The World Health Organization
says that up to the age of 12 children
should only have three cavities. In Brazil, the average has now
reached 2.8. But there are other less honorable numbers: 30
million Brazilians have never been to a dentist, 60 million do not
brush their teeth and 8 million have lost all their teeth.
The World Health Organization has established five targets in the area of
buccal hygiene for the world's nations. Brazil has managed to reach one of
them: number of cavities in children between the ages of 6 and 12.
Speaking at the opening
of the 3rd National Conference on Buccal Hygiene, on July 30, minister of
Health, Humberto Costa, declared that there is little for Brazil to celebrate
and much to do. "We only reached one target out of five," said the
WHO says that up to the
age of 12 children should only have three cavities. In Brazil, the average
is 2.8. The other targets were: percentage of children at the age of 5 who
do not have cavities; percentage of youths age 18 with all their teeth, percentage
of adults (35 to 44) with 20 or more teeth; percentage of senior citizens
with 20 or more teeth.
Brazil plans to spend
US$ 428 million (1.3 billion reais) on buccal hygiene by the year 2006, which
will be a historical record.
Brazil is estimated to
have 8 million people who do not have teeth. Another 30 million have never
been to the dentist. Around 60 million Brazilians (40 percent of the population)
do not regularly brush their teeth.
A Ministry of Health survey
has found that only 55 percent of Brazilian adolescents have all their teeth.
Among adults, the figure rises to 54 percent. All together, there are some
30 million Brazilians who do not have all their teeth.
The survey was made at
the beginning of the year and found that besides missing teeth there is an
epidemic of cavities and an enormous need for dental care. The survey found
that it is hard to find free government-provided dental care.
In March the Brazilian
government launched the Brazil Smile program which intends to distribute dentalcare
kits (toothbrushes and toothpaste) to 500,000 public school students.
By 2006, the program will
spend 1.2 billion reais (US$ 400 million), build 354 dentalcare centers in
municipalities and set up 559 dental offices as part of the government's Family
Health Plan. It is estimated that 13 percent of the country's adolescents
have never been to the dentist.
With the Brazil Smile
program the number of government buccal health teams should more than double
to 16,000 by the year 2006. Another objective of the program is to provide
Adding fluor to water
is cheap; it costs around R$1 per year per inhabitant. At the moment, slightly
less than half the population of Brazil (70 million) has water with fluor.
The president of the Federal
Odontological Council, Miguel Nobre, says that Brazil has a good dentist-to-population
ratio (1 to 1,000; the World Health Organization recommends 1 to 1,500) and
that the best cure is prevention.
He says the tooth villain
has always been sugar, but people insist on eating sugar. "That is all
right. What you cannot do is eat sugar without brushing your teeth,"
The Brazil Smile program
will provide complete dental treatment, including periodontal care, surgery,
orthodontic procedures, and assistance with buccal lesions and cancer.
In a related health field,
there are now 20,561 Family Health Program (PSF) teams operating in over 83
percent of Brazil's almost 5,600 municipalities.
Ten years after its creation,
the program reaches around 67 million families. The objective of the program
is to bring healthcare closer to Brazilian families.
With a 2004 budget of
US$ 658 million (2 billion reais), the PSF deals with prevention of disease,
delivery of care and recovery from illness. This takes place in basic healthcare
centers or in homes where PSF teams visit.
The teams consist of a
doctor, a nurse, a nurse's aide and four to six community health agents. Each
team visits an average of 3,500 people monthly.
Their priorities are children,
pregnant women, the elderly and people with diabetes or hypertension problems,
as well as those who cannot make it to the healthcare center. They are always
on the lookout for diseases requiring mandatory notification, such as leprosy,
tuberculosis and AIDS.
The simplicity of the
program and proximity of the healthcare teams makes for a strong, close relationship
with the community being served, characterized by mutual respect.
Caio d'Arcanchy works for Agência Brasil (AB), the official press
agency of the Brazilian government. Comments are welcome at email@example.com.
from the Portuguese by Allen Bennett.