As far as I can tell there are three main reasons why this topic isn't discussed more often in a manner that educates the public.
- People are reluctant to share personal hygiene stories involving their feet
- Almost no one regularly sees a podiatrist (foot doctor) and general practitioners don't normally check or ask about toenail issues - even in children.
- Schools, health classes, first aid training, etc. don't discuss this problem. There's no formal structure in place to get this info to the public.
As discussed and illustrated in the ingrown toenail solutions post the gold standard in advice for understanding the cause is to realize that improperly cutting toenails in a rounded arc like fashion (like fingernails) as opposed to straight across can lead to rogue portions of the nail growing at an angle into the skin.
It's when a piece of toenail (even an extremely tiny piece) grows sideways at the corner into the flesh that irritation mounts. The longer the problem if left untreated the further the misplaced toenail can grow into the skin causing irritation that can easily lead to an inflamed ingrown toenail, and potentially if left untreated an infected ingrown toenail.