<University of Copenhagen -Healthy teeth and mouth are linked to a person’country income >
August 1, 2020 • jainendra joshi • MEDICAL AND HEALTH



Access to preventive dental care depends very much on where in the world you live.

Healthy teeth and mouth are linked to a person’s state of health in general. At an equivalent time,

diseases within the mouth and general chronic diseases share risk factors like an unhealthy diet, sugar

consumption, use of tobacco and high alcohol intake. Therefore, prevention of dental and oral diseases

aimed toward the common risk factors also features a positive effect on the state of health generally .

Public health intervention against dental and oral diseases is especially poor in low- and middle-income

counties. This is the conclusion of new research from the Faculty of Health and Medical Sciences at the

University of Copenhagen. The research is based on a questionnaire survey conducted among the health

authorities in the 194 WHO member states.

Classification of counties by national income per person*

High income: USD 12.376 or more
(For example Denmark and Australia)

Middle income: USD 1026-12.375
(For example Argentina and Cambodia) 

Low income: USD 1025 or less
(For example Niger and Bangladesh)

*GNI per capita, World Bank 2019.

The results show that there is only one dentist per 152,721 citizens in low-income countries, and one per

13,810 citizens in middle-income countries. In comparison, there's one dentist per 1,708 citizens in high-

income countries. That is, a dentist in a low-income country should take care of around 90 times as many

people as dentists in high-income countries like Denmark’, says Professor Emeritus Poul Erik Petersen

from the Department of Odontology at the Faculty of Health and Medical Sciences.

’Especially in low-income countries like Burkina Faso and Laos, for example, many people receive no

treatment at all. And if they do, it is only in connection with symptoms that may end with extraction of the

tooth’, he says.

According to the new study, this lack of preventive dental care is a result of poor financial resources,

failing political support from governments, limited public health sectors and a shortage of dentists.

Prevention Is the Best Treatment

Local health services are often insufficient. The same is true of 75 percent of high-income countries. 43 per cent

of low-income countries offer emergency treatment, while the same is true of 92 per cent of high-income


In addition, there are significant differences between the countries’ offer of preventive care like regular

dental examinations, information about dental diseases and self-care, diet and nutrition, sugar

consumption, tobacco and alcohol, school dental clinics and the use of fluoride against cavities.

’Low- and middle-income countries have seen an explosion in dental and oral diseases, mainly thanks to

the extreme increase in consumption of unhealthy food containing tons of sugar, sugary soft drinks, use

of tobacco and insufficient dental care and ineffective systems. Add to this, poor material living

conditions, which are a threat to people’s dental and oral health as well as to their state of health in

general’, Poul Erik Petersen says and continues:

‘By increasing disease prevention and health promotion it is possible to avoid pain and discomfort in teeth

and mouth, just as the quality of life and function may be improved by saving the natural teeth’.

Need for More Preventive Actions – Also in High-Income Countries

Dentists today have extensive knowledge of how dental and oral diseases are often prevented. The

challenge is to translate this knowledge into practice and thus establish effective dental healthcare and

public health programmes for all population groups in all countries. 

‘We need to strengthen the preventive measures for all age groups and both for poor and rich people. In

the world’s high-income countries, disease prevention is generally aimed at children and young people

and only to a minor extent at adults, just as it is fairly modest for senior citizens. There is also a need for

clear health policies that gives priority to prevention’, Poul Erik Petersen stresses.

The new research provides information on prevention throughout the world, and it focusses on all key

population groups: pre-school children, schoolchildren, young people, adults and senior citizens. The

study is based on a questionnaire survey conducted among the health authorities in the WHO member


The report, ’Global application of oral disease prevention and health promotion as measured 10 years

after the 2007 World Health Assembly statement on oral health’, has been published in the journal

Community Dentistry and Oral Epidemiology.

The study was conducted by the WHO Collaborating Centre at the Department of Odontology, which

researches community dentistry for the World Health Organization, WHO.