Oral Health Surveillance Research Articles

Oral Health Surveillance System in India: Need and Proposal

Public health surveillance is described as the ongoing systematic collection, analyzing, and interpreting of the data, closely integrated with the transmission of these data to public health practitioners, doctors, and policymakers responsible to prevent and manage disease as well as injury. Both developed and developing nations are becoming aware of the significance of information from efficient surveillance systems for allocating resources and evaluating programs. Over the past few decades, there was a significant change in oral health profiles around the world. Indicators of oral health have improved in many countries, but not in India. An organized system for providing, monitoring, and evaluating oral health care services is needed in India. Draft National oral health policy 2021 has mentioned specific objectives: (a) by 2025, establish baseline data on the burden of oral diseases in the nation, (b) by 2030, the mortality and morbidity from dental and oro-facial diseases reduce to 15%, (c) By 2025, community-based awareness initiatives and practices for oral health will be covered by the healthcare system by a factor of 50%, and by 2030, by a factor of 70%, (d) the creation of an electronic database at district-level on components of the health system by 2025. A well-defined oral health surveillance system in India will serve the purposes (a) to provide standardized recording procedures, standards, and techniques to collect, analyze and interpret the oral health data at the state and central levels (b) to prioritize oral diseases or conditions that will be the focus of oral health surveillance or disease elimination, (c) to digitally monitor and evaluate the progress of nation’s oral health care programs.

Electronic oral health surveillance system for Egyptian preschoolers using District Health Information System (DHIS2): design description and time motion study

BackgroundEarly childhood caries (ECC) is a major global health issue affecting millions of children. Mitigating this problem requires up-to-date information from reliable surveillance systems. This enables evidence-based decision-making to devise oral health policies. The World Health Organization (WHO) advocates the adoption of mobile technologies in oral disease surveillance because of their efficiency and ease of application. The study describes developing an electronic, oral health surveillance system (EOHSS) for preschoolers in Egypt, using the District Health Information System (DHIS2) open-source platform along with its Android App, and assesses its feasibility in data acquisition.MethodsThe DHIS2 Server was configured for the DHIS2 Tracker Android Capture App to allow individual-level data entry. The EOHSS indicators were selected in line with the WHO Action Plan 2030. Two modalities for the EOHSS were developed based on clinical data capture: face-to-face and tele/asynchronous. Eight dentists in the pilot team collected 214 events using modality-specific electronic devices. The pilot’s team's feedback was obtained regarding the EOHSS's feasibility in collecting data, and a time-motion study was conducted to assess workflow over two weeks. Independent t-test and Statistical Process Control techniques were used for data analysis.ResultsThe pilot team reported positive feedback on the structure of the EOHSS. Workflow adaptations were made to prioritize surveillance tasks by collecting data from caregivers before acquiring clinical data from children to improve work efficiency. A shorter data capture time was required during face-to-face modality (4.2 ± 0.7 min) compared to telemodality (5.1 ± 0.9 min), p < 0.001). The acquisition of clinical data accounted for 16.9% and 21.1% of the time needed for both modalities, respectively. The time required by the face-to-face modality showed random variation, and the tele-modality tasks showed a reduced time trend to perform tasks.ConclusionsThe DHIS2 provides a feasible solution for developing electronic, oral health surveillance systems. The one-minute difference in data capture time in telemodality compared to face-to-face indicates that despite being slightly more time-consuming, telemodality still shows promise for remote oral health assessments that is particularly valuable in areas with limited access to dental professionals, potentially expanding the reach of oral health screening programs.

Artificial intelligence in oral health surveillance among under-served communities.

A sizable percentage of the population in India still does not have easy access to dental facilities. Therefore, it is of interest to document the role of artificial intelligence (AI) in oral surveillance of underserved communities. Available data shows that AI makes it possible to screen, diagnose, track, prioritize, and monitor dental patients remotely via smart devices. As a result, dentists won't have to deal with simple situations that only require standard treatments; freeing them up to focus on more complicated cases. Additionally, this would allow dentists to reach a broader, more underprivileged population in difficult-to-reach places. AI fracture recognition and categorization performance has shown promise in preliminary testing. Methods for detecting aberrations are frequently employed in public health practise and research continues to be focused on them.

