(By Dr. Joseph D. Lim and Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI)
IT IS MORE expensive for Filipinos to buy toothpaste than it is for people in Thailand, according to a study published in PLOS One.
The study was conducted by Athanasios Gkekas of the Department of Health Sciences, University of York, United Kingdom, and colleagues at the World Health Organization’s (WHO) Oral Health Program, the London School of Hygiene and Tropical Medicine, the College of Dentistry at New York University, and the Department of Dentistry, Radboud University Medical Center, The Netherlands. The study is now part of the WHO Global Oral Health Report.
It found that fluoride toothpaste is “strongly affordable” in high-income countries, relatively affordable in upper middle-income countries, and strongly unaffordable in lower middle-income and low-income countries.
The study classified the Philippines as a lower-middle income country, defined by the World Bank as a nation with a gross national income per capita of US$1,005 or less.
“The study has shown that the affordability of fluoride toothpaste needs to be addressed as a matter of public health concern at least in countries with a risk of unaffordable expenditure, mainly low, middle-income countries,” Gkekas says.
To help change this dire situation, interventions that lead to lower consumer prices and better affordability are needed, the study recommends.
The interventions are related to government regulations that influence the prices of medical commodities, Gkekas says.
To make essential medicines more affordable, the World Trade Organization suggests strategies such as generic competition, high volume production, the adoption of differential pricing, or voluntary licensing and technology transfer. Similar strategies apply for fluoride toothpaste as well.
If financially feasible, it should be provided free of charge in community, school or workplace settings to improve the oral health outcomes of people living in poor areas.
“Dental diseases, including dental caries, have a major economic impact on both individuals and healthcare systems,” says Gkekas. “In low- and middle-income countries, out-of-pocket oral healthcare payments are among the common reasons for catastrophic expenditures for households.”
Fluoride toothpaste is the main source of topical fluoride, essential in the prevention and control of caries or tooth decay, especially when alternative sources of fluoride, such as water fluoridation, are not available – as in the Philippines.
There is good evidence that fluoride concentrations from 1,000 parts per million (ppm) to 1,500 ppm in toothpaste are effective in reducing the incidence and prevalence of dental caries, says Gkekas.
The World Dental Federation estimates that 1.5 billion individuals worldwide use fluoride toothpaste every day.
Due to a lack of quality control and government oversight, fluoride toothpaste in low-income countries may contain insufficient levels of effective fluoride, says Gkekas.
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Dr. Joseph D. Lim, Ed. D., is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; Honorary Life Member of the Thai Association of Dental Implantology; and Founding Chairman of the Philippine College of Oral Implantologists. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.
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Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines, College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De la Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate Professor; Fellow, International Congress of Oral Implantologists; Member, American Academy of Implant Dentistry and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com./PN
