Interview: “If change is going to happen, it has to happen locally”

Prof. Pitts, could you please briefly introduce ACFF and what the organisation does?
ACFF is a non-profit charity set up seven years ago to bring together different groups around the world to stop caries now. It was born out of a group of people working in caries treatment and prevention who had become frustrated that not enough was being done to stop caries, despite this being the goal of many groups, associations and dental bodies. We therefore formed an expert panel to give guidance on integrated clinical and public health action to stop caries initiation and progression and have people from all around the world meet each year with the aim of moving collectively towards a cavity-free future. However, we are very much aware that, if change is going to happen, it has to happen locally. Which is why we now have 26 chapters around the world who work locally in bringing together different role-players in dentistry and linking them with public health bodies, government and policymakers, basically anybody who has in interest in stopping caries and the ability to help do so.

Tomorrow, ACFF is meeting for the eight time. How far has the organisation come?
We started with an idea. Now, we have 26 chapters and websites and more countries and groups wanting to come on board; for example, we are discussing a new chapter in Japan for next year. We have also produced and shared a great deal of information about education and are working with a number of different groups on a cariology curriculum that has spread from Europe to Latin America, the US and now further. With all this, we are helping provide the tools to help dentists, patients and educators focus on caries prevention.

What exactly can summit attendees expect?
First, there will be a local introduction about caries in Spain. Afterwards, I will give a brief progress report on everything that has been achieved since our last meeting. Prof. Svante Twetman from Copenhagen in Denmark will review the many European developments, and then attendees will hear about a very encouraging achievement by Dr Jaime Edelson and a local congressman from Mexico, where they actually brought in a law with the aim of accelerating caries prevention. It is a great example of how bringing together local government, dentistry and education has mandated a law to implement regular toothbrushing with fluoride toothpaste in schools in Mexico City.

You will also cover the recent ACFF-led Policy Lab meeting.
Yes, a key part of the discussion will be about the Policy Lab meeting, titled “The economics of a cavity-free future”, we just had in London in the UK. This was a really different meeting that was convened in order to seek to understand the economic dimension of our objectives and answer questions such as: How can we understand how caries prevention pays? How can we persuade policymakers? How can we help policy makers, dentists and patients understand the value of a cavity-free future?

What is the intermediate status regarding your long-term goal that every child born from 2026 should stay cavity-free during his or her lifetime?
When we started seven years ago, it was further away [laughs]. It is a stretch goal, but it was based on the possible results if we brought all the preventative interventions together. From all this, it looked like we could achieve cavity-free children by 2026. However, it is very important to emphasise what we mean by “cavity-free children”. This refers to children having either no evidence of disease at all or controlled initial stage decay, white spots or brown spots, but no open cavities into dentine. We are not saying that we can eradicate every sign of the disease, but we would be very pleased to achieve people completely free of the disease or with the initial stage controlled so that it would never progress to a cavity. That is what we are aiming for. We think it is realistic, but only if everybody works together.

Thank you very much for the interview.

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