MANILA, Philippines—According to a study published in the June issue of the journal Globalization and Health, only 800 million of the nearly seven billion people on this planet have access to fluoride toothpaste, which can help prevent tooth decay. In the June issue of the said journal, researchers from the United States, France and the Netherlands identified the toothpaste’s cost as part of the problem.

Led by George Washington University epidemiologist Ann Goldman, the researchers conducted a survey in 39 countries, including the Philippines, between 2005 and 2006 to find out how much it would cost to buy enough toothpaste (based on the cheapest retail brand identified) for one person to use for an entire year. They then also calculated the annual toothpaste cost in comparison to the annual household budget for the poorest 30 percent, 50 percent and 70 percent of each country’s population.

Some interesting stats

The researchers came up with some interesting statistics. For example, they determined that in the Philippines, toothpaste cost less than half a percent of the annual household budget—roughly about what one could earn from less than a day’s work—for each of the three categories cited above.

In the African country Zambia, however, the researchers found that for the poorest 30 percent of the population, a year’s worth of toothpaste for one person came to 4 percent of the household budget, or the earnings from 11 days of work. The poorest 50 percent of Zambians would have to work six days to buy a year’s worth of toothpaste, and the poorest 70 percent would have to work four days to buy the same amount of toothpaste.

More affordable

Goldman and her colleagues used the results to emphasize the need to make fluoride toothpaste more affordable. Good teeth aren’t just a matter of oral health, they said, but also affect quality of life. A study published last week in the journal BMC Oral Health suggests a way special candies could someday be used to augment toothpaste in childhood dental care.

To test their theory, lead author Kiet Ly and his colleagues from the University of Washington gave 154 children from two schools in rural areas of the state of Washington three daily doses of gummy bears made specifically for this study. They wanted to see if a particular ingredient, the natural sugar xylitol, would reduce the levels of bacteria that cause plaque to form on teeth. Several chewing gum products on the market already contain xylitol, which has been shown to help counter tooth decay. To see if eating the bears really did reduce plaque levels, the gummy candies for the control group were made with maltitol, an artificial sweetener.

The children were divided into three groups: two groups were given bears dosed with different levels of xylitol and the third group of children was given bears made with maltitol. At specific times during class, each child received a small pack with four strawberry-flavored red and green bears with either xylitol or maltitol.

Results

After six weeks, plaque samples were collected from the children and compared against the plaque levels taken at the beginning of the study. Ly and his colleagues found that the bacterial plaque levels for the groups who’d eaten the xylitol-laced gummy bears had been reduced, as expected. The researchers are now repeating the study with schoolchildren in another state to see if the results can be replicated.

The xylitol bears from the study aren’t commercially available, but the researchers noted that the teachers and parents of the students involved had positive feedback for the project. If the candy can someday become part of a public health initiative, it might be a way to help kids take care of their teeth not just in the United States but in other countries where toothpaste may not be very affordable.

E-mail the author at massie@massie.com.