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an the worsening of the situation in other countries be halted?
     The reply to these three questions is one and the same: prevention, more prevention and still
more prevention.
     In the industrialized countries the promotion of oral hygiene, the widespread use of fluoride
toothpaste, the introduction of fluoride into drinking water or salt in some countries, advice on nutrition (no sweets between meals and etc.) are the factors behind an unprecedented public health success story!
     Wherever community prevention programmes are set up, caries stop advancing. For example, this has happened in Bulgaria, French Polynesia and Thailand. Apart from the fluoridation of water, salt and milk, which requires more advanced technology and supervised central administration, all the methods of oral hygiene make use of simple techniques, cost little and are perfectly suited to implementation at primary health care level.
      As a result of the progress made in the last 25 years, the developing countries now have the
knowledge and means of prevention that will enable them to avoid the problems the industrialized
countries have had to face, and indeed still are facing at a very high price!
     In most industrialized countries the oral health services still absorb between 5% and 11% of
the national health budget.
     There is no reason at all to continue devoting substantial resources to treating a condition that can be prevented by simple, varied and inexpensive measures. But there needs to be the political will to give priority to prevention.
* * * *
     What about the "periodontal disease"?
     Towards the end of the 1960s most dental epidemiologists shared the view that periodontal diseases, unlike caries, were more common in the developing countries than in the industrialized countries. However, the available data were very fragmentary and difficult or impossible to compare since there were no fewer than five different indices in common use. This plethora of methods was compounded by the difficulty of collecting data from adults; a problem that is less serious in the case of caries, where the key age is 12 years.
     With the definition of a periodontal index, which very quickly achieved wide international acceptance, the epidemiology of periodontal diseases has made great strides. The CPITN (Community Periodontal Index of Treatment Needs) was proposed by a WHO scientific group and recommended in the early 1980s by a joint working group from WHO and the FDI (International Dental Federation).
     This index records the periodontal diseases in terms of four clinical signs:
     l. Bleeding from the gum
     2. Presence of calculus
     3. Presence of shallow periodontal pockets
     4. Presence of deep periodontal pockets
     A "periodontal pocket" is considered to be present when 'the gum, under the effect of inflammation and/or infection, retracts, forms a pocket and no longer adheres to the tooth. The ligaments become impaired and the tooth becomes increasingly loose.
     To measure periodontal status, the mouth is divided into s