Oral health in Iran.

The health network in the Islamic Republic (I.R.) of Iran is an integrated public health system with a four-level Dental Health Care System integrated into it by 1997. The first level is one of primary prevention at 'health houses', at the next, oral hygienists and dentists in health centres perform basic oral health care services such as fillings, scaling and extractions. At the third level, dentists manage and treat oral diseases in 'urban health centres, while the last level is for advanced treatment by specialists in university health centres in the big cities. There are about 13,000 dentists nationwide (1 dentist: 5,500 population) and nearly 1,200 specialists in universities and private practices. Data from surveys in the past two decades, show a marked decline in dental caries from DMFT of 4 to 1.5 in 12-year-old children. However, the general level of oral health is still not satisfactory, particularly among children. The percentage of caries-free children (deciduous and permanent teeth) among 6- and 9-year-olds is 13.8 and 11.5 respectively and more than 50% of 12-year-old children have caries experience, with the decayed component being the greatest component. The main objective would be to cope with the dental caries problem in primary teeth and, in this respect, the national oral health plan should be aimed at developing oral hygiene skills, reducing the frequency of sugar intake, instituting water fluoridation, improving access to fissure sealants and regular dental care, and finally promoting dental health services toward minimum treatment intervention and effective preventive strategies and health promotion.