Authors: Richard Niederman, Eyitope Ogunbodede, Magda Feres


Almost 50 percent of the global population suffers from tooth decay and periodontitis in addition to other oral diseases like oral cancer, and that unlike the global burden of other diseases which has decreased in the last decade, oral diseases have increased by 11 percent. Treatment approaches include fluoridation, surgery, and antibiotic administration. Noma, a destructive ulceration that degrades facial and bone tissues, responds early on to antibiotics and nutritional rehabilitation, but if left untreated, will later require surgical repair with anesthesia. In the Philippines, the award-winning Fit for School program, provides an example of the beneficial and significant impact of an integrated community-based care program. To make effective inroads in improved care, new education, training, and workforce models are needed. A conceptual strategic starting point for thinking about alternative care models is value-based oral health care relying on community health workers to deliver care.


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