Oral Health, Social and Emotional Well-Being, and Economic Costs: Protocol for the Second Australian National Child Oral Health Survey.

Given the significant investment of governments and families into the provision of child dental care services in Australia, continued population oral health surveillance through national oral health surveys is imperative. The aims of this study are to conduct a second National Child Oral Health Survey (NCOHS-2) to (1) describe the prevalence, extent, and impact of oral diseases in contemporary Australian children; (2) evaluate changes in the prevalence and extent of oral diseases in the Australian child population and socioeconomic subgroups since the first National Child Oral Health Study (NCOHS-1) in 2012-2013; and (3) use economic modeling to evaluate the burden of child oral disease from the NCOHS-1 and NCOHS-2 and to estimate the cost-effectiveness of targeted programs for high-risk child groups. The NCOHS-2 will closely mimic the NCOHS-1 in being a cross-sectional survey of a representative sample of Australian children aged 5-14 years. The survey will comprise oral epidemiological examinations and questionnaires to elucidate associations between dental disease in a range of outcomes, including social and emotional well-being. The information will be analyzed within the context of dental service organization and delivery at national and jurisdictional levels. Information from the NCOHS-1 and NCOHS-2 will be used to simulate oral disease and its economic burden using both health system and household costs of childhood oral health disease. Participant recruitment for the NCOHS-2 will commence in February 2024. The first results are expected to be submitted for publication 6 months after NCOHS-2 data collection has been completed. Thematic workshops with key partners and stakeholders will also occur at this time. Regular surveillance of child oral health at an Australian level facilitates timely policy and planning of each state and territory's dental public health sector. This is imperative to enable the most equitable distribution of scarce public monies, especially for socially disadvantaged children who bear the greatest dental disease burden. The last NCOHS was conducted in 2012-2014, meaning that these data need to be updated to better inform effective dental health policy and planning. The NCOHS-2 will enable more up-to-date estimates of dental disease prevalence and severity among Australian children, with cost-effective analysis being useful to determine the economic burden of poor child dental health on social and emotional well-being and other health indicators. PRR1-10.2196/52233.

World Health Organization's global oral health status report: Paediatric dentistry in the spotlight.

World Health Organization's global oral health status report: Paediatric dentistry in the spotlight.

Level of natural fluoride in public water supply: geographical and meteorological factors in Brazil's Northeast.

This study analyzed the relationships between the concentration of natural fluoride in public water supply and meteorological and hydrographic factors in a northeastern region of Brazil. This was a descriptive, analytical, ecological, longitudinal, and field study conducted by collecting water in 23 municipalities (2019 to 2020) of four macroregions of Paraíba (Brazil): coast (1), borborema (2), agreste (3), and outback (4). Four collection sites were selected per municipality: two near and two distant from the water treatment plant. Fluoride concentration was determined using a combined ion-specific electrode and classified according to the Collaborating Center of the Ministry of Health in Oral Health Surveillance. Meteorological, hydrographic, and population characteristics were also collected. All analyzed samples showed natural fluoride; macroregions 2 and 4 showed the highest mean fluoride concentration, macroregion 4 presented the highest mean temperature, and all macroregions showed a similar pattern of precipitation. The mean fluoride concentration of the four macroregions was below the appropriate value to prevent caries. An increase in precipitation would decrease the fluoride concentration in water. In conclusion, the concentration of natural fluoride varied according to meteorological and hydrographic factors. The concentration in surface waters increased during periods of low precipitation. Therefore, this study provided important information to support implementation of community water fluoridation in this region.

