'Inadequate' health response leaves 3.5bn with poor dental care

21 Juillet, 2019, 09:24 | Auteur: Yves Courtet
  • “Current dental care and public health responses have been inadequate and inequitable leaving billions of people without access to even basic oral health care,” said Richard Watt a dental public health specialist at the University College London

The dental profession and the practice of dentistry are still very much dominated by a treatment-focused, interventionist, and technical philosophy that reflects patterns and understandings of dental disease that were current over 80 years ago, and ultimately date back to the surgical origins of the profession, the researchers pointed out. Prevalence of oral cancer is highest in South Asian countries, the series added.

The Lancet Series authors argue a pressing need exists to develop clearer and more transparent conflict of interest policies and procedures, and to restrict and clarify the influence of the sugar industry on dental research and oral health policy. In India, oral disorders are the most prevalent disease condition, and have remained so for the past 30 years.

Oral health has been isolated from traditional healthcare and health policy for too long, despite the major global public health burden of oral diseases, according to a Lancet Series on Oral Health, published today in The Lancet.

However, oral diseases also have a major economic impact.

"Dentistry is in a state of crisis".

The series highlighted that in high-income countries, such as Ireland, dentistry is increasingly focused on technology, but is also trapped in a "treatment-over-prevention cycle", which fails to tackle the underlying causes of oral diseases. Cutbacks introduced during the recession meant that many people were foregoing even basic dental check-ups due to the costs involved, and were only attending a dentist when their problem was already at a serious stage.

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"However the rapid increase in the number of dental schools in the country has not resulted in reducing the burden of oral diseases or has made oral health services available and accessible by each and every section of the society", Dr Manu Raj Mathur, additional professor at Public Health Foundation of India and one of the researchers, told The Indian Express.

"While this breakdown in the delivery of oral healthcare is not the fault of individual dental clinicians committed to caring for their patients, a fundamentally different approach is required to effectively tackle to the global burden of oral diseases", Professor Richard Watt, Chair and Honorary Consultant in Dental Public Health at UCL and lead author of the series said. "In low-income countries the current situation is most bleak, with even basic dental care unavailable and most disease remaining untreated", the study stated.

Peres and his colleagues identify three main determinants, being sugar, tobacco and alcohol, among which sugar is the single greatest contributor to deteriorating oral health worldwide.

"The use of clinical preventive interventions such as topical fluorides to control tooth decay is proven to be highly effective, yet because it is seen as a panacea, it can lead to many losing sight of the fact that sugar consumption remains the primary cause of disease development".

"In middle-income countries the burden of oral diseases is considerable, but oral care systems are often underdeveloped and unaffordable to the majority".

Meanwhile, Prof Daly said that in Ireland, it is "essential" that the implementation of the new oral health policy, Smile Agus Sláinte, which was launched in April, "delivers on the goal of enabling vulnerable groups to access oral healthcare and improve their oral health". "Everyone who cares about global health should advocate to end the neglect of oral health", Clark said.

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