Oral diseases: a global public health challenge

• Published in: The Lancet (British edition) Vol. 395; no. 10219; p. 185
• Main Authors: Bawaskar, Himmatrao Saluba, Bawaskar, Pramodini Himmatrao
• Format: Journal Article
• Language: English
• Published: London Elsevier Limited 18.01.2020
• Subjects: Cancer; Chewing; Children; Chocolate; Cigarettes; Confectionery; Dental caries; Dental fluorosis; Fluorides; Health risk assessment; Ice cream; Leukokeratosis; Mastication; Medical practices; Nuts; Oral cancer; Oral diseases; Oral hygiene; Public health; Smoking; Tea; Teeth; Tobacco; India
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(19)33016-8

In India, the mean prevalence of dental caries is 49% in children aged 5–12 years, 60% in people aged 15–34 years, 78% in people aged 35–44 years, and 84% in people aged 65–74 years.2 The incidence of oral cancer in India (50% of total cancers) is higher than in other countries and has been attributed to tobacco chewing, repeated use of masheri (a paste prepared from incompletely burned tobacco; appendix p 1), bidi smoking (small, hand-rolled tobacco cigarettes), betel nut and gutkha chewing, and alcohol consumption.3 Many individuals continue habits such as tobacco chewing, even after surgical treatment for oral cancer (appendix p 2). Since 1976, when we opened our rural medical practice, we have been writing “stop smoking and tobacco chewing” in red ink in the first line of our prescriptions.4 We also allow patients with leukoplakia caused by tobacco chewing to see the lesions that form where the tobacco has been held in the mouth (appendix p 3). People of all ages routinely drink heavily sweetened tea, and children often enjoy chocolate, ice cream, and candy. At social occasions, such as weddings, bidis, betel nuts, and gutkha are freely distributed to guests.