Dental News - IFDH and EDHF issue joint statement on WHO draft global strategy on oral health

IFDH & EDHF

Tue. 17. May 2022

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For the last three decades, the combined global prevalence of dental caries, periodontal disease and tooth loss has remained unchanged and higher than the prevalence of other non-communicable diseases (NCDs). Case numbers of untreated oral diseases more than doubled between 1990 and 2017 in low-income countries and increased by more than 50% globally.

The cost of oral disease treatment is high and can lead to a significant economic burden. Of the more than US$350 billion (€335 billion) that is spent directly on treating oral disease globally, an estimated 90% is spent in just 6% of countries. Meanwhile, half of all countries spend less than US$20 (€19.11) per person each year on oral health.

The burden of oral disease and the importance of oral health were recognised by the World Health Assembly in 2021, and the result has been the adoption of the resolution WHA74.5 (2021) on oral health and the publication of the WHO Discussion Paper: Draft Global Strategy on Oral Health. This strategy is intended to lead to the development and implementation of national oral health policies in member states, resulting in the improvement of oral health globally.

Risk factors for severe oral health problems

Most healthcare systems still focus on a curative approach rather than a preventive approach. Dental hygienists are not yet established as primary oral healthcare providers in many countries, and the number of dental hygienists in countries where the profession does exist is, in most cases, far lower than the number of dentists.

Severe oral health problems are often related to lifestyle, poverty, mental health issues, neglect and abuse. Environmental circumstances should be addressed first, but oral health can also be an indicator of these circumstances.

Half of all countries spend less than US$20 (€19.11) per person each year on oral health

Oral diseases—dental caries, periodontal disease and oropharyngeal cancers—have major consequences and a significant public health impact. Most oral diseases are multifactorial in their origin and have a core group of modifiable risk factors in common with the four most prominent NCDs: cardiovascular disease, diabetes, cancer and chronic pulmonary diseases. Common risk factors include unhealthy diets rich in sugar, tobacco use and alcohol consumption.

Addressing these risk factors in an integrated way is key to improving oral health. Oral disease prevention and control, oral health promotion and oral care should all be aligned with the primary healthcare system and integrated in existing and new general health policies and public health programmes as well as in nurseries, schools, workplaces, hospitals and homes for the elderly.

Oral health promotion and oral disease prevention

Most oral health conditions are largely preventable and can be treated in their early stages. Prevention is cost-effective when compared with the cost of the curative treatment of these conditions.

Evidence-based recommendations for cost-effective preventive interventions need to be formulated and implemented in national health systems. For those not included in any governmental, national or private health system, non-governmental organisations and voluntary work by the oral health profession could be a temporary solution. Taxes on detrimental products, the wider use of fluoride and the subsidisation of oral care products could also prove to be beneficial in this regard.

The role of the dental hygienist

Most healthcare systems still focus on a curative approach rather than on prevention. Oral health promotion and oral disease prevention are the primary tasks of mid-level oral healthcare providers—dental hygienists, oral health therapists and dental nurses—along with community health workers. However, the global oral health workforce is far too limited in number to resolve and prevent all oral health problems.

To reach all groups in a population, cross-sectoral collaboration is necessary in schools, communities, workplaces, care homes and beyond. The oral health workforce can provide information and education so that teachers, nurses, public health workers and other caretakers can effectively participate in oral health promotion and oral disease prevention. Team collaboration and an emphasis on the promotion of preventive care in both dental and medical care can be developed.

To reach all groups in a population, cross-sectoral collaboration is necessary in schools, communities, workplaces, care homes and beyond

Dental hygienists play an important role in public health and social responsibility programmes to improve the oral health of communities and individuals. Their knowledge, competencies and skills meet the requirements for primary and secondary oral healthcare and screening and, in some countries, even tertiary and curative care. The curriculum for training dental hygienists also includes competencies to achieve behavioural changes and competencies to inform and educate other healthcare providers and relevant people such as teachers and caretakers.

The role of the IFDH and EDHF

The International Federation of Dental Hygienists (IFDH) and the European Dental Hygienists Federation (EDHF) call for all member states to be active in the implementation of the WHO Draft Global Strategy on Oral Health so that oral health can be improved globally and oral health inequalities reduced. To create a significant resource for preventive oral healthcare, IFDH and EDHF recommend that member states prioritise the training of dental hygienists according to the principles set out in the consensus statement titled “A common European curriculum for dental hygiene”.

IFDH and EDHF encourage their respective member organisations and individual members to inform national governments and become involved as creators and providers of more efficient, prevention-focused and sustainable oral healthcare systems and to be active in clinical work, public health, social responsibility, education and scientific research.

Editorial note:

The International Federation of Dental Hygienists and the European Dental Hygienists Federation are both non-profit and non-governmental organisations free from any political, racial or religious ties. Together, they represent approximately 90,000 dental hygienists globally and are united in their aim of promoting oral health and preventing oral disease.

Righolt AJ, Jevdjevic M, Marcenes W, Listl S. Global-, regional-, and country-level economic impacts of dental diseases in 2015. J Dent Res. 2018 May;97(5):501–7. doi: 10.1177/0022034517750572.