Figures 2-3 outline the current levels of dental caries in 12-year-olds and 35-44 year olds in Africa. However, the incidence of dental caries is predicted to increase in several developing countries in the region, particularly as a result of a growing consumption of sugars and inadequate exposure to fluorides.

In many African countries, access to oral health services is limited and teeth are often left untreated or are extracted to relieve pain or discomfort. This is reflected in the components of the DMFT index as shown for some AFRO countries4-7 in Figure 4. Losing teeth is still seen by many as a natural consequence of ageing. Some countries have in recent years experienced an increase in tooth loss among adults in Africa, the proportion of edentulous adults aged 65 years varies from 6% in Gambia2 to 25% in Madagascar4.

Globally, most children have signs of gingivitis and, among adults, the initial stages of periodontal diseases are prevalent. Severe periodontitis, which may cause tooth loss, is found in 5-15% of most populations. The periodontal conditions of populations surveyed recently in some African countries4-7 are highlighted in Figure 5; the surveys used the so-called Community Periodontal Index1.

The prevalence of oral cancer is particularly high among the male population, and is the eighth most common cancer worldwide8. Figure 6 shows the figures available on oral cancer in Africa related to the oral cavity. The high incidence rates relate directly to risk behaviours such as smoking, use of smokeless tobacco and alcohol consumption. In Africa the prevalence of smoking is particularly high in men and varies from 15% of adults in Nigeria to 67% in Kenya9.