TODAY, whenever we hear the word “pandemic,” we immediately think of COVID-19, commonly called the coronavirus. But less than two decades ago the World Health Organisation (WHO) described dental caries as a pandemic and the bane of civilisation. The prevalence, up until the early 1970s, was high in developed countries and low in developing countries. The child and adolescent populations — literally tens of millions– suffered painful consequences.

Since nearly all susceptible tooth surfaces had been attacked by early adulthood, caries ( tooth decay)was considered to be essentially a disease of children. However, during the past 50 years, such traditional concepts of the disease have been revised in response to changes that have occurred n the prevalence, severity, distribution and pattern of tooth decay in many developed countries of the world.

During this period the dramatic reduction in caries levels in the developed countries has occurred even though the consumption of sugar has remained relatively static. Undoubtedly the most important reason for this improvement in dental health has been the introduction of fluoride into the oral environment.

In developing countries like Guyana, the situation is unequivocal. Data from the (WHO) indicate that in Central and South America the prevalence and severity of the disease is high whereas, throughout Asia, Africa and China caries levels remain generally low. However, if history were to repeat itself and these populations were to adopt the cariogenic diets and lifestyles of the developed world without the protection of fluoride, caries levels would increase.

Numerous dentists and research scientists the world over are unanimous in their conclusion that the challenge to everyone involved in the promotion of oral health is to sustain the benefits of fluoride to those already receiving them and encourage the use of appropriate and effective strategies and products by those who are not.

Because dental caries is a ubiquitous disease affecting all age groups, prevention is important throughout life. The prevalence and severity of this condition vary considerably between and within different countries and the choice of appropriate and effective preventive strategies should be based on data obtained from surveys that use standardised measurements of disease with carefully defined criteria. The last such survey done in all 10 Regions, and which I was privileged to participate in, was conducted by Dr. David W. Johnson under the auspices of The University of Western Ontario and CESO International Services in December 1995.

Population strategies such as water and salt fluoridation are the most cost-effective measures available and should be implemented where deemed befitting and feasible. Fluoride toothpaste are a highly effective means of caries control and their use should underpin any preventive programme.

Finally, the dramatic and welcome improvements in the dental health of populations in many countries across the globe represent one of the most significant public health achievements of this century. Governments of the poorer countries need to adopt national programmes to combat and control dental diseases to maintain the momentum.