Europeans worst oral health

Information on oral health suffer mainly from the poor quality of data available for development, implementation? Workforce, management and evaluation. The profusion of recommended indicators at the international level may complicate the selection of national indicators and cause unnecessary and costly controls.

The European Commission launched the EU's European Global Oral Health Indicators, coordinated by the University Claude Bernard in Lyon, to assist Member States in their efforts to reduce the numbers of morbidity, disability Work related to disorders of the oral health, including:

identify indicators of oral health (problems, determinants and risk factors related to lifestyle) dental criticism, the quality of care and health resources essential
strengthen the capacity at the local, national and regional levels, to measure, compare and determine the results of oral health and use of resources,
identify indicators of oral health (problems, determinants and risk factors, factors related to lifestyles) of the major oral health care,
identify the types of production problems and management of data within the health information system
identify principles to guide the selection and use of indicators of oral health,
identify a set of basic indicators of oral health,
take stock of the recent selection of indicators of oral health.
A program on indicators of oral health is clearly justified by the impact of diseases on society. However, the oral health of European populations is generally satisfactory. At least in the countries of the European Union, it has improved recently. An analysis of the literature on the subject indicates that between 1970 and 2000 oral health of children has improved from 50 to 80%. Similarly, most dental caries were treated. Even more remarkable is the fact that the state of dental health of European populations, including adults, seems to have "internationalized". Thus, the index of severe dental caries (CAOD number of teeth decayed, filled or not) is generally the same throughout Europe. The variability of the importance of dental caries observed in the 1970s greatly reduced. All EU countries currently converging to a threshold of serious tooth decay at the age of 12, which is about 1-1.5 times the index CAOD. Only adults aged 65 to 74 years show significant differences regarding the number of teeth in Europe. These differences are related to sanitary conditions and historical cultural habits, but should quickly disappear in future generations. The analysis also covers periodontal disease. In their severe form, the latter could reach 10% of all adults in some European locations.

The indicator index severe dental caries (CAOD) is the international benchmark in terms of oral health. The forty years of existence is an asset to assess past and future trends. However, designing an epidemiological study using representative updated the methodology for monitoring the oral health is invariably in most cases, similar results for low-risk groups and even moderate. Thus, a significant investment led only limited gains in terms of information, without real implications at the operational level. The problem is less the value of the index CAOD that its ability to translate changes in short-term health and perceptions within systems of oral health.

The monitoring system of dental caries using the database for the WHO Program on the profile of oral health by country / region has existed since 1969. Data on periodontal diseases were added in 1985 on the basis of CPITN index (index Community periodontal care needs). In 1995, the database has been forwarded to the WHO Collaborating Center at the University of Malmö, which conducted a national synthesis of oral updated for the Internet.

The health objectives for 2000 were assessed on the basis of these reports, as well as recommendations for the year 2015? in short, most policy guidelines on oral health supported by the WHO. However, despite the great advances in oral health in the European countries over the past twenty years, a problem remains unresolved.

Disease prevention and identifying risk factors and preventive factors, the evaluation of health and treatment quality were necessary and were gradually replaced by the concept of restorative dentistry (restorative care). As in other areas of health, the question is whether the clinical data, with all the logistical and economic implications involved, must remain the cornerstone of the monitoring system dentaire. This is not to replace the CAOD. What is at stake is its own place and rule over other indicators more flexible, such as indicators based on a questionnaire.

Thus, the preventive methods "traditional" attested in most cases show the limits in groups at high risk of dental caries, also misidentified in epidemiology. These populations at high risk for tooth decay - which is also perhaps not the only risk factor - are still on the charts dental recorded in 1965, the same populations for which treatment is apparently difficult to implement. The failure of prevention is also the failure of dental care. We must define other approaches if we want progress. Eliminate inequalities should be the primary objective of the health system, hence the proposed approaches, integrated. It should be very careful with the type of indicators for this program, its strategies and outcomes.

This final report is the starting point of the second phase of the project (which will be launched in coming years) based on common approaches to oral health, health surveys based on interviews and surveys health clinics nationally.