The Saudi Arabian national demographic and health survey, 2017: Study design and oral health-related influences

ObjectiveTo describe the study design, and the distal and proximal influences on oral health reported in the national demographic and health survey (DHS) of the Kingdom of Saudi Arabia (KSA) in 2017. MethodsThe 2017 KSA DHS used an innovative multistage stratified random-sampling technique to select the population sample by using primary health care centers’ (PHCs) catchment areas as the primary sampling unit. Over 45,000 household heads plus a family member were interviewed. A conceptual framework for distal and proximal oral health influences specific to the KSA was adapted based on the oral health surveillance model. Cross-tabulation and Chi-square tests were performed with consideration for sample weights to provide estimates representative for the KSA population. Frequencies and weighted percentages for each variable reflecting each construct were reported. ResultsThe total number of individuals included in the analysis was n = 55,511, ages ranging between 2 and > 65 years. Lack of dental care when needed was reported for 22.5 % of the population (males = 20.8 %/females = 24.7 %). Proportion of population from Central, West, East, South, and North regions who reported available dental care services when needed was 62.3 %, 58.0 %, 58.9 %, 62.3 %, and 60.1 %, respectively. PHCs were the most regular source for dental care (55.1 %). In total, 48.3 % visited the dentist at least once last year (males = 49.4 % /females = 46.8 %). Dental pain was the most common reason for last dental visit (69.0 %), while only 6.4 % reported visited the dentist for routine visit. Only 15.3 % reported brushing their teeth at least twice per day (males = 14.6 % /females = 16.4 %). ConclusionTwo major oral health influences previously reported to have a significant negative influence on oral health, namely, limited routine dental check-up visits and inadequate oral hygiene, were present among KSA residents. Further inferential study is needed to investigate such influence on oral health status within the KSA population.

Electronic Health Records in Dental Education: A Scoping Review and Quantitative Analysis of Publications

The use of Electronic Health Records (EHRs) by dentists is already a reality in several countries, including Brazil, both in private practices and in higher education institutions, also providing data for oral health surveillance and epidemiology. The purpose of this scoping review was to search the literature for publications on the importance, applicability, efficacy and ease of the use of electronic medical records in dental education. Following the terms of the PRISMA-ScR, this review sought publications on the use of EHRs in dentistry schools. The databases used in the search were Pubmed, BVS, Web of Science, Scopus and ProQuest, without language limitations and publication period, using the terms ‘Dental School’, ‘Dental Education’ and ‘Electronic Health Records’. Initially, the search resulted in 548 articles. After reading the abstract, full text and removing duplicates, 63 were included. Then, it was divided in three groups according to main thematic: EHRs implementation (n = 25); Data obtained from Dental Schools EHRs used for publications (n = 26); EHRs system efficacy and challenges (n = 12). The use of electronic medical records in the teaching of dentistry collaborates positively with the development of students during graduation. We believe that this alternative of searching and collecting information will be increasingly used in epidemiological studies, due to its practicality and objectivity.

Electronic Health Records in Dental Education: A Scoping Review and Quantitative Analysis of Publications

The use of Electronic Health Records (EHRs) by dentists is already a reality in several countries, including Brazil, both in private practices and in higher education institutions, also providing data for oral health surveillance and epidemiology. The purpose of this scoping review was to search the literature for publications on the importance, applicability, efficacy and ease of the use of electronic medical records in dental education. Following the terms of the PRISMA-ScR, this review sought publications on the use of EHRs in dentistry schools. The databases used in the search were Pubmed, BVS, Web of Science, Scopus and ProQuest, without language limitations and publication period, using the terms ‘Dental School’, ‘Dental Education’ and ‘Electronic Health Records’. Initially, the search resulted in 548 articles. After reading the abstract, full text and removing duplicates, 63 were included. Then, it was divided in three groups according to main thematic: EHRs implementation (n = 25); Data obtained from Dental Schools EHRs used for publications (n = 26); EHRs system efficacy and challenges (n = 12). The use of electronic medical records in the teaching of dentistry collaborates positively with the development of students during graduation. We believe that this alternative of searching and collecting information will be increasingly used in epidemiological studies, due to its practicality and objectivity.

