Oral health problems facing society

WITH more than 90% of South African dentists working in the private sector, treating only 16% of the population (those who are covered by some form of health insurance), most South Africans are forced to look to the public sector for their healthcare needs.

“Unfortunately, the public sector is under immense pressure and is ill-equipped when it comes to oral and dental healthcare. They therefore focus largely on extraction rather than any restorative procedures, let alone preventative support.” This is according to Nirvada Niranjan, Head of Coding and Nomenclature at the South African Dental Association (SADA) — a leading professional membership body for dentistry and the voice of oral healthcare in South Africa. Niranjan highlights that without the required support and greater oral and dental health education, particularly in impoverished communities, many South Africans remain unaware of the significant importance of good oral hygiene and find themselves dealing with unpleasant consequences.

Niranjan explains that while the majority of the country are somewhat aware that good oral hygiene is associated with preventing bad breath and tooth decay, as well as ensuring a great looking smile, there is still a great deal of education required in South Africa on the importance of prioritising oral and dental health for overall health - avoiding infections and exposure to harmful bacteria.

“With this in mind, it is still very common for South Africans to experience certain oral health issues which, if left untreated, can result in more serious health problems as well as unwelcome changes to one’s smile,” she adds.

Niranjan shared the current top five oral health issues in South Africa.


Also known as gingivitis, gum disease is the inflammation of the gums.

If left untreated, gum disease can worsen and turn into periodontal disease or periodontitis, which causes the bone supporting the teeth to weaken and disintegrate, leaving teeth feeling loose and eventually resulting in them falling out altogether.

Causes — poor oral hygiene and smoking.


Also known as cavities or tooth decay, caries refers to the breakdown and crumbling of teeth caused by acids associated with high levels of bacteria.

While preventable by incorporating good oral hygiene habits such as regular brushing and flossing, untreated caries can result in infection, pain and even tooth loss.

Causes — poor oral hygiene and a high sugar diet.


Tooth sensitivity (or dentin hypersensitivity) refers to the sensation of pain or discomfort that patients experience when they eat hot, cold, sweet or acidic food, or when breathing particularly cold air. Sensitivity is often a symptom of another oral health problem as it generally occurs when either the enamel or the gum (both of which protect the teeth) are reduced or thinned.

Causes — gum recession and inappropriate brushing techniques.


The loss of a tooth, or teeth, occurs either as a result of loosening and naturally falling out, or professional extraction. Tooth loss is often linked to untreated, continued issues relating to oral hygiene practices and healthcare support.

Causes — untreated caries or periodontal disease which cause pain or the loosening of teeth; and may be a result of trauma.


Oral pain and discomfort are associated with various ailments including infection, sensitivity, trauma and tooth decay.

Causes — trauma, caries, periodontal disease

Niranjan explains that caries and periodontal or gum disease are the two most prevalent general health conditions in the world and South Africa is no exception.

In terms of treatment options for all five of these common oral health issues, Niranjan highlights that regular consultations with a dentist are vital to prevent further deterioration and pain. “South Africans can, however, do their best to avoid these problems from occurring by adopting good oral hygiene habits and adjusting to a healthier lifestyle. Some examples, beyond brushing and flossing twice daily, include reducing dietary sugar intake, regularly visiting a dentist or oral hygienist, and quitting smoking. “While these are the most common oral healthcare issues currently experienced by South Africans, it is important to note that oral cancer is also on the rise. The eighth most common cancer in the world, it is a growing concern among the country’s leading oral healthcare professionals. Recognising and addressing the increasing prevalence of all kinds of oral health problems, big and small, is crucial for communities and leaders in healthcare to begin increasing awareness in this regard and give South Africans the information they need to protect their health — and their smiles,” Niranjan concludes.