A Call to Action: The Need to Address Dental Disease Prevention in The Gambia

Background: The purpose of this paper is to examine the global burden of dental disease, review the literature behind dental health promotion programs in sub-Saharan Africa, and suggest strategies for incorporation of dental prevention programs in The Gambia’s national health policy to increase dental health. Methods: A review of published studies was conducted with key word searches including “The Gambia” and “dental” through the University of Wisconsin Milwaukee’s library system. Databases searched included: PubMed (NCBI), Global Health (CABI), Journal of Public Health Dentistry, Google Scholar, and the International Journal of Dentistry. Studies in sub-Saharan Africa were included due to limited availability of empirical studies in The Gambia. Results: In eleven studies reviewed, mixed results persisted regarding the efficacy of dental promotion programs in accurately describing and addressing dental disease. Two of the eleven studies indicated low caries prevalence, four studies indicated high prevalence and one study indicated equal levels compared to neighboring countries. Six of the eleven articles call for additional research to determine baseline caries rates, inform prevention programs, and direct future oral health policy. Conclusion: A significant lack of published studies in The Gambia calls for a rigorous program in epidemiological research to accurately describe The Gambia's state of oral health and begin to develop an oral health infrastructure. Innovative strategies include collection of surveillance data in a culturally integrated manner, capitalizing on existing health systems and incorporation of apprenticeship models. These strategies pose promising new directions for countries, like The Gambia, that currently lack a dental health infrastructure.