Comparison of a full arch digital photographic assessment of caries prevalence in 5-year-old children to an established visual assessment method: a cross-sectional study

IntroductionDigital epidemiology in dental disease screening has a number of advantages which warrant further exploration.AimThis study aimed to test the examination accuracy of digital images to evaluate child oral health by comparing the new method to a gold standard method. It also investigated the levels of diagnostic accuracy between different examiners, including dental care professionals and a lay examiner, when quantifying dental disease using images.MethodsA calibrated dental examiner inspected forty 5-year-olds. In addition, three sets of digital images were taken per child. These images were assessed by six examiners. Sensitivity and specificity of caries diagnosis and inter-examiner reliability were calculated to compare the caries scores derived from examination of the images to those of the gold standard examinations.ResultsThe mean values for sensitivity and specificity scores were 48.0% and 99.1%, respectively. The mean value for kappa showed moderate agreement between 0.43 and 0.73 (0.57). Mean values for agreement using intra-class coefficients were excellent (0.78) and good (0.73) for dt and dmft, respectively. No statistical difference in the validity of the caries scores was shown between the different image assessors.ConclusionsThese data demonstrate the feasibility of using digital images to screen child oral health and for nondental professionals to be recruited to carry out digital epidemiology for the oral health surveillance of children.

Utility of State-Based Basic Screening Survey Reports for National Oral Health Surveillance in Older Adults.

IntroductionUntreated dental disease and resulting tooth loss can diminish quality of life for older adults by limiting food choices and discouraging social interaction. Before the Basic Screening Survey (BSS) for older adults, no clinical data were available to monitor the oral health of older adults in long-term care (LTC) facilities at the national level or older adults overall at the state level. Although BSS is widely used, no guidelines exist to ensure the validity, reliability, and comparability of survey information across states. We examined BSS content to help establish reporting guidelines and synthesized findings across states for older adults living in LTC.MethodsWe systematically reviewed BSS reports published from 2011–2019, assessing how oral health outcomes were measured and reported. For reports that included statewide estimates for LTC residents, we calculated the mean, median, and ranges of 3 preventable oral health conditions and 4 indicators of tooth loss.ResultsWe found wide variation in reporting of sampling, screening, and statistical methods, as well as in indicators of tooth loss. Median prevalence of untreated tooth decay and edentulism (total tooth loss) among LTC adults in 11 states was almost twice that for community-dwelling adults in a national survey.ConclusionsThe substantial variation in BSS reporting highlights the potential benefits of adopting standardized guidance, which could improve the utility of BSS. Poor oral health outcomes among LTC residents underscore the importance of systematic monitoring of the oral health of this vulnerable population.

Oral Health Surveillance in Childhood by Family Pediatricians in the Province of Trento - North Italy. Limits and Perspectives

Introduction: The prevalence of dental caries in childhood has seen a significant decrease in the last few decades. The monitoring systems allow us to know the progress of the disease over time and the other aspects that require improvement. The study reports the temporal trend of the oral health state in children residing in the province of Trento (north east Italy) and evaluated at the age of 6 years. The study also analyzes, on the birth cohort of 2011 and assessed in 2017, by family pediatricians, the association of dental caries on deciduous teeth with socio-demographic factors. Materials and Methods: The source of the data is represented by the forms filled by the family pediatricians on the occasion of the 6-year health assessment. Since the birth cohort of 2008, family pediatricians have been involved in the surveillance of oral health in childhood. On this basis, the trend of the prevalence of free caries and the trend of oral hygiene procedures followed by children over time have been calculated. The factors associated with the risk of decay of deciduous teeth have been analyzed with a multiple analysis according to the logistic model. Mother-related variables were retrieved using the Birth Assistance Certificate archive. Results: There is a progressive increase in the proportion of caries-free children which is statistically significant. The prevalence at 2017 is 77%, higher in Italian than in foreign children. The proportion of children with optimal oral hygiene practice increased statistically significantly. The proportion of children who underwent fluoride prophylaxis within the age of 6 has been statistically significantly reduced. The proportion of children with at least one access to the dentist within the age of 6 recorded an increase in an initial period. The accesses for sealing the first molars have also increased over time with a statistically significant trend. Differences remain between Italians and foreigners. The presence of a mother of foreign nationality, a mother aged 24 or younger and a sub-optimal practice of oral hygiene are independent risk factors for the onset of decay of deciduous teeth at the age of 6. Discussion: Family pediatricians can contribute to oral health surveillance in childhood. Family pediatricians can also play an important role, considering that he comes into contact with the child and his family from birth to puberty. It is necessary however integrate this professional into the network of local health services. A revisit of the provincial program for the oral health promotion in childhood would seem necessary, improving the relations with schools and the interventions to the most vulnerable groups such as foreigners Women of childbearing age and during pregnancy should also receive special care, considering that the mother’s lifestyle can have significant impact on the health and behavior of the child.

