BRAZIL-HEALTH: No Longer Toothless

By Mario Osava Reprint | | Print |

Mario Osava

RIO DE JANEIRO, Jul 30 1997 (IPS) - The cavity rate among Brazilian children has plunged 30 percent in the past decade thanks to unflagging prevention efforts, according to a study backed by the World Health Organisation (WHO).

Although it is one of the world’s leading consumers of sugar, Brazil is no longer a nation of toothless adults. “There was a time when my father and I made more than 500 dentures a month, but now I make very few,” says Helio Dutra, a dentist in Belo Horizonte, the capital of the eastern state of Minas Gerais. “I have made some 50,000 dentures in my lifetime,” he told IPS.

With nearly half a century working in the field, Dutra has seen enormous changes. In some areas of Brazil, where comprehensive prevention programmes have been implemented, the cavity rate has been reduced to close to zero, he points out.

Widespread prevention efforts are relatively new in Brazil. They began “around 10 years ago,” says Dutra, who has played an active role in the campaign, as vice-president of the Minas Gerais Dentists Union from 1989 to 1994, and participating in Catholic outreach efforts to the poorest sectors.

Recent progress is due largely to preventive measures such as the fluoridation of water in urban areas, the wider distribution of fluoride toothpaste, and direct applications of fluoride in schools, says Vitor Pinto, a consultant with the Industry Social Service (SESI), an industrial sector social assistance body.

A comprehensive prevention programme must also cover pregnancy and breastfeeding – with orientation and assistance towards a balanced diet complete with vitamins and minerals – advice on avoiding sugar, the teaching of appropriate toothbrushing techniques, application of fluoride and regular dental check-ups, says Dutra.

In 1986, the Health Ministry found that 76 percent of children under 12 had six or more cavities, while only eight percent had less than three cavities, considered an acceptable level.

In examinations of over 110,000 three to 14 year olds this year, SESI found that the proportion of children with more than six cavities had plummeted to 34 percent. Meanwhile, the number of kids with good dental health – three or less cavities – increased to 37 percent.

The improvement was not more impressive “because Brazil is one of the biggest consumers of sugar in the world, with a per capita consumption of 130 grams a day, compared to a world average of 50 grams,” SESI’s Pinto underlined.

Odontology in Brazil has changed since the 1950s, when dentists “pulled out enormous numbers of teeth,” says Dutra. In the 1970s, the watchword became preservation of teeth, and specialisations for correcting dental problems began to appear.

Dental schools and professionals have also mushroomed in Brazil, a country of 160 million. Today there are over 142,000 dentists registered in Brazil’s Federal Odontology Council, while some 10,000 new dentists graduate every year, says Claudio Teixeira, in charge of the Council’s data sector.

Dutra predicts a future surplus of dentists, given the growing number of new odontologists and the trend towards less and less cavities and other dental problems. There will soon be one dentist for every 1,000 Brazilians, says Teixeira. Several hundred local dentists have already emigrated to Portugal.

But while there is an increasing abundance of dentists in Brazil’s larger cities, they are scarce in the rest of the country. “There is a lot of work in the interior,” says Teixeira, who adds that the most frequent consultations to the Federal Council are by new graduates looking for cities where dentists are needed.

Although Dutra acknowledges that new dentists may find it harder to get established today, he says “the work offers greater professional satisfaction, because we are treating healthier mouths than in the past.” Prevention, he underlines, is cheaper than recovery, and better for people’s health.