Kids are suffering in silence: It’s time to make oral health a priority

BY ADEKEMI ADENIYAN

Imagine being a child who wakes up in the middle of the night with a throbbing toothache. The pain is unbearable, no dentist around, no money for treatment, and no option but to endure it. The next morning, that same child struggles to eat, speak, and concentrate in school, and that is if they even make it to class at all. For many children in underserved communities around the world, this is their everyday reality: poor dental health steals their education, self-esteem, and general well-being.

Oral disease is a silent epidemic, ignored until it becomes unbearable. Globally, tooth decay ranks among the most common diseases, yet public health rarely prioritizes its treatment. The consequences are more than just cavities; poor oral health affects children’s ability to eat, speak, sleep, and even attend school.

In my twelve years as a dentist, I have seen children as young as five lose their front teeth to decay, not because their parents didn’t care, but because they lacked access to basic dental care. This is not just a problem in Nigeria. Across the world, over 514 million children suffer from untreated tooth decay in their primary teeth, with 2 billion people affected in their permanent teeth.

In Nigeria alone, more than 80 percent of children have untreated cavities. In Nepal, surveys show that 58 percent of five- to six-year-olds suffer from tooth decay, with three out of five missing school due to pain. The numbers paint a grim picture: children are falling behind in their education simply because of a preventable disease.

Research shows that children with poor oral health are three times more likely to miss school. But the impact goes beyond absenteeism. Chronic pain from cavities affects sleep, nutrition, and even self-esteem. A child with visibly decayed teeth may be bullied, leading to withdrawal from social interactions and a decline in academic performance.

Despite overwhelming evidence that oral health improves well-being and academic performance, it remains ignored in school health policies, unlike vaccinations or malaria prevention.

When we talk about education reform, we discuss better teachers, improved infrastructure, and digital access. But how often do we talk about the simple, fundamental need for children to be free from pain so they can learn? If we truly want to improve learning outcomes, we must start with health, and oral health must be part of the conversation.

The solution, however, is within reach.

Several developed countries that have implemented school-based oral health programs have seen dramatic improvements in both oral health and educational success.

In Scotland, for example, the Childsmile program provides supervised tooth brushing, dental screenings, and fluoride varnish applications in schools. Since its introduction, there has been a considerable decrease in cavities among five-year-olds. Similarly, Japan’s School-Based Fluoride Mouth-Rinse (S-FMR) program has demonstrated positive outcomes in preventing tooth decay among children.

If these programs can work in high and middle-income countries, why not in Nigeria or other underserved communities? The key is integrating oral health into school health programs, just as we do with vaccinations and nutrition.

In 2024, I saw first-hand, how early intervention can change the narrative around oral health. My team and I brought together children from rural communities in Del Carmen, Philippines, and Ekiti state, Nigeria, for a simple yet transformative initiative, virtual health book clubs, where they learned not just about oral hygiene but also about each other’s cultures.

At first, many of them had never considered why their teeth mattered beyond eating. But by the end of the program, children who had never thought about oral health before began reminding their siblings to brush their teeth.

They shared their knowledge with parents, sparking conversations about oral hygiene in households where it had never been discussed. Initiatives like this show that even with limited resources, change is possible.

These children proved something important: awareness at an early age and access can spark a lasting change. Yet, too many children never get that opportunity. That’s why every school needs an oral health program. No child should have to choose between their health and their education.

Contrary to what some policymakers believe, implementing school-based oral health programs is neither expensive nor complicated. Simple interventions like health clubs, annual dental check-ups, supervised toothbrushing programs, and fluoride varnish applications can have a lifelong impact.

Governments, educators, and health organizations must work together to make dental screenings mandatory in schools. The Ministries of Health and Education must establish nationwide school oral health programs, partnering with local dental professionals to provide annual check-ups, preventive treatments, and supervised tooth brushing at subsidised rates.

Additionally, policymakers should integrate oral health education into school curricula and guarantee that every child receives at least one dental screening each year. Oral health must be treated as a fundamental pillar of childhood development just like nutrition and vaccinations.

This is not just a health issue; it is an equity issue. No child should have to suffer in silence or miss out on an education because of an entirely preventable disease.

The question is not whether we can afford to implement school-based oral health programs. The question is whether we can afford not to.

As we celebrate World Oral Health Day 2025, let’s remember: it’s up to you and me to ensure that every child, regardless of where they are born, has the chance to smile, learn, and thrive. The solution is simple, the cost is low, and the impact is life-changing. So, what’s stopping us from taking action today?

Dr. Adekemi Adeniyan is a rural dentist breaking down barriers to oral health for underserved communities to ensure equitable health access for all in Nigeria. She is a Senior New Voices Fellow at the Aspen Institute and a Global Atlantic Fellow. You can follow her on Twitter @PstDrKemi or Instagram @Dentdocdekky