Risk Indicators of Urgent and Extensive Dental Treatment Needs in U.S. Air Force Recruits.

Dental Readiness Classifications (DRCs) enable the Military Health System to prioritize dental care in garrison, minimizing dental emergencies and mission degradation during deployments. Over half (52.4%) of 2008 military recruits presented with high-priority urgent needs classified as DRC3 upon initial dental examination and 18.1% required extensive treatment, needing 7 or more restorations, in order to achieve operational dental readiness. The purpose of this study is to identify risk indicators for urgent and extensive dental treatment needs in current U.S. Air Force (USAF) recruits so that Dental Corps leadership can target interventions to maximize oral health, prioritize resources, and reduce health expenditures in this patient population. A secondary data analysis was performed of deidentified survey and clinical exam data from the 2018 to 2019 USAF Recruit Oral Health Surveillance study conducted at Lackland Air Force Base from February 2018 to February 2019. Select demographic and self-reported variables were analyzed with two outcome variables: urgent (DRC3) and urgent and extensive (DRC3 + 7) dental treatment needs. Univariate log binomial regression was performed to determine relative risk of DRC3 and DRC3 + 7 by independent variable. The Uniformed Services University of the Health Sciences institutional review board approved the study as an exempt protocol. Among the 1,335 recruits studied, the overall prevalence of urgent dental needs was 21.5%, whereas 5.5% of participants had both urgent and extensive needs. The study group included participants who were mostly male (69%), were non-Hispanic white (60%), aged 17 to 19 years (48%), were high school educated (47%), had private dental insurance coverage (50%) and self-reported: no need for dental care in the past year (65%), excellent or good condition of teeth (63%), were toothbrushing more than once a day (58%), and had daily consumption of one to three servings of sugary beverages (62%) and foods (69%). Statistically significant differences in relative risk for DRC3 were found for all independent variables except gender and education level. Risk indicators significant for DRC3 and DRC3 + 7 were aged 25 to 29 years; Other and Black race/ethnicity; Medicaid insurance; uninsured; self-reported fair, poor, or unsure current condition of teeth; and past year needed care but did not go (P < .05). The majority of DRC3 and DRC3 + 7 cases were in the small subset of recruits who self-reported fair, poor, or unknown current condition of teeth or need for dental care in the past year without a dental visit. Among USAF recruits, oral health disparities are observed in certain groups. The study findings can inform targeted utilization of resources and interventions to efficiently optimize oral health and operational dental readiness and decrease dental expenditures. Additionally, a two-question screening tool is proposed to facilitate priority assignment for dental examination during boot camp. This tool has the potential to correctly identify nearly 90% of those with urgent and extensive dental treatment needs at half the typical workload.

Oral health surveillance in Australia: the need for ongoing data to inform public health decision-making.

Surveillance of people's health takes on an important meaning in the practice of public health because it allows monitoring of diseases and prompt response to change in proportions and rates at which diseases occur in populations. Improving health of populations requires establishment of an effective public health system. Population level data and analysis is critically important in government policy and program development and monitoring. Lack of or inadequate information about the health of populations leads to ineffective policies that may often attenuate health problems instead of solving them. Australia's current oral health surveillance is mostly through ad hoc sentinel surveys, which lack recency in time. This position paper is to present the need for real-time oral health surveillance in Australia, which can be used to inform health decision-making in a timely manner.

Using electronic dental records to establish a surveillance system for dental decay in rural Western Alaska.

Previous surveys have demonstrated high rates of early childhood caries (ECC) in the Alaska Native (AN) population of western Alaska. There are many challenges to providing dental care in this road-less Yukon-Kuskokwim Delta region. The regional Tribal Health Organization implemented an electronic dental record (EDR) system in the late 1990s. We explored use of the EDR to establish an oral health surveillance system in children. We contracted with EDR software developers to implement calculation of a summary count of decayed (d), missing (m) or filled (f) primary (dmft) score for each individual. We calculated the yearly average dmft scores for 2011-2019 for children aged 3 and 5 years with a comprehensive exam in a given year. We also assessed the number of children undergoing full mouth dental rehabilitation (FMDR). We used US census data population estimates for these age groups to calculate rates. Over the 9-year period, 2,427 3-year-old children (47 percent of all 3-year olds over this period), received a comprehensive exam; increasing from 24 percent in 2011 to 62 percent in 2019. Their average dmft score over the 9-years was 6.4 with a significant annual decline over this period. Seventy percent of AN children who turned 6 between 2015 and 2019 had received at least one FMDR. An oral health surveillance system has been established in western Alaska using the Electronic Dental Record. High rates of ECC and FMDR were observed. This surveillance system will allow assessments of ECC prevalence and impact of dental interventions.

Heterocontrole da fluoretação da água de abastecimento público em Uberlândia, Minas Gerais, Brasil

Este estudo teve como objetivo analisar os teores de flúor na água de abastecimento público do município de Uberlândia (MG) e, adicionalmente, comparar os valores encontrados com os dados do controle operacional e de um laboratório de referência. Durante seis meses coletaram-se 126 amostras, as quais foram analisadas pela técnica eletrométrica, inicialmente na Universidade Federal de Uberlândia e depois pelo laboratório de referência. Por meio do teste Generalized Estimating Equations, os dados foram comparados entre si e com os de controle operacional. Observou-se diferença estatística entre os laboratórios, entre os momentos avaliados e na interação entre laboratório e tempo. Mesmo com variabilidade entre os resultados, pôde-se concluir que o flúor está presente na água de abastecimento de Uberlândia com teores dentro dos padrões recomendados pelo Centro Colaborador do Ministério da Saúde em Vigilância da Saúde Bucal quanto à concentração de fluoretos e que a população tem sido assistida de forma segura.&#x0D;

Accuracy of the need for dental prosthesis and associated factors between elderly in Recife, Brazil

Abstract Background The latest national oral health survey showed a high prevalence of the need for dental prostheses between the Brazilian elderly. To classify this need, normative (clinical) and subjective (self-reported) criteria must be considered since patients' self-perception takes into account social and functional issues that arise with oral health problems. Few studies investigate the agreement between these criteria, as well as its determinants. Thus, this study aimed to investigate the accuracy of the need for the use of total dental prosthesis and factors associated with the agreement between criteria. Methods Cross-sectional study, carried out in three municipalities in the Metropolitan Region of Recife, with a random sample of 816 elderly people from 65 to 74 years old. The dependent variable was the accuracy, calculated by the agreement between the self-reported and the normative need for a total dental prosthesis, and the independents were assembled in three blocks (socioeconomic/demographic, access to oral health services and self-perceived oral health). Hierarchical logistic models were conducted for total upper prosthesis (TUP) and total lower prosthesis (TLP). Results The self-perception of the need for prosthetic use presented an accuracy of 75.9% (95% CI = 72.8-78.7%) for TUP and 78.6% (95% CI = 75.6-81.3%) for TLP. In the multiple analysis, the accuracy for TUP and TLP needs holds an association with the variables: family income, age and time since the last dental appointment. Conclusions In conclusion, the self-perception of need for dental prosthesis demonstrates potential applicability for the elderly, presenting notable accuracy values. It suggests that studies based on patients' self-reports should be stimulated, aiming for the evaluation and validation of self-reported criteria in different contexts and cultures. Furthermore, the identification of accuracy associated factors can help to build more meaningful questions to be used in future surveys. Key messages The use of the self-reported need for total dental prosthesis may be feasible when considering lower cost, reduced time of execution and ease of use in population epidemiological surveys. Application of self-reporting as an epidemiological tool for planning and monitoring oral health services, incorporating it in the form of indicators for oral health surveillance.

Global application of oral disease prevention and health promotion as measured 10years after the 2007 World Health Assembly statement on oral health.

ObjectivesThe WHO World Health Assembly established in 2007 a Resolution (WHA60.17) on oral health, which called upon countries to ensure that public health actions for disease prevention and health promotion are established. The objective of the present survey undertaken 10 years later (2017‐2018) was to measure the application of such programmes for key population age groups in low‐, middle‐ and high‐income countries.MethodsOral health focal points of ministries of health worldwide (n = 101) answered a structured questionnaire on existing national oral health systems and the actual public health activities. The response rate was 58.4%. The questionnaire was used to collect information about structural factors, country workforce, financial models, provision of preventive services and promotion for oral health, school health programmes, administration of fluoride, national oral health targets and oral health surveillance. The countries were classified by national income for analysis of data.ResultsCoverage of population groups by primary oral health care and emergency care varied by national income. The gap between countries in delivery of preventive care was strong since low‐income countries less often reported preventive activities than middle‐income countries and particularly when compared to high‐income countries. School oral health programmes were less frequent in low‐income than other countries. Moreover, population methods of fluoridation and use of fluoridated toothpaste were unusual in low‐income countries. Health education, mass communication and community events were often essential elements in health promotion. In disease prevention, many countries considered the link between oral health and general health conditions and intervention towards shared risk factors of NCDs. The health concern for the consumption of tobacco, unhealthy diet and sugars was particularly emphasized by high‐income countries but less highlighted by low‐income countries. Finally, while national oral health targets for children and surveillance systems were frequently reported by countries, similar systems for adolescents, adults and older people were rare.ConclusionsThe inequities between countries in oral disease prevention and health promotion were substantial. Limited financial resources for preventive care and health promotion; inadequate workforce for oral health, and insufficient coverage in primary health care were observed in low‐resource countries. The results of the survey demonstrate the need for building effective oral health systems oriented towards oral disease prevention and health promotion.

External control of water fluoridation in a small municipality of northeast of Brazil

Abstract Introduction Fluoridation of public water supply is an important measure in the prevention of dental caries. Objective This study aimed to monitor the fluoride (F) concentrations of a public water supply with water fluoridation program in a small municipality in the Northeast region of Brazil. Material and method It is a quantitative study with a descriptive approach. Three points of the urban area were selected for collecting water samples twice a month for 12 months. The average of F concentrations was calculated considering these three samples of each collection point at the same occasion. F concentrations in the water samples were determined by potentiometry and the results were classified according to the criterion proposed by criterion set down by Collaborating Center of the Brazilian Ministry of Health for Oral Health Surveillance. The samples were classified according to the best risk-benefit adjustment (0.55 – 0.84 mg F /L). Result Less than 10% of the samples were within the ideal range. Conclusion It was observed that water fluoridation in this municipality was interrupted since many water samples showed f-levels below the minimal acceptable values.

Increasing access to oral healthcare for marriage-immigrant women in South Korea: programme design to policy recommendation

To examine oral health status and access to dental care among marriage-immigrant women (MIW) in South Korea (Korea). We analysed patients' demographic information and access to dental services through the 'Family-Love Dental Program' and compared them with Korean oral health surveillance data. The 'Family-Love Dental Program' resulted from a partnership among the Korean Ministry of the Gender Equality and Family, Seoul National University Dental Hospital, and Cigna Insurance Company (registered as 'LINA' in South Korea) to increase access to oral health for MIW from 2010 to 2016. Over the programme duration, 1,944 MIW underwent dental examination and 1598 MIW received dental treatment. More than two-thirds of MIW (69.5%) receiving dental services were aged between 20 and 39years. In 2016, the proportion of untreated dental caries among MIW was 54.8%, which was significantly higher than that of untreated dental caries among Korean women within the same age group (24.9%). Over the programme duration, 501 MIW (25.8%) underwent final restoration, and advanced care was provided at the Seoul National University Dental Hospital. MIW have a significantly higher number of dental caries than Korean women within the same age group. Future programmes and policies should consider specific barriers that will promote oral health parity for MIW and their children.