainly focusing on programmes aimed at 12-13 year olds in primary school. Programmes from Morocco, Kenya, Madagascar, Côte d'Ivoire, Benin, and Tanzania are briefly presented and show that in Africa, dental health promotion has mostly consisted of the implementation of health education actions and that there are no consistent policies, unlike in other developing countries, for fluoridation of water, salt, and milk. In terms of dental health promotion, WHO recommends the promotion of traditional methods of dental hygiene (such as plants or sticks for cleaning), especially among adolescents living in rural and low income communities. In turn, the identification and promotion of the positive aspects of hygiene and traditional care will allow for the implementation of more culturally acceptable